Abstract

Background Nebraska ranks fifth in the US for childhood obesity among children 2-4 years old. Children in rural areas are more likely to be classified as obese than children in urban areas. There is limited research on nutrition-related practices and barriers of childcare across urban and rural areas. Objective To examine the differences in implementation, barriers, and difficulty of nutrition practices including foods served and mealtime practices in childcare settings across urban-rural contexts in Nebraska. Study Design, Settings, Participants An exploratory cross-sectional study in 2017. Data were collected from 1,170 childcare providers (urban = 591; rural = 579) participating in the Child and Adult Care Food Program (CACFP), including 200 childcare centers (CCCs) and 970 family childcare homes (FCCHs) in Nebraska. Measurable Outcome/Analysis Childcare programs completed the self-administered ‘Healthy Children, Healthy State’ questionnaire. Descriptive statistics and chi-square tests were conducted to assess implementation, difficulty, and barriers to nutrition practices across urban-rural CCCs and FCCHs. Results For implementation of nutrition-related practices, CCCs in urban areas were significantly more likely to serve lean and low fat meat ( P P P P P P P Conclusion This study illuminates factors that may influence high rates of obesity in rural childcare settings.Future research should examine rural childcare programs and how local food systems may decrease costs and increase healthy food availability. Funding USDA National Institute of Food and Agriculture.

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