Abstract

<h3>Background</h3> Early Childhood Education (ECEs) directors and teachers experience substantial barriers to implementing childhood nutrition recommendations. Diet in older children is influenced by nutrition environments surrounding homes and schools; influence of the community environment on ECEs is not understood. <h3>Objective</h3> Determine associations between community nutrition environments and ECE barriers to classroom nutrition practices, by ECE context [Head Starts, community-based childcare (CBCs), and family child care homes (FCCHs)]. <h3>Study Design, Setting, Participants</h3> Cross-sectional study including licensed Oklahoma ECEs. Locations of 457 grocery stores were determined in-person. Locations of participating ECEs and grocery stores were geocoded and analyzed using ArcMap 10.6. <h3>Measurable Outcome/Analysis</h3> ECEs were considered located within a "Food Desert" if no grocery stores were available within a 0.25-mile radius for urban ECEs, or 10-mile radius for rural ECEs. Presence of barriers to serving healthier foods and beverages were reported. Fisher's exact test was used to compare differences in barriers among those within Food Deserts versus Non-Deserts. Benjamini Hochberg calculations for False Discovery Rate were applied (α<0.004). <h3>Results</h3> Fifty-four Head Starts, 159 CBCs, and 160 FCCHs participated with 24%, 27% and 37%- respectively- being located within a Food Desert. ECE descriptive characteristics including food purchasing and meal planning strategies varied by ECE context. Among Head Starts and CBCs, barriers were not different by Food Desert status (<i>P</i> > 0.0004). In FCCHs only, those located within Food Deserts reported a 20% higher prevalence of concern for food waste compared to those within Non-Deserts (<i>P</i> < 0.004). <h3>Conclusion</h3> Food Desert status was related to reported barriers in FCCHs only; therefore, those provider's experiences and perceptions may be most susceptible to influence of the community nutrition environment, compared to other ECE contexts. Findings suggest a need for future research and policy implementation to support FCCHs residing in low-access areas and experiencing difficulty implementing classroom health practices.

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