Moving from Policy to Practice for Early Childhood Obesity Prevention: A Nationwide Evaluation of State Implementation Strategies in Childcare

Erica L. Kenney, Rebecca S. Mozaffarian, Wendy Ji (), Kyla Tucker (), Mary Kathryn Poole, Julia DeAngelo (), Zinzi D. Bailey, Angie L. Cradock, Rebekka M. Lee and Natasha Frost ()
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Erica L. Kenney: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Rebecca S. Mozaffarian: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Wendy Ji: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Kyla Tucker: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Mary Kathryn Poole: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Julia DeAngelo: Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Zinzi D. Bailey: Miller School of Medicine, University of Miami, Miami, FL 33136, USA
Angie L. Cradock: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Rebekka M. Lee: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
Natasha Frost: Public Health Law Center, Mitchell Hamline School of Law, St. Paul, MN 55105, USA

IJERPH, 2022, vol. 19, issue 16, 1-18

Abstract: Policies requiring childcare settings to promote healthy eating, physical activity, and limited screentime have the potential to improve young children’s health. However, policies may have limited impact without effective implementation strategies to promote policy adoption. In this mixed-methods study, we evaluated the type, quality, and dose of implementation strategies for state-level childcare licensing regulations focused on healthy eating, physical activity, or screentime using: (1) a survey of state licensing staff and technical assistance providers (n = 89) in 32 states; (2) a structured review of each state’s childcare licensing and training websites for childcare providers; and (3) in-depth, semi-structured interviews with 31 childcare licensing administrators and technical assistance providers across 17 states. Implementation strategies for supporting childcare providers in adopting healthy eating, physical activity, and screentime regulations vary substantially by state, in quantity and structure. Childcare programs’ financial challenges, staff turnover, and lack of adequate facilities were identified as key barriers to adoption. Access to federal food programs was seen as critical to implementing nutrition regulations. Implementation resources such as training and informational materials were rarely available in multiple languages or targeted to providers serving low-income or racially/ethnically diverse families. There is a substantial need for implementation supports for ensuring policies are successfully and equitably implemented in childcare.

Keywords: childcare programs; policy; nutrition; physical activity; implementation science (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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