Academic journal article Childhood Obesity

Nutrition and Physical Activity Environments of Home-Based Child Care: What Hispanic Providers Have to Say

Academic journal article Childhood Obesity

Nutrition and Physical Activity Environments of Home-Based Child Care: What Hispanic Providers Have to Say

Article excerpt

[Author Affiliation]

Alison Tovar. 1 Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI.

Noereem Z. Mena. 1 Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI.

Patricia Risica. 2 Institute for Community Health Promotion, Brown University School of Public Health, Providence, RI.

Gemma Gorham. 2 Institute for Community Health Promotion, Brown University School of Public Health, Providence, RI.

Kim M. Gans. 3 Department of Human Development and Family Studies and Center for Health Interventions and Prevention, University of Connecticut, Storrs, CT.

Address correspondence to: Alison Tovar PhD, MPH, Assistant Professor, Department of Nutrition and Food Sciences, University of Rhode Island, 12 Ranger Hall, Kingston, RI 02881, E-mail: alison_tovar@uri.edu

Introduction

Close to one third of 2- to 5-year-old children are overweight or obese with clear disparities observed by ethnicity; 17% of Hispanic children within this age group are obese compared to 3.5% of their white, non-Hispanic counterparts.1 Contributing to the obesity epidemic are unhealthy physical activity and eating patterns, including high consumption of energy-dense snack foods and inadequate fruit and vegetable consumption.2,3 This is troubling, given that early childhood is a critical period during which dietary intake and physical activity patterns, are developed.4,5 Although parents play a critical role in shaping children's food and physical activity (PA) preferences and determining their physical and social environment, the child care setting (nonparental care either at a center or family child care home [FCCH]) and its providers also play a critical role in shaping healthy behaviors.6 Child care providers can impact children's healthy eating and PA through their practices and attitudes and by providing supportive physical and social environments.7 Therefore, fostering effective strategies to help child care providers establish healthy eating and PA habits and promote healthy environments among disadvantaged populations is critical.

Many interventions and programs to improve healthy behaviors have focused on child care centers,8 yet 2 million (25%) of US children in nonparental care attend a FCCH,9 a child care setting where children are cared for outside of their homes by child care providers in the provider's home, rather than a center. Regulations for licensed FCCHs are different, and in many cases less stringent, than those for child care centers.10 In fact, time spent in FCCH settings during infancy has been shown to be associated with increased BMI z-scores at 3 years of age, whereas time spent in child care centers has not.11

In Rhode Island (RI), 28% of children are cared for in FCCHs,9 with at least 40% of the RI providers being Hispanic. A previous survey with RI family child care providers (FCCPs) found ethnic differences between Hispanic and non-Hispanic providers in reported feeding practices and attitudes.12 In order to intervene and improve the FCCH environment, it is important to understand the perceptions and beliefs of FCCPs on what factors influence PA, screen time (ST), and dietary behaviors in children among ethnic minority providers. Therefore, the aim of this exploratory qualitative study was to examine the perceptions and beliefs of FCCPs in Providence, RI, on what influences a child's PA, ST, and dietary behaviors while under their care.

Methods

The work completed for this study is part of the formative stages of an ongoing project (R01HL123016), which is conducting a randomized trial to study the efficacy of a novel multicomponent intervention with ethnically diverse providers to improve the food and PA environments of FCCH and the diet, PA, and ST behaviors of the 2- to 5-year-old children they care for. …

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