Family child care home providers' self-reported nutrition and physical activity practices, self-efficacy, barriers and knowledge: baseline findings from happy healthy homes

Family child care home providers' perceived difficulty in serving vegetables to children: findings from a multi-method study

The study aims to identify family child care home (FCCH) setting- and environment-level predictors related to providers' perceived difficulty in implementing the Child and Adult Care Food Program (CACFP) recommendations for serving vegetables to children. This was a cross-sectional study, which used a validated paper-based survey with a multi-method data analysis approach. Participants were licenced FCCH providers (N = 943) in Nebraska, who were predominantly White (94%), non-Hispanic (97%), CACFP-participants (89%), and in urban areas (64%). Reflective latent variable modelling was conducted in Mplus to explore associations between dependent variable and predictors. Dependent variable was providers' perceived difficulty to implement CACFP recommendations for serving vegetables. Predictors were providers' mealtime practices, perceived barriers to serve healthy foods, CACFP participation, geographic location, food access, food insecurity, and child poverty. Qualitative comments (n=122) from the survey were analysed using direct content analysis approach. Providers' perceived lack of time to prepare foods and perceived children's taste preferences increased their perceived difficulty; and CACFP-participation decreased their perceived difficulty to implement CACFP recommendations for serving vegetables. Qualitative comments highlighted that providers felt discouraged to serve vegetables knowing that vegetables would likely be wasted because of children's preferences. More tailored professional development is required to address FCCH providers' perceived difficulty and build providers' skills on preparing time saving, CACFP-reimbursable and appealing vegetable recipes, and on strategies to promote vegetable consumption in children.

How to integrate and leverage digital health modalities for health promotion in early childhood education: Opportunities to improve intervention access and engagement

Early childhood education (ECE) settings are important for the development of children's healthy eating and physical activity behaviors. Efforts to disseminate and implement health behavior promotion strategies in ECE settings have seldom optimized digital health, a missed opportunity highlighted by the COVID-19 pandemic. In this commentary, we discuss previous efforts to shift ECE-based health behavior programs to digital health modalities, notable opportunities for digital health in these settings, and a multilevel perspective to support future efforts. We propose future directions in digital health literacy, reaching various ECE settings, implementation science, and community partnerships to expand the use of digital interventions.

Process evaluation of the Yéego! Program to increase healthy eating and gardening among American Indian elementary school children

BACKGROUND

American Indian children are at increased risk for obesity and diabetes. School-based health promotion interventions are one approach to promoting healthy behaviors to reduce this risk, yet few studies have described their implementation and fidelity. We conducted a qualitative process evaluation of the Yéego! Healthy Eating and Gardening Program, a school-based intervention to promote healthy eating among Navajo elementary school children. The intervention included a yearlong integrated curriculum, as well as the construction and maintenance of a school-based garden.

METHODS

Our process evaluation included fidelity checklists completed by program staff and qualitative interviews with program staff and classroom teachers after the intervention was implemented. We used content analysis to identify themes.

RESULTS

We identified several themes related to evidence of delivery adherence, program satisfaction, and lessons learned about delivery. Intervention staff followed similar procedures to prepare for and deliver lessons, but timing, teaching styles, and school-level factors also impacted overall implementation fidelity. Teachers and students had positive perceptions of the program, especially lessons that were highly visual, experiential, and connected to Navajo culture and the surrounding community. Teachers and program staff identified ways to enhance the usability of the curriculum by narrowing the scope, relating content to student experiences, and aligning content with school curriculum standards.

CONCLUSIONS

The program was implemented with moderately high fidelity across contexts. We identified areas where modifications could improve engagement, acceptability, efficacy, and sustainability of the program. Our results have implications for the evaluation and dissemination of school-based health interventions to promote healthy eating among children, especially in American Indian communities.

The Effect of an Educational Intervention Based on the Health Belief Model (HBM) on Nutritional Performance Related to Gastric Cancer in Rural Women in Northern Regions of Iran

Gastric cancer is a common cause of cancer death in the world. This study examined 120 rural women. The educational program included four sessions for each group based on the health belief model. The mean age of the women was 34.51 ± 9.16. The mean score of the perceived barriers significantly decreased in the experimental group (11.08 ± 0.37) compared to the control group (14.92 ± 0.42) (P < .001), and the mean score of knowledge, performance and HBM constructs, increased significantly 2 months after the education (P < .001).It is recommended that educational interventions be designed by HBM to improve nutritional behaviors related to GC in the female population.

Food Desert Status of Family Child Care Homes: Relationship to Young Children's Food Quality

Family child care homes (FCCHs) are a favored child care choice for parents of young children in the U.S. Most FCCH providers purchase and prepare foods for the children in their care. Although FCCH providers can receive monetary support from the Child and Adult Care Food Program (CACFP), a federal subsidy program, to purchase nutritious foods, little is known about FCCH providers' access to nutritious foods, especially among FCCH providers serving children from communities that have been historically disinvested and predominantly Black. This study aims to describe the food desert status of FCCHs in Baltimore City, Maryland, and examine the relationship between food desert status and the quality of foods and beverages purchased and provided to children. A proportionate stratified random sample of 91 FCCH providers by CACFP participation status consented. Geographic information system mapping (GIS) was used to determine the food desert status of each participating FCCH. Participants reported on their access to food and beverages through telephone-based surveys. Nearly three-quarters (66/91) of FCCHs were located in a food desert. FCCH providers working and living in a food desert had lower mean sum scores M (SD) for the quality of beverages provided than FCCH providers outside a food desert (2.53 ± 0.81 vs. 2.92 ± 0.70, p = 0.036, respectively). Although the significant difference in scores for beverages provided is small, FCCH providers working in food deserts may need support in providing healthy beverages to the children in their care. More research is needed to understand food purchases among FCCH providers working in neighborhoods situated in food deserts.