Family Child Care Homes Research Articles

Child care for young children with disabilities.

More than half (56%) of Canadian children aged 0 to 5 years are in non-parental child care, but data on child care attendance among children with disabilities is limited. This study examines child care participation among young children with disabilities in Canada, with a focus on different disability types. Analyses were conducted on 1,189 children aged 0 to 5 years identified with disabilities from Statistics Canada's 2023 Survey on Early Learning and Child Care Arrangements - Children with Long-term Conditions and Disabilities. Rates of child care participation, difficulties finding child care, difficulties within child care, and whether parents reported that their child had ever been denied a child care space because of their condition were examined. Logistic regression models tested for differences in the main child care arrangement and difficulty finding child care based on the child's disability while controlling for sociodemographic variables. Among children aged 0 to 5 years with disabilities, 45% attended a daycare centre, preschool, centre de la petite enfance, or before or after school care as their main child care arrangement; 17% attended another type of child care, such as a family child care home or care by a relative; and 38% did not regularly attend non-parental child care. The parents of nearly half of children with disabilities reported difficulty finding a child care arrangement, particularly for children with emotional conditions. Close to 1 in 10 parents of children with disabilities who were using child care reported that their child had been denied a child care space because of their condition. These findings highlight the need for information to support inclusive policies, practices, and resources for children with disabilities within the Canada-wide early learning and child care system.

Child and Adult Care Food Program: Family Childcare Home Providers’ Perceptions of Impacts of Increased Meal and Snack Reimbursement Rates during the COVID-19 Pandemic

Introduction: The U.S. Child and Adult Care Food Program (CACFP) provides tiered reimbursements for healthy foods for children at participating family childcare homes (FCCH). Higher tier 1 reimbursements are for providers who operate in low-income communities or who are themselves living on a low income. All FCCHs received a higher rate to address food insecurity during the COVID-19 pandemic. Methods: A survey was administered in the spring of 2023 to a randomly selected sample of licensed California FCCHs to assess the perceived impacts of the increased reimbursement on CACFP participation and anticipated challenges with reinstated tiered rates. A total of 518 surveys (261 tier 1, 257 tier 2) were analyzed using linear or logistic regression, adjusting for confounders. Results: Among tier 1 and tier 2 providers combined, over half reported lowering out-of-pocket spending for food (59%) and serving greater variety (55%) and quality (54%) of foods. Tier 2 providers reported experiencing more benefits (p < 0.05) and tended to be more likely to implement optional CACFP best practices (although not significantly different between tiers). Most FCCH providers found reimbursement rates were inadequate before (83%) the pandemic; this amount decreased to 54% post-pandemic for tier 1 and tier 2 providers combined. Conclusions: The temporary CACFP reimbursement positively impacted the perceived quality and variety of foods served to children, especially among tier 2 providers. Increased reimbursements for all FCCHs may ensure children have access to the healthy meals and snacks provided by the CACFP.

Children's physical activity in family child care homes: Influence of quality status, environment and policy features, and child characteristics.

About half of preschool-age children are not meeting recommendations of 15 min/h of physical activity (PA), and nearly one out of seven children between the ages of 2-5years are living with obesity. Furthermore, children attending family child care homes (FCCHs), compared with larger child care centers, engage in lower levels of PA and appear to be at a higher risk of obesity. Therefore, examining PA and multi-level factors that influence PA in children who attend FCCHs is essential. The Childcare Home Eating and Exercise Study (CHEER) examined PA behaviors of 184 children enrolled in 56 FCCHs and FCCH quality status, environment and policy features, and child characteristics. PA was assessed by accelerometer, and FCCH environment and policy was assessed via structured observation. Multiple linear regression was used to model associations between school day total PA and FCCH quality status, environment and policy features, and child characteristics. Child participants were on average 3.1years old; participants were non-Hispanic Black (47.3%), Non-Hispanic White (42.9%), other race/ethnicity (7.1%), and Hispanic/Latin (2.7%). Children in FCCH settings participated in 11.2min/h of total PA, which is below the recommended 15 min per hour. The PA environment and policy observation yielded a score of 11.8 out of a possible 30, which is not supportive of child PA. There were no associations between total child PA and FCCH quality status, environment and policy features, and child characteristics in these FCCH settings. This study was unique in its examination of PA and a comprehensive set of factors that may influence PA at the individual, organizational, environmental, and policy levels in a diverse sample of children attending FCCHs in South Carolina. Additional research is needed to better understand how to increase children's physical activity while they are in the FCCH setting. This research should use multi-level frameworks and apply longitudinal study designs.

Perceived barriers and facilitators of childcare providers’ physical activity: A mixed-methods study

Background: Childcare providers’ work demands have been associated with high rates of stress and health conditions. Physical activity (PA) may help to alleviate some of these issues, yet few studies have explored this topic. The purpose of the study was to assess childcare providers’ PA levels and to explore their perceived barriers and facilitators to PA. Methods: This was a mixed-methods concurrent triangulation study with childcare providers ( n = 27) from both family childcare homes and childcare centres from urban ( n = 14) and rural ( n = 13) areas. Accelerometers and the Global Physical Activity Questionnaire (GPAQ) measured the amount of PA (leisure, transport-related, occupational), and a semi-structured interview explored barriers and facilitators to PA. Descriptive statistics were calculated for PA data. Qualitative data were analysed using thematic content analysis. Results: For accelerometer data, on average per day, childcare providers accumulated 199.5 ± 62.5 minutes of light activity, 125.9 ± 68.1 minutes of moderate to vigorous PA (MVPA) and 666.3 ± 23.7 minutes of sedentary time. For GPAQ data, childcare providers reported 114.5 ± 48.4 minutes/day of MVPA and 295.6 ± 141.4 minutes/day of sedentary time. Common barriers included time constraints and health issues, while common facilitators included knowledge of PA health benefits and family/peer support. Conclusion: The study suggests an estimated 92% of childcare providers met the US national PA guidelines of 150 minutes of MVPA per week. However, they exhibited prolonged periods of sedentary behaviour (~11 hours). Programmes and interventions could address barriers to PA such as providing short movement breaks to decrease sedentary time and improve childcare providers’ health.

Policies, Practices, and Environmental Characteristics Among Family Child Care Homes in South Carolina.

Background: Child care program requirements have adopted nutrition and physical activity standards to address childhood obesity, but few studies have examined the effects of these standards in family child care homes (FCCHs). Methods: In a cross-sectional study (2017-2019), the Childcare Home Eating and Exercise study examined self-reported provider characteristics and observed policies and practices related to physical activity and nutrition in FCCHs in South Carolina. Two-sample t-tests were used to compare observed nutrition and physical activity policy, practice, and environment scores in child care homes that participated in versus did not participate in the state's ABC Quality program, which is designed to improve child care and includes policies and practices intended to increase physical activity levels and improve diet quality. Results: Environment and Policy Assessment and Observation results for nutrition and physical activity were 7.5 out of 21 and 11.8 out of 30, respectively, indicating much room for improvement in nutrition and physical activity policies, practices, and environment in South Carolina FCCHs. The study found one difference between FCCHs that did and did not participate in the ABC Quality program; non-ABC homes provided more time for physical activity. Conclusions: Future research should develop ways to strengthen the guidelines and improve the implementation of obesity prevention standards in FCCHs.

Evidence for Criterion-Related Validity of Pressure-Mediated Reflection Spectroscopy for Approximating Fruit and Vegetable Consumption among Preschool Children

BackgroundSkin carotenoids are a valid biomarker for approximating fruit and vegetable consumption (FVC). Veggie Meter® (VM®, Longevity Link Corp.) is a pressure-mediated reflection spectroscopy (RS)-based device that allows for noninvasive and rapid assessment of skin-carotenoid score (SCS) in adults and children. Although VM® is established as a valid tool to measure FVC in adults, there is limited research supporting the validity evidence of the VM® to approximate FVC among preschool children. ObjectiveThe current study aims to assess evidence supporting the criterion-related validity of RS-based SCS for approximating FVC among preschool children (3–5-y old). MethodsWe collected cross-sectional data from typically developing preschool children (n = 136) attending the Child and Adult Care Food Program-participating family child care home settings (FCCHs) (n = 46) in Nebraska. Research team members collected children’s height and weight to calculate body mass index; and measured children’s SCS using the VM®. Children’s FVC in FCCHs were collected using dietary observation. In addition, parents (n = 89) completed a shortened food frequency questionnaire to report children’s FVC at home. Kendall’s Tau (τ) correlation tests were conducted to measure the association between children’s SCS with FVC in FCCHs and with parent-reported total fruit and vegetable (FV) frequency scores. ResultsChildren’s SCS were significantly correlated with their mean FVC in FCCHs, τ = 0.14 (P = 0.02), total provitamin A carotenoids intake in FCCHs, τ = 0.19 (P < 0.001), and with parent-reported total FV frequency score, τ = 0.16 (P = 0.04). ConclusionThe correlation coefficients in this study are comparable with results from a meta-analysis examining associations between FVC and SCS in 7–10-y-old children (r = 0.20). Thus, evidence suggests that RS offers a potentially valid, objective, and feasible method to assess preschool children’s total FVC in multiple settings, especially in conjunction with other dietary assessment tools.

Mediation of the association between social environmental characteristics of family childcare home and weight status in children by diet quality

BackgroundThe food and beverages served in family childcare homes (FCCHs) may play an important role in the development of childhood overweight and obesity. This analysis examines whether children’s diet quality mediates the relationship between foods and beverages served in FCCHs and preschool-aged children’s weight status.MethodsTrained and certified staff conducted observations for two days in each FCCH, using the Environment and Policy Assessment and Observation (EPAO) measure to determine the foods and beverages served to children (N = 370) in FCCHs (N = 120). They also used the Dietary Observation in Child Care (DOCC) protocol to assess children’s food and beverage intake during childcare, from which we calculated the Healthy Eating Index-2015 (HEI), a measure of diet quality. Height and weight were measured for each child with parent consent from which the child’s body mass index (BMI) z-scores were calculated. A multilevel mediation analysis was conducted to indicate whether children’s diet quality mediates the relations between food and beverage served in FCCHs and preschool-aged children’s weight status.ResultsChildren’s total HEI scores significantly mediated the relationship between the EPAO subscale Food Provided and children’s BMI z-scores (B=-0.01, p < .05, 95% CI = [-0.03, − 0.002]). Further, the EPAO subscale Food Provided was positively associated with the total HEI score (B = 0.75, p < .01, 95% CI = [0.32, 1.18]). Total HEI scores were negatively associated with BMI z-score (B=-0.01, p < .05, 95% CI = [-0.02, − 0.001]).ConclusionChildren’s diet quality did significantly mediate the relationship between the food served in FCCHs and children’s weight status. More longitudinal studies with longer follow-up periods need to be conducted to confirm these relationships. Further, future studies need to examine the relationships between a broader spectrum of FCCH environmental characteristics and home environment with children’s weight status, as well as other mediators including physical activity.

Child Care Feeding Programs Associated With Food Security and Health for Young Children From Families With Low Incomes.

The Child and Adult Care Food Program is the primary national program that enables child-care settings to provide healthy meals for children. Associations between Child and Adult Care Food Program participation and child health and development and health care utilization are understudied. To assess associations between children's health, development, health care utilization and food security by meal source (child-care-provided vs parent-provided) among children from low-income families with a child care subsidy attending child-care in settings likely eligible to participate in Child and Adult Care Food Programs. The study used repeat cross-sectional surveys (new sample at successive time points) conducted year-round. Primary caregivers of 3,084 young children accessing emergency departments or primary care in Baltimore, MD; Boston, MA; Little Rock, AR; Minneapolis, MN; and Philadelphia, PA, were interviewed between 2010 and 2020. The sample was limited to children aged 13 to 48 months, receiving a child care subsidy and attending child-care centers or family child-care homes ≥20 hours per week. Outcomes included household and child food security; child health, growth, and developmental risk; and admission to the hospital on the day of the emergency department visit. Meal source and participant characteristics were analyzed using χ2 tests; associations of outcomes with parent-provided meals were analyzed with adjusted logistic regression. The majority of children had child-care-provided meals (87.2% child-care-provided vs 12.8% parent-provided). Compared with children with parent-provided meals, children with child-care-provided meals had lower adjusted odds of living in a food-insecure household (adjusted odds ratio 0.70, 95% CI 0.55 to 0.88), being in fair or poor health (adjusted odds ratio 0.61, 95% CI 0.46 to 0.81), or hospital admission from the emergency department (adjusted odds ratio 0.59, 95% CI 0.41 to 0.83), with no differences in growth or developmental risk. Compared with meals provided from home, child-care-provided meals likely supported by the Child and Adult Care Food Program are related to food security, early childhood health, and reduced hospital admissions from an emergency department among low-income families with young children.

Young Children's Dietary Quality in Family Child Care and in Their Own Home.

Some evidence suggests that children may have higher quality dietary intake in early care and education settings, compared with their respective homes, but no studies have explored these differences among children in less formal family child care. The purpose of this study was to compare dietary quality via the Healthy Eating Index 2015 among children in family child care and in their own home. This was a cross-sectional analysis of baseline dietary intake data from the Childcare Home Eating and Exercise Research study, a natural experiment, using directly observed dietary data in child care and 24-hour recall data in homes among children in South Carolina. Participants were 123 children in 52 family child-care homes between 2018 and2019. The main outcome was total and component Healthy Eating Index 2015 scores. The analysis was a hierarchical linear regression of children nested within family child care homes adjusting for child, provider, facility, and parent characteristics, including sex, age, race, ethnicity, and income, with parameters and SEs estimated via bootstrap sampling. Children had a mean ± SD Healthy Eating Index 2015 score of 60.3 ± 12.1 in family child-care homes and 54.3 ± 12.9 in their own home (P < 0.001). In adjusted analysis and after accounting for clustering of children in family child care homes, total HEI-2015 scores were lower at home than in care (β= -5.18 ± 1.47; 95% CI -8.05 to -2.30; P= 0.003). Children had healthier dietary intake in family child-care homes vs their respective homes.

Feasibility of a Mental Wellbeing Program for Rural Family Childcare Home Providers

Feasibility of a Mental Wellbeing Program for Rural Family Childcare Home Providers

Nutrition Practices of Family Child Care Home Providers and Children's Diet Quality

ObjectiveTo examine the relationship between the diet quality of children aged 2–5 years cared for in family child care homes (FCCHs) with provider adherence to nutrition best practices. DesignCross-sectional analysis. ParticipantsFamily child care home providers (n = 120, 100% female, 67.5% Latinx) and children (n = 370, 51% female, 58% Latinx) enrolled in a cluster-randomized trial. Main Outcome MeasuresData were collected over 2 days at each FCCH. The Environment and Policy Assessment and Observation tool was used to document whether providers exhibited nutrition practices on the basis of the Nutrition and Physical Activity Self-Assessment for Child Care. Each practice was scored as either present or absent. Children's food intake was observed using Diet Observation at Child Care and analyzed with the Healthy Eating Index–2015. AnalysisMultilevel linear regression models assessed the association between providers exhibiting best practices regarding nutrition and children's diet quality. The model accounted for clustering by FCCH and controlled for provider ethnicity, income level, and multiple comparisons. ResultsChildren in FCCHs in which more of the best practices were implemented had higher diet quality (B = 1.05; 95% confidence interval [CI], 0.12–1.99; P = 0.03). Specifically, children whose providers promoted autonomous feeding (B = 27.52; 95% CI, 21.02–34.02; P < 0.001) and provided nutrition education (B = 7.76; 95% CI, 3.29–12.23; P = 0.001) had higher total Healthy Eating Index scores. Conclusions and ImplicationsFuture interventions and policies could support FCCH providers in implementing important practices such as autonomy feeding practices, talking informally to children about nutrition, and providing healthful foods and beverages.

Financial Challenges of Family Child Care Providers During the COVID-19 Pandemic: A Phenomenological Study.

The impact of COVID-19, both in quality and quantity, on the field of early childhood education, ECE is immeasurable. However, as research shows, its impact on family child care (FCC), has been worse than other sectors of ECE. FCC providers worldwide have always perceived their work as a service to families and children, yet FCC homes have not received much attention and recognition from researchers and policymakers compared to center-based ECE programs. This phenomenological inquiry with 20 FCC providers in a large urban county in California highlights the financial challenges that FCC providers faced during the early part of the pandemic before they received financial support from the state in the spring of 2021. The cost of running the program was quite high because of reduced enrollment and the regular purchase of sanitary materials. To keep their programs afloat, some participants had to lay off their staff, others kept them without salary, others had to exhaust their savings, and most incurred credit card debt. Most of them also experienced psychosocial stress. Their financial hardships during the pandemic would have been far worse without the emergency funding received from the state. However, as experts warn, the field of ECE needs a permanent solution and the situation could be even worse after the emergency funds run out in 2024. The nation has witnessed the dedicated service of FCC providers during the pandemic, especially to families of essential workers. Much work is needed at empirical and policy levels to support and celebrate the service of FCC providers.

Online training for child care providers teaches child nutrition in English and Spanish

Poor nutrition among young children is a national health crisis which contributes to obesity and chronic disease later in life. Since children spend so much time in child care, child care providers can help improve the quality of young children's nutrition and foster lifelong healthy eating habits. However, California's family child care home (FCCH) providers receive little training on what and how to feed young children. To address this problem, we developed a self-paced online training on child nutrition in English and Spanish for FCCH providers. Our feasibility study evaluated providers’ satisfaction with the training and ease of use, using an online survey and a 45-minute interview upon completing the training. Providers rated their training experience as excellent, easy to enroll in, and complete. Most providers reported they were somewhat likely to make changes to what and how they feed infants and toddlers. Many recommended adding printed resources and culturally relevant material for future trainings.

Nurse Child Care Health Consultants, Professional Development, and Accreditation Improve Medication Safety in Child Care Programs.

Medication administration is a critical safety issue in hospitals and the community. Children are especially at risk because of their dependence on adults to safely administer medications. The purpose of this study was to examine non-compliance with state child care medication administration regulations and factors associated with improved compliance. The data included routine, unannounced inspections of child care programs by state licensing specialists collected in two time periods over 10 years. Factors potentially associated with regulatory compliance were included in this secondary analysis. Most child care center medication administration regulations showed decreased non-compliance between the two time periods. However, regulations pertaining to prescriber orders and parent permission revealed a significant increase in non-compliance (58.4%). Factors positively associated with medication administration regulatory compliance included: compliance with annual professional development (p < 0.0001 in both periods), achievement of accreditation (p = 0.0115 in Time 1), and among centers with children under 3 years of age, compliance with a weekly mandatory visit by a nurse consultant (p = 0.0004 in Time 2). Though family child care homes had a lower frequency of medication administration non-compliance, only 19% were administering medications in Time 1. High quality, safe, and affordable child-care is essential for all children including those with special health care needs. This study highlights the importance of medication safety practices in child care programs, national child care health and safety standards, federal and state policies regarding medication administration regulations, and the critical role of nurse child care health consultants in promoting safe medication administration in child care programs.

Facilitators and barriers to family child care home participation in the U.S. Child and Adult Care Food Program (CACFP)

This paper describes facilitators, barriers, and potential strategies to promote participation in the Child and Adult Care Food Program (CACFP) by family child care homes (FCCHs). This descriptive study occurred from January-May 2022 in Arizona and New York, two states with varying levels of CACFP participation. Stakeholders from three state-level CACFP-administering agencies, representatives of six sponsor organizations, and 23 FCCH providers (70% CACFP, 30% non-CACFP) participated in interviews. Facilitators of CACFP participation included the simple enrollment, technical assistance from sponsors, software provided by sponsors, and incentives from state agencies. Barriers included perceptions that CACFP paperwork would be burdensome, lack of access to sponsors, and challenges with meal pattern requirements. Recommended strategies to promote CACFP uptake included educating providers about CACFP, expanding outreach, and additional funding. Efforts to address state-level disparities in FCCH participation in CACFP are needed. This study provides some insight into policy and systems changes that could be beneficial.

Feeding and Activity Environments for Infants and Toddlers in Childcare Centers and Family Childcare Homes in Southeastern New England.

Few studies have documented the food and physical activity (PA) environments of childcare settings caring for children <24 months of age, although they may be key contributors to developing child PA and diet patterns. We used an adapted Environment and Policy Assessment and Observation tool to assess the food and activity environments for infants and toddlers in childcare centers (n = 21) and family childcare homes (FCCH) (n = 20) and explored differences by childcare type. Many similarities were found between childcare site types; however, centers used more recommended feeding practices than FCCH (e.g., 100% of center providers talked with toddlers about feelings of hunger or fullness compared to 18% of family childcare providers (FCCP), p < 0.01). Differences in non-recommended feeding practices (e.g., spoon feeding, bottle propping and encouraging unhealthy foods) were mixed between childcare types. Toddlers in centers spent more time playing at higher PA levels than those in FCCH (61 vs. 13 min, p < 0.001). Screen time was observed in FCCH, but not in centers. Differences between childcare types may indicate differential influences on infant and toddler feeding and PA behaviors, which could predict disparate obesity risk. Future research should further observe these behaviors in a larger sample of centers and FCCH to inform childcare interventions and policies.

Relationships between proximity to grocery stores and Oklahoma Early Care and Education classroom nutrition practices

The study purpose was to determine associations between proximity to grocery stores and Early Care and Education programs’ (i.e., ECEs) classroom nutrition practices and barriers, by ECE context (Head Start, community-based childcare [CBC], and family child care homes [FCCHs]). A statewide cross-sectional survey was implemented in Oklahoma ECEs. Directors reported classroom nutrition practices with the Nutrition and Physical Activity Self-Assessment tool, and barriers to implementation. Locations of 457 grocery stores statewide were determined by in-person audit. Geocoded ECEs were considered within a “low proximity” area if no grocery stores were available within a 0.25-mile radius for urban, or 10-mile radius for rural, ECEs. From November 2019 to February 2020, 54 Head Starts, 159 CBCs, and 160 FCCHs participated. 31.0 % were considered as low proximity. Head Starts demonstrated the highest classroom nutrition scores for mealtime practices, and nutrition education and policy. While proximity to grocery stores was not related to classroom nutrition practices for any ECE context (p > 0.05), FCCHs located within a low proximity area reported barriers to implementing those practices more often compared to FCCHs in an area within accessible proximity of grocery store. Thus, proximity to grocery stores was related to barriers in FCCHs only; those provider’s experiences and perceptions may be most susceptible to influence of the community nutrition environment, compared to other ECE contexts. Contrary to studies in residential areas and schools, nutrition environments were not related to nutrition practices in ECEs. ECEs may serve as protective micro-environments supporting health for children residing in nearby low-access communities.

P065 Using Diffusion of Innovations Theory Explore Family Child Care Home Providers Perspectives on Responsive Feeding Practices

<h3>Background</h3> Early Care and Education (ECE) programs offer ideal settings for young children to develop healthy dietary intake. Implementation of responsive feeding evidence-based practices (EBPs) are a promising avenue to promote healthy eating in young children while supporting children's autonomy and self-regulation. However, implementation of responsive feeding EBPs is low, especially in rural family childcare homes (FCCH). Little is known about how organizational structure in FCCH impact implementation of responsive feeding EBPs in this unique setting. <h3>Objective</h3> To determine FCCH providers' perspectives for implementing evidence-based responsive feeding practices using the Diffusion of Innovations Theory's innovation-decision process. <h3>Study Design, Setting, Participants</h3> Six qualitative, semi-structured focus group interviews were conducted with 19 rural FCCH providers. <h3>Measurable Outcome/Analysis</h3> Interviews were analyzed using thematic analysis. <h3>Results</h3> Providers reported having knowledge regarding responsive feeding EBPs and had learned about them through various communication channels such as the Child and Adult Care Food Program, Go Nutrition and Physical Activity Self-Assessment for Child Care, and Step Up to Quality (Knowledge). Providers reported perceived challenges to implementing responsive feeding related to the organizational structure of the FCCH settings, such as the mixed age groups of children and balancing multiple roles such as administrator, cook and teacher during mealtimes (Persuasion and Decision). Additionally, providers who were implementing responsive feeding EBPs provided strategies used to overcome these challenges (Implementation). Finally, providers reported the benefits of using responsive feeding EBPs, such as supporting children's healthful development and more pleasant mealtimes, as reasons for their continued use of responsive feeding EBPs (Confirmation). <h3>Conclusions</h3> Results indicate that organizational structure impacts successful implementation of responsive feeding EBPs in ECE programs. Programming and policy efforts should consider these factors when targeting children's healthful dietary needs. <h3>Funding</h3> USDA

P101 Dissemination and Uptake of a Nutrition Training Library for ECE Providers Using Go NAPSACC

<h3>Objective</h3> To assess dissemination, uptake, and perceived usefulness of on-demand e-learning nutrition trainings for early care and education (ECE) providers over the first year of availability. <h3>Use of Theory or Research</h3> Guided by adult learning and nutrition education principles, 22 on-demand, interactive nutrition trainings (∼30-minutes each) were developed for ECE providers with diverse learning styles. Principles from Diffusion of Innovation Theory guided dissemination strategies. <h3>Target Audience</h3> Go NAP SACC participating programs across 21 states. <h3>Program Description</h3> Go NAPSACC provides a structured process and web-based tools to help improve the health of children. Providers have access to four content areas related to nutrition (i.e., child nutrition, oral health, breast/infant feeding, farm to ECE) covering a variety of topics (e.g., foods provided, feeding practices/environments, policy, etc.). In January 2021, Go NAPSACC launched and marketed a new on-demand training library. Process evaluation over the first year identified opportunities for improvement in dissemination. <h3>Evaluation Methods</h3> Data on reach, engagement, and perceived usefulness were captured using the Go NAPSACC platform. Online surveys were used to capture state-level dissemination strategies. <h3>Results</h3> In 2021, 7,211 trainings sessions were completed by 2,932 providers from 760 programs. The child nutrition foods provided training had the most completed sessions (701). The majority of programs completing trainings were center-based (45.4%) or family childcare homes (42.5%), not associated with military, faith-based, or native groups (89.6%), located in a metro area (63.6%), and Child and Adult Care Food Program participants (72.4%). Dissemination strategies for states with the greatest uptake included approval for professional development credit, embedding trainings within another project or system, use of existing listservs, and advertising on state/local agency websites. Majority of programs reported trainings were engaging (95.8%) and they will be able to apply what they learned (96.4%). <h3>Conclusions</h3> Go NAPSACC is a highly scalable platform for dissemination of on-demand nutrition trainings for ECE providers with potential to greatly increase the reach and accessibility of nutrition education for this critical population. <h3>Funding</h3> None

Food Desert Status of Family Child Care Homes: Relationship to Young Children's Food Quality.

Family child care homes (FCCHs) are a favored child care choice for parents of young children in the U.S. Most FCCH providers purchase and prepare foods for the children in their care. Although FCCH providers can receive monetary support from the Child and Adult Care Food Program (CACFP), a federal subsidy program, to purchase nutritious foods, little is known about FCCH providers’ access to nutritious foods, especially among FCCH providers serving children from communities that have been historically disinvested and predominantly Black. This study aims to describe the food desert status of FCCHs in Baltimore City, Maryland, and examine the relationship between food desert status and the quality of foods and beverages purchased and provided to children. A proportionate stratified random sample of 91 FCCH providers by CACFP participation status consented. Geographic information system mapping (GIS) was used to determine the food desert status of each participating FCCH. Participants reported on their access to food and beverages through telephone-based surveys. Nearly three-quarters (66/91) of FCCHs were located in a food desert. FCCH providers working and living in a food desert had lower mean sum scores M (SD) for the quality of beverages provided than FCCH providers outside a food desert (2.53 ± 0.81 vs. 2.92 ± 0.70, p = 0.036, respectively). Although the significant difference in scores for beverages provided is small, FCCH providers working in food deserts may need support in providing healthy beverages to the children in their care. More research is needed to understand food purchases among FCCH providers working in neighborhoods situated in food deserts.