Focus Groups Support the Use of the Environment and Policy Assessment Observation (EPAO) for Obesity Prevention in Childcare

Abstract

Preschool age is a critical period for obesity prevention. Increasingly more children are being cared for outside the home; however, no national nutrition and physical activity guidelines exist for child care centers. The Environment and Policy Assessment Observation (EPAO) instrument was administered at two child development centers (CDC) located in Fairfax, VA. Sites were selected based on partial vs. non‐subsidized status. Focus groups were conducted with parents at each center to identify the factors which promote a healthy child care environment. CDC 1, serving a population of lower mean income level, scored significantly higher (69%) on the EPAO compared to CDC 2 (53%). Higher scores related to serving more meals family style, teachers eating with children, and encouraging new foods. The emergent themes of the focus groups reinforced these findings as CDC 1 parents, as compared to CDC 2 parents, felt better informed about nutritional policies and practices. Parents appreciated that the menu included wide variety, cultural exposure, and allergen/gluten free options. CDC 1 parents commented on the relationship that staff had with children stating that staff nurtured a calm and encouraging environment. CDC 1 parents felt family style meals promoted table manners, self‐sufficiency, and civility. The policies pertaining to birthdays and celebrations were also clearly articulated and favorable. This study suggests that parents support many of the policies and practices identified by the EPAO. National child care policies for nutrition and physical activity should integrate the use of assessment tools such as the EPAO in the prevention of childhood obesity.