A nutrition and physical activity intervention for family child care homes

Trost, S.G., Messner, L., Fitzgerald, K., & Roths, B. (2011) A nutrition and physical activity intervention for family child care homes. American Journal of Preventive Medicine, 41(4), pp. 392-398.

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Family child care homes (FCCHs) provide child care to 1.9 million children in the U.S., but many do not meet established child care standards for healthy eating and physical activity.


To determine the effects of a community-based train-the-trainer intervention on FCCHs policies and practices related to healthy eating and physical activity.


Quasi-experimental design with replication in three independent cohorts of FCCHs.


Registered FCCHs from 15 counties across Kansas participated in the Healthy Kansas Kids (HKK) program. Resource and referral agencies (RRAs) in each county recruited and enrolled between five and 15 child care providers in their service delivery area to participate in the program. The number of registered FCCHs participating in HKK in Years 1 (2006-2007); 2 (2007-2008); and 3 (2008-2009) of the program were 85, 64, and 87, respectively. A stratified random sample of registered FCCHs operating in Kansas (n=297) served as a normative comparison group.


Child care trainers from each RRA completed a series of train-the-trainer workshops related to promotion of healthy eating and physical activity. FCCHs were subsequently guided through a four-step iterative process consisting of (1) self-evaluation; (2) goal setting; (3) developing an action plan; and (4) evaluating progress toward meeting goals. FCCHs also received U. S. Department of Agriculture resources related to healthy eating and physical activity.

Main outcome measures

Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) self-assessment instrument (NAP SACC-SA). Analyses of outcome measures were conducted between 2008 and 2010.


Healthy Kansas Kids FCCHs exhibited significant improvements in healthy eating (Delta=6.9%-7.1%) and physical activity (Delta=15.4%-19.2%) scores (p<0.05). Within each cohort, pre-intervention scores were not significantly different from the state average, whereas post-intervention scores were significantly higher than the state average.


Community-based train-the-trainer interventions to promote healthy eating and physical activity in FCCHs are feasible, sustainable, and effective.

Impact and interest:

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13 citations in Web of Science®

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ID Code: 71798
Item Type: Journal Article
Refereed: Yes
Additional Information: ISI Document Delivery No.: 832FV
Times Cited: 3
Cited Reference Count: 20
Trost, Stewart G. Messner, Lana Fitzgerald, Karen Roths, Barbara
United Methodist Health Ministry Fund, Hutchinson Kansas
This project was supported by a grant from the United Methodist Health Ministry Fund, Hutchinson Kansas. The authors wish to thank Cathy Gray and Gloria Duffey from KACCRRA and the Family Child Care Homes who participated in the study.
Elsevier science inc
New york
Keywords: self-assessment, hip-hop, environment, prevention
DOI: 10.1016/j.amepre.2011.06.030
ISSN: 0749-3797
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Deposited On: 20 May 2014 01:00
Last Modified: 21 May 2014 03:05

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