Williams Bethany D, Sisson Susan B, Lowery Bryce C, Dev Dipti A, Horm Diane M, Campbell Janis E, Finneran Denise A, Graef-Downard Jennifer
Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N. Stonewall Ave., Oklahoma City, OK 73114, USA.
Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University Health Sciences Spokane, 412 E Spokane Falls Blvd, Spokane, WA 99202, USA.
Prev Med Rep. 2022 Jul 21;29:101917. doi: 10.1016/j.pmedr.2022.101917. eCollection 2022 Oct.
The study purpose was to determine associations between proximity to grocery stores and Early Care and Education programs' (i.e., ECEs) classroom nutrition practices and barriers, by ECE context (Head Start, community-based childcare [CBC], and family child care homes [FCCHs]). A statewide cross-sectional survey was implemented in Oklahoma ECEs. Directors reported classroom nutrition practices with the Nutrition and Physical Activity Self-Assessment tool, and barriers to implementation. Locations of 457 grocery stores statewide were determined by in-person audit. Geocoded ECEs were considered within a "low proximity" area if no grocery stores were available within a 0.25-mile radius for urban, or 10-mile radius for rural, ECEs. From November 2019 to February 2020, 54 Head Starts, 159 CBCs, and 160 FCCHs participated. 31.0 % were considered as low proximity. Head Starts demonstrated the highest classroom nutrition scores for mealtime practices, and nutrition education and policy. While proximity to grocery stores was not related to classroom nutrition practices for any ECE context (p > 0.05), FCCHs located within a low proximity area reported barriers to implementing those practices more often compared to FCCHs in an area within accessible proximity of grocery store. Thus, proximity to grocery stores was related to barriers in FCCHs only; those provider's experiences and perceptions may be most susceptible to influence of the community nutrition environment, compared to other ECE contexts. Contrary to studies in residential areas and schools, nutrition environments were not related to nutrition practices in ECEs. ECEs may serve as protective micro-environments supporting health for children residing in nearby low-access communities.
本研究的目的是根据早期护理与教育项目（即ECE）的背景（Head Start项目、社区儿童保育机构[CBC]和家庭儿童保育之家[FCCH]），确定与杂货店的距离与ECE课堂营养实践及障碍之间的关联。在俄克拉荷马州的ECE机构开展了一项全州范围的横断面调查。负责人使用营养与身体活动自我评估工具报告课堂营养实践情况以及实施过程中的障碍。通过实地审计确定了全州457家杂货店的位置。对于城市ECE机构，如果其0.25英里半径范围内没有杂货店，或者对于农村ECE机构，如果其10英里半径范围内没有杂货店，则将地理编码的ECE机构视为处于“低可达性”区域。2019年11月至2020年2月，54个Head Start项目、159个CBC机构和160个FCCH机构参与了调查。31.0%的机构被视为低可达性。Head Start项目在就餐时间实践、营养教育和政策方面的课堂营养得分最高。虽然对于任何ECE背景而言，与杂货店的距离均与课堂营养实践无关（p>0.05），但与处于杂货店可达范围内区域的FCCH机构相比，处于低可达性区域的FCCH机构报告实施这些实践存在障碍的情况更为频繁。因此，与杂货店的距离仅与FCCH机构中的障碍有关；与其他ECE背景相比，这些提供者的经验和认知可能最容易受到社区营养环境的影响。与居民区和学校的研究相反，营养环境与ECE机构中的营养实践无关。ECE机构可能作为保护性微环境，支持居住在附近低可达性社区的儿童的健康。
