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Research and Professional Brief
Nutrition Policies at Child-Care Centers and Impact on Role Modeling of Healthy Eating Behaviors of Caregivers

https://doi.org/10.1016/j.jada.2011.08.048Get rights and content

Abstract

Studies suggest that caregivers influence children's dietary behaviors through role modeling in child-care environments. However, few studies have examined role modeling by caregivers and child-care center policies. This cross-sectional study evaluated the associations between child-care center policies about staff eating practices and caregivers' eating behaviors during mealtime interactions with children. Data were collected in 2008-2009 at 50 North Carolina child-care centers. Caregivers (n=124) reported about modeling healthy eating behaviors to children, trained research staff observed caregivers' (n=112) eating behaviors in classrooms, and directors reported about the presence/absence of center policies on staff eating practices. About 90% of caregivers reported modeling healthy eating behaviors to children. At 80% of centers, caregivers were observed modeling healthy dietary behaviors (eg, sitting with or eating same foods as children), but at fewer centers they were observed consuming unhealthy foods (eg, fast foods, salty snacks: 25%; and sugar-sweetened beverages: 50%). Although no substantial associations were observed between caregiver behaviors and center policies, effect size estimates suggest differences that may be of clinical significance. For example, caregivers were observed modeling healthy dietary behaviors more frequently at centers that had written policies about staff discouraging unhealthy foods for meals/snacks and having informal nutrition talks with children at meals. However, caregivers were observed consuming unhealthy foods and sugar-sweetened beverages more often at centers with policies that promoted healthier foods for meals/snacks. Future research should build on this study by using larger samples to understand why healthy food policies in child-care centers may not translate to eating practices among caregivers.

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Sample

Data for this cross-sectional study were collected in Fall 2008 and Winter 2009 as part of a larger study to develop new measures for evaluating the nutrition and physical activity environments in child-care centers. Fifty child-care centers were recruited from six counties in the Piedmont region of North Carolina. About half of the centers (n=23; 46%) participated in the federally funded Child and Adult Care Food Program. On average, 78 (±55) children were enrolled at the centers, with more

Results and Discussion

A total of 112 caregivers were observed during mealtimes in all 50 centers. One hundred twenty-four caregivers completed the staff survey. All caregivers who completed the survey were female, and their mean age was 37 (±11) years. Fifty-three percent (n=61) were non-Hispanic white, 39% (n=45), non-Hispanic black, and 9% (n=10) were other race/ethnicities. Ten percent (n=12) had completed at least some high school, 39% (n=45) some college, and 29% (n=33) had an associate or college degree.

Conclusions

Findings of this study suggest that center policies related to the encouragement of healthy eating promote mealtime interactions between caregivers and children (talking, encouraging, sitting with), but not consumption of healthy foods in the presence of children. Further research that may help researchers understand the effect of center policies on caregiver practices include examining how recently policies were put in place, whether caregivers were involved in policy development, and whether

T. O. Erinosho is a postdoctoral research associate, The Department of Nutrition and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill.

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T. O. Erinosho is a postdoctoral research associate, The Department of Nutrition and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill.

D. P. Hales is a research assistant professor, The Department of Nutrition and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill.

D. S. Ward is a professor, The Department of Nutrition and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill.

C. P. McWilliams is a research associate, The Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill.

J. Emunah is a research associate, The Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill.

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