LiveWell in early childhood: results from a two-year pilot intervention to improve nutrition and physical activity policies, systems and environments among early childhood education programs in South Carolina

Meghan Slining,Miguel Negrete,Melissa Fair,Joanna Smyers,Tia Prostko,Misty Pearson,Sally Wills,Jen Stephenson,Stephanie Knobel,Joanne Timberlake

doi:10.1186/s12889-021-10975-7

Abstract

BackgroundEarly childhood education (ECE) settings are critical intervention targets for obesity prevention. This study evaluated a pilot two-year community-based participatory research (CBPR) project designed to assist ECE center directors and caregivers in policy, systems and environmental (PSE) change for improving healthy eating (HE) and physical activity (PA).MethodsA two-year CBPR study was conducted in 10 licensed ECE centers in Greenville, South Carolina. The intervention consisted of five steps: [1] baseline data collection and self-assessment using the Nutrition and Physical Activity Self-Assessment for Child Care (Go-NAP SACC), [2] tailored goal setting and action planning, [3] technical assistance and access to resources, [4] post intervention data collection and re-assessment, and [5] celebration of success. Main outcome measures (HE and PA environments, practices and policies) were assessed using the Environment and Policy Assessment and Observation (EPAO) tool at baseline and 24 months. One classroom of 3–5-year-olds was randomly selected for observation from each center (mean of 12 children per classroom). Means and standard deviations were calculated for total PA, total nutrition and each subscale of PA and nutrition. Paired sample t-tests were calculated to assess changes in EPAO scales from baseline to post intervention.ResultsTen ECE centers enrolled in the pilot study and eight completed the two-year intervention. Center-based goals were accomplished across all 8 ECE centers over the two-year intervention: 16 child nutrition goals, 6 outdoor play goals, 11 physical activity goals and 8 screen time goals across the entire sample. Nutrition policy and PA policy significantly improved (p < 0.05), with greater improvements in PA (10.0 point increase, p = .048) as compared to nutrition (3.3 point increase, p = 0.02).ConclusionsUtilizing a CBPR approach, this two-year nutrition and PA PSE intervention in ECE centers improved ECE center HE and PA policies.

Highlights

Childhood education (ECE) settings are critical intervention targets for obesity prevention
Center-based goals were accomplished across all 8 Early childhood education (ECE) centers over the two-year intervention: 16 child nutrition goals, 6 outdoor play goals, 11 physical activity goals and 8 screen time goals across the entire sample
Over the course of the two-year intervention, one center withdrew and two centers merged, resulting in eight ECE centers that completed post intervention data collection in August of 2018

Summary

Introduction

Childhood education (ECE) settings are critical intervention targets for obesity prevention. Childhood has been acknowledged as a critical time for the development of eating and activity patterns [6, 7]. Both sedentary behaviors and PA appear to track consistently from early childhood to middle childhood [7]. While children in childcare often do not meet national dietary, activity or sedentary behavior guidelines [10,11,12], these settings have been shown to be important predictors of behavior [13]

Objectives

Methods

Results

Discussion

Conclusion