Creating ways to involve HCP, early care and education teachers, and parents together in multilevel and multisector interventions has the potential to improve the health of young AI children.
Teachers of tribally affiliated ECE centers are important stakeholders in promoting the health and well-being of young American Indian children. Additional efforts are needed to more effectively integrate teachers and nurses in order to create effective interventions. We propose a stakeholder partnership to guide the development of future interventions.
Objective:
Describe nutrition and physical activity practices, nutrition self-efficacy and barriers, and food program knowledge within Family Child Care Homes (FCCH), and differences by staffing.
Design:
Baseline, cross-sectional analyses of the Happy Healthy Homes randomized trial (NCT03560050).
Setting:
FCCH in Oklahoma, United States
Participants:
FCCH providers (n=49, 100% women, 30.6% Non-Hispanic Black, 2.0% Hispanic, 4.1% American Indian/Alaska Native, 51.0% Non-Hispanic white, 44.2±14.2 years of age. 53.1% had additional staff) self-reported nutrition and physical activity practices and policies, nutrition self-efficacy and barriers, and food program knowledge. Differences between providers with and without additional staff were adjusted for multiple comparisons (p<0.01).
Results:
The prevalence of meeting all nutrition and physical activity best practices ranged from 0.0-43.8% and 4.1-16.7%, respectively. Average nutrition and physical activity scores were 3.2±0.3 and 3.0±0.5 (max 4.0), respectively. Sum nutrition and physical activity scores were 137.5±12.6 (max 172.0) and 48.4±7.5 (max 64.0), respectively. Providers reported high nutrition self-efficacy and few barriers. The majority of providers (73.9-84.7%) felt they could meet food program best practices; however, knowledge of food program best practices was lower than anticipated (median 63-67% accuracy). More providers with additional staff had higher self-efficacy in family style meal service than did those who did not (p=0.006).
Conclusions:
Providers had high self-efficacy in meeting nutrition best practices and reported few barriers. While providers were successfully meeting some individual best practices, few met all. Few differences were observed between FCCH providers with and without additional staff. FCCH providers need additional nutrition training on implementation of best practices.
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