Opportunities to Promote Healthy Weight Through Child Care Licensing Regulations: Trends in the United States, 2016-2020.
J Acad Nutr Diet
; 121(9): 1763-1774.e2, 2021 09.
Article
en En
| MEDLINE
| ID: mdl-33810994
ABSTRACT
BACKGROUND:
Policies that support healthy nutrition and physical activity environments in early care and education (ECE) settings can help promote healthy weight in children. State child care licensing regulations are a critical mechanism for setting such policies.OBJECTIVES:
To develop a research instrument to evaluate the promotion of healthy child weight in state child care licensing regulations and assess the strength of the regulations over time.DESIGN:
For measure development, systematic reviews of evidence on the impact of healthy weight strategies relevant to the ECE environment were combined with expert stakeholder input to identify 15 healthy weight promotion policy standards and a coding tool to measure the strength and comprehensiveness of regulatory language matching these standards. For assessing the strength of regulations, the coding tool was applied to child care regulations nationwide in 2016 and again in 2020. SUBJECTS/SETTING:
Child care licensing regulations in 2016 and 2020 for all 50 US states plus Washington DC. OUTCOMEMEASURES:
Strength and comprehensiveness scores for state licensing regulations. STATISTICAL ANALYSES Intraclass correlation coefficients were calculated to estimate interrater reliability of the coding tool. Paired t tests were used to compare scores within states from 2016 to 2020.RESULTS:
Interrater reliability for the coding tool had intraclass correlation coefficients of 0.81 for strength and 0.87 for comprehensiveness scores. Strength and comprehensiveness of states' healthy weight promotion policies increased significantly over time (P < .001). However, most states still lack important healthy weight policies in their licensing regulations, such as prohibiting serving sugary drinks.CONCLUSIONS:
This study presents a reliable research instrument for measuring the strength and comprehensiveness of healthy weight promotion standards in child care licensing regulations. States have increased their incorporation of strategies for healthy weight into state policy.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cuidado del Niño
/
Salud Infantil
/
Política de Salud
/
Promoción de la Salud
/
Concesión de Licencias
Tipo de estudio:
Prognostic_studies
Límite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Acad Nutr Diet
Año:
2021
Tipo del documento:
Article