Family Child Care Homes Best Practices promote Healthy Activies, Healthy Eating

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A new study from UConn and Brown University researchers found that toddlers and preschoolers that goes to family child care homes ate better and were more active if the provider was coached on best practices and shown ways to meet those expectations.

The Healthy Start/Comienzos Sanos study looked at 400 children between the ages of 2 and 5 in 120 family child care homes within a 60-mile radius of Providence. The goal was to see, over the course of eight months, if certain interventions would change the quality of the food served and the amount of time spent sitting down.

Kim M. Gans, a professor of human development and family sciences at UConn and one of the lead researchers, says, "There's a lot of evidence that shows the earlier kids are exposed to healthy foods and the earlier they get used to eating them, the more likely they are to keep those habits as they get older and into adulthood."

"We looked at kids in family child care homes because national data suggests that kids who are cared for in this way may be more likely to be overweight," she says.

Family child care homes are different from center-based day cares because only a few children are cared for at each licensed provider's home. This gives young children the feeling of being at home instead of at school. Some have a set curriculum, but many don't. This gives kids the chance to get more one-on-one attention.

Gans said that most research is done on day care centers, but there hasn't been much done on child care homes, even though 2 million of the 2 million U.S. children whose parents send them to day care while they work are in these programs.

At the start of the study, researchers visited the homes and talked to the caregivers in person. Then, they watched what happened in the home for two days and wrote down what they saw, such as what was served, what was eaten, and what kind and how long of physical activity was done.

Then, over the course of eight months, caregivers got monthly feedback on what they could do better based on the 26 best practices listed in the NAP SACC, which stands for Nutrition and Physical Activity Self-Assessment for Child Care.

With this information and the help of a peer coach, caregivers set monthly goals. They also got a newsletter and video related to their goal every month and met with other people in the study for support group meetings.

Half of the homes got help with nutrition and physical activity, and the other half got help with getting children ready to read. So, each home got either a box of toys to get kids moving, like soft balls, hula hoops, tunnels, and bean bags, or a box of books and other materials to help kids get ready to read.

Gans says, "We found that the children whose homes had the nutrition and physical activity intervention ate better than those whose homes had the reading and literacy readiness intervention." "We also noticed that these kids spent less time sitting than the kids in the literacy group."

Using a Healthy Eating Index score, specialist have researched that the vegetable and added sugar scores improved during the intervention period compared to the literacy group.

Also, Gans says, "We put activity monitors on the kids to keep track of how active they were." "We saw a link between how much time people spent outside and how active they were. The kids were more physically active the more time they spent outside with their caretaker. That changed things."

She also says that a future paper will talk about whether or not the literacy group improved their reading skills more than the group that worked on nutrition and exercise.

Gans says that the family child care providers were very interested in getting an intervention because they wanted to find out more. "We found that the providers cared a lot about the kids' health. They really feel like part of the family, and they want more training so they can do a better job of giving kids healthy food and fun things to do.

During the observations, Gans says, researchers noticed that many homes didn't provide self-serve water for the kids or breaks to get water after playing outside. "Not very many of them told kids to drink water. They had water dispensers on their fridges and other things, but they didn't always try to get the kids to drink water.

Gans says that Drink Well/Bebe Bien is a new study that will look at water intake and access in family child care homes. It is similar to the Healthy Start/Comienzos Sanos study. Researchers are now looking for 40 family child care providers in Connecticut, Massachusetts, and Rhode Island to take part in the study. The study will also include intervention and surveys supplies, such as water testing, water bottles, water filters, and water pitchers.

"There are studies that show kids, especially younger kids, don't get enough water, and people tend to give them too much milk and juice and don't think about water," Gans says. "It's kind of like food. If you get your children getting used to drinking water, they will just keep drinking water. But if they're only used to drinking juice, milk, or soda with added sugar, that's all they'll want to drink in the future."

She makes it clear that this is a widespread problem that isn't limited to family child care homes or even day cares.

"One thing we've learned from this study is that we need to work with the parents, too. Gans says, "If the kids are eating one thing at child care and then getting soda, sweets, and fast food at home, that's not going to help the child." "Really, we need to reach the child in both places."

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