TY - JOUR
T1 - Barriers and Facilitators to Compliance with a State Healthy Eating Policy in Early Care and Education Centers
AU - Zaltz, Daniel A.
AU - Pate, Russell R.
AU - O'Neill, Jennifer R.
AU - Neelon, Brian
AU - Benjamin-Neelon, Sara E.
N1 - Funding Information:
This study was supported, in part, by a grant from the Robert Wood Johnson Foundation (RWJF), Healthy Eating Research #69551. The content is solely the responsibility of the authors and does not necessarily represent the official views of the RWJF. The funders had no role in the design of the study, data collection and analysis, decision to publish, or preparation of the article.
Publisher Copyright:
© 2018, Mary Ann Liebert, Inc., publishers.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background: Early care and education (ECE) policies can improve childhood obesity risk factors. We evaluated barriers and facilitators to implementing mandatory nutrition standards for foods provided in South Carolina ECE centers serving low-income children, comparing centers participating in the Child and Adult Care Food Program (CACFP) with non-CACFP centers. Methods: We mailed 261 surveys (demographics, policies and practices, barriers and facilitators) to center directors after new state nutrition standards were implemented in South Carolina. We conducted univariate and bivariate analyses to explore relationships between barriers, facilitators, and center-level characteristics, by CACFP status. Results: We received 163 surveys (62% response rate). Centers had a median [interquartile range (IQR)] of 5 (4-7) classrooms and 59 (37.5-89) total children enrolled. More than half (60.1%) of directors reported they were moderately or fully informed about the standards. The most common barriers were food costs (17.8%) and children's food preferences (17.8%). More non-CACFP directors reported food costs as a barrier (28.6% vs. 6.5%, p < 0.001), having to spend additional money on healthier foods (48.8% vs. 28.6%, p = 0.01), and having to provide additional nutrition education to parents (28.6% vs. 11.7%, p = 0.01), compared with CACFP directors. Conclusions: Center directors were generally well informed about the nutrition standards. The most common barriers to implementing the standards were food costs and children's food preferences. Centers participating in CACFP may be in a better position to adhere to new state nutrition standards, as they receive some federal reimbursement for serving healthy foods and may be more accustomed to regulation.
AB - Background: Early care and education (ECE) policies can improve childhood obesity risk factors. We evaluated barriers and facilitators to implementing mandatory nutrition standards for foods provided in South Carolina ECE centers serving low-income children, comparing centers participating in the Child and Adult Care Food Program (CACFP) with non-CACFP centers. Methods: We mailed 261 surveys (demographics, policies and practices, barriers and facilitators) to center directors after new state nutrition standards were implemented in South Carolina. We conducted univariate and bivariate analyses to explore relationships between barriers, facilitators, and center-level characteristics, by CACFP status. Results: We received 163 surveys (62% response rate). Centers had a median [interquartile range (IQR)] of 5 (4-7) classrooms and 59 (37.5-89) total children enrolled. More than half (60.1%) of directors reported they were moderately or fully informed about the standards. The most common barriers were food costs (17.8%) and children's food preferences (17.8%). More non-CACFP directors reported food costs as a barrier (28.6% vs. 6.5%, p < 0.001), having to spend additional money on healthier foods (48.8% vs. 28.6%, p = 0.01), and having to provide additional nutrition education to parents (28.6% vs. 11.7%, p = 0.01), compared with CACFP directors. Conclusions: Center directors were generally well informed about the nutrition standards. The most common barriers to implementing the standards were food costs and children's food preferences. Centers participating in CACFP may be in a better position to adhere to new state nutrition standards, as they receive some federal reimbursement for serving healthy foods and may be more accustomed to regulation.
KW - child care
KW - healthy eating
KW - obesity
KW - policy
KW - regulations
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U2 - 10.1089/chi.2018.0077
DO - 10.1089/chi.2018.0077
M3 - Article
C2 - 30199292
AN - SCOPUS:85053273814
VL - 14
SP - 349
EP - 357
JO - Obesity and Weight Management
JF - Obesity and Weight Management
SN - 2153-2168
IS - 6
ER -