P44 Influences of Provider Nutrition Knowledge and Self-Efficacy on Nutrition Practices and Policies of Oklahoma Family Child Care Homes

Abstract

<h3>Background</h3> Early child care and education (ECE) are favorable locations for early obesity prevention. Few studies include Family Child Care Homes (FCCH) compared to larger ECE settings. Several ECE interventions show that introducing or improving a written policy has positive effects on food environment and foods served. However, a gap exists on possible influences of policies and practices in FCCHs. <h3>Objective</h3> To determine impact of FCCH providers' nutrition knowledge and nutrition self-efficacy on program nutritional practices and policies. <h3>Study Design, Setting, Participants</h3> This cross-sectional study uses baseline data from an intervention study (Happy Healthy Homes) of FCCH providers caring for 2- to 5-year-old children within 60 miles of Oklahoma City. <h3>Measurable Outcome/Analysis</h3> From October 2017 to November 2018 providers completed surveys including demographics, nutrition knowledge, nutrition self-efficacy (confidence and barriers), and NAP SACC practices and policies. Spearman's rank-order correlation, linear regression, and logistic regression were used via SPSS version 25. <h3>Results</h3> Forty-nine FCCH providers participated (100% women, 45 ± 13 years old). Confidence self-efficacy is inversely correlated with barriers self-efficacy (rs(47) = −0.4, <i>P</i> = .004). Nutrition knowledge was not correlated with confidence or barriers self-efficacy. Multivariate linear regression indicates nutrition knowledge as the strongest predictor of nutrition practices (std β = 0.442, <i>P</i> = .001) followed by confidence self-efficacy (std β = 0.358, <i>P</i> = .001), while barriers self-efficacy does not (std β = −0.061, <i>P</i> = .651). There was no association between knowledge, self-efficacy, and nutrition policies. <h3>Conclusions</h3> As FCCH provider nutrition confidence increases, barriers to serving healthy foods decrease. However, nutrition knowledge was not related to either confidence or barriers self-efficacy. Collectively, knowledge and self-efficacy were associated with FCCH practices. Results suggest that increase in knowledge and confidence may have a positive effect on nutrition practices in the FCCH. However, they do not necessarily influence each other. Knowledge and self-efficacy each need to be included in provider training opportunities.