Health Behavior, Nutrition Poor
Conditions
Keywords
early childhood education, family child care home, food environment
Brief summary
This study evaluates the effect of a nutrition technical assistance training program for family child care home providers on the food they serve young children in their care and the food environment in their home. Half the providers will be assigned to the nutrition program and the other half will receive a comparison on environmental health.
Detailed description
Early care and education (ECE) providers play a vital role in ensuring that young children have access to nutritious foods. Over 25% of children in ECE (1.2 million children) attend Family Child Care Homes (FCCH). Improvements in the Child and Adult Care Food Program (CACFP) may introduce new barriers for FCCH, which have limited meal preparation capacity. Limited research has examined foods served by FCCH providers, and no group randomized trials have been conducted using a Community-Based Participatory approach in FCCH and including an evaluation of intervention costs. Goals: 1. Determine compliance of menus and meals provided in FCCH with CACFP guidelines. 2. Determine the effectiveness of a community-based Nutrition Technical Assistance intervention to enhance meeting CACFP best-practices. Methods: Conduct a cross-sectional assessment of a random sample of FCCH providers' (n=52) menus and meals served. Foods will be evaluated against the CACFP requirements and best-practices. After the cross-sectional examination, providers will be randomly assigned to a Nutrition Technical Assistance (n=26) or attention comparison intervention (n=26). The intervention is based on theoretical foundations and formative interviews, and will consist of two 60-90-minute visits to the FCCH and one group class lasting approximately 3 hours.
Interventions
BEHAVIORALNutrition assistance
Participating family child care home providers in and around the Oklahoma City (OKC) area will be randomized to either the Nutrition, or an environmental health comparison group. Briefly, the Nutrition Technical Assistance Intervention and comparison group will consist of three encounters with the intervention team: two home-based, 90-minute visits scheduled at the convenience of the family child care home provider and a 3-hour group class session that will be conducted on a weekend. Total contact time with intervention staff will be 6 hours. All participants will receive a toolkit. Providers will complete either intervention over a period of three months.
BEHAVIORALChildren's environmental health/comparison
Participating family child care home providers in and around the OKC area will be randomized to either the Nutrition, or an environmental health intervention that will receive an Integrated Pest Management and Green Cleaning intervention with the same format and visit frequency. Briefly, the Intervention will consist of three encounters with the intervention team: two home-based, 90-minute visits scheduled at the convenience of the family child care home provider and a 3-hour group class session that will be conducted on a weekend. Total contact time with intervention staff will be 6 hours. All participants will receive a toolkit. Providers will complete either intervention over a period of three months.
Sponsors
University of Oklahoma
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Randomized trial where family child care home providers (the participant) are randomized to either nutrition or environmental health technical assistance intervention. Interventions are matched for time and contact
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* Family child care home providers within 60 minutes of Oklahoma City who participate in the Child and Adults Care Food Program
Exclusion criteria
* none
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Self-reported Nutrition Practices | baseline, post 3-months, post 12-months | Providers report the nutrition environment using the Nutrition and Physical Activity Self Assessment for Child Care (NAPSACC). Scores averaged across items range 0-4. Higher score indicates more desired/healthier outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Provider Nutrition Knowledge | baseline, post 3-months, post 12-months | Self-reported nutrition knowledge using a modified Revised General Nutrition Knowledge Questionnaire. It was reduced in length to 38 items from 88 items. Scores ranged from 0-38 with a higher score indicating greater nutrition knowledge. |
| Change in Compliance of Menu With Child and Adult Care Food Program Best Practices | baseline, post 3-months, post 12-months | menus are compared to the best practices of the Child and Adult Care Food Program (CACFP). The scale measures the number of elements of the menu which are compliance with the CACFP best practices. The CACFP best Practice compliance tool has a range of 0-25. A higher score is associated with a more desirable outcome and thus higher CACFP best practice compliance. |
| Change in Children's Dietary Intake of Vegetables at Lunch | baseline, post 3-months, post 12-months | Observation of children's dietary intake on 2 unannounced days using the Dietary Observation in Child Care methods and Food Processor for nutrient analysis. Outcome is cups of vegetables consumed. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORSusan B Sisson, PhD
University of Oklahoma
Participant flow
Recruitment details
Family Child Care Home Providers who participated in the Child and Adult Care Food Program within 60 miles of the university campus were invited to participate. Recruitment efforts were made at local training events and through food program sponsor emails and newsletters.
Pre-assignment details
Participants who were unresponsive after multiple follow-ups prior to group assignment OR those not interested anymore were excluded from the study.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 46.6 years STANDARD_DEVIATION 12.6 |
| Annual household income $100 000-$199 999 | 6 participants |
| Annual household income $15 000-$34 999 | 4 participants |
| Annual household income $35 000-$49 999 | 4 participants |
| Annual household income $50 000-$99 999 | 7 participants |
| Annual household income Do not wish to provide | 4 participants |
| Highest level of education 4-year college graduate or higher | 14 participants |
| Highest level of education High school graduate or GED | 1 participants |
| Highest level of education Some college or vocational training | 13 participants |
| Race/Ethnicity, Customized American Indian or Alaska Native | 4 participants |
| Race/Ethnicity, Customized Do not wish to provide | 2 participants |
| Race/Ethnicity, Customized Hispanic White | 0 participants |
| Race/Ethnicity, Customized Non-Hispanic Black | 10 participants |
| Race/Ethnicity, Customized Non-Hispanic White | 12 participants |
| Region of Enrollment United States | 24 Participants |
| Sex: Female, Male Female | 24 Participants |
| Sex: Female, Male Male | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 24 | 0 / 21 |
| other Total, other adverse events | 0 / 24 | 0 / 21 |
| serious Total, serious adverse events | 0 / 24 | 0 / 21 |
Outcome results
None listed