College of Osteopathic Medicine Faculty Articles

Title

Training early childcare providers in evidence-based nutrition practices improves nutrition environments, policies, and practices of early childcare centers

Publication Title

American Journal of Health Promotion

Abstract

Introduction: Due to the amount of time and caloric intake large numbers of children experience in early childcare centers (ECC), plus the benefits of early-targeted anti-obesity interventions, ECCs and their nutrition environments are valuable public health arenas for preventing and addressing childhood obesity. We evaluated the extent to which training early childcare providers in the implementation of evidence-based nutrition practices improved the nutrition environments, policies, and practices of early childcare centers serving racially and ethnically diverse, low-income children in Broward County, Florida. Methods: To determine the extent to which the county-wide initiative improved the nutrition environments and policies of ECCs, we used the nutrition observation and document review portions of the Environment and Policy Assessment and Observation (EPAO) instrument to conduct observations of ECCs as part of a one-group pretest-posttest evaluation design. Our baseline and follow-up data collection consisted of two waves of observations (Spring 2013 and Spring 2014) of the same 18 ECCs by trained EPAO observers. Results: We found statistically significant improvements in the centers’ overall nutrition environments (p=.01). Specific significant gains were made within centers’ written nutrition policies (p=.03), nutrition education (.01), and provisions of fruits and vegetables (p=.05). Discussion: The findings from this evaluation support the idea that training early childcare providers in evidence-based nutrition practices can help improve the nutrition environments, policies, and practices of centers serving racially and ethnically diverse, low- income children. Methods. In Spring 2013 and Summer 2014, we surveyed residents (n=960) at 15 MUH properties as part of a repeated cross-sectional evaluation design. We tested for differences in reported SHS exposure among residents prior to and after implementation of the smoke-free policy. Results. Before policy implementation, 31.1% of residents reported SHS exposure within their apartments from elsewhere in or around their building. At follow-up, the percentage was 23.6% (p=0.017). In multivariate analysis of non-smoking residents after policy implementation, residents who reported having one or more comorbidities were two times more likely to report SHS exposure within their apartments than residents who did not report any comorbidities (aOR=2.23, 95% CI=1.12-4.40, p=0.022). Conclusions. Considering the vulnerability of low-income seniors to SHS exposure, our findings are particularly relevant to residents, property owners/managers, and public health actors making decisions about smoke-free policies for MUH properties in which seniors reside.

Disciplines

Medical Specialties | Medicine and Health Sciences | Osteopathic Medicine and Osteopathy

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