Family child care providers' compliance with state physical activity regulations, Delaware Child Care Provider Survey, 2011.

INTRODUCTION: Delaware is one state that has implemented comprehensive child care regulations to foster healthy dietary and physical activity behaviors of young children. This study describes the Delaware family child care environment and providers' knowledge of and compliance with physical activity regulations. We analyzed the data to determine characteristics associated with predictors of knowledge of and compliance with these regulations. METHODS: A random stratified sample of 663 licensed Delaware family child care providers was mailed a survey on family child care characteristics and providers' awareness and practices of the child care regulations. Three logistic regression models were used to explore the association between provider characteristics and their knowledge of and compliance with the regulations. RESULTS: Ultimately, 313 of the 663 eligible family child care providers participated in the survey (47.2% response rate). Controlling for covariates, we found that family child care providers' education level was significantly associated with knowledge of the physical activity regulation. Another model showed that family child care providers with larger amounts of outdoor space were more likely to report compliance with the recommendation for unstructured physical activity than those without this described space (odds ratio, 2.45). A third model showed a significant association between available indoor space for all activities including running and reported greater compliance with the recommendation for structured physical activity than was reported by caregivers with less indoor space (odds ratio, 11.2). CONCLUSION: To provide the recommended levels of physical activity for children in child care, the available physical space environment is an important area of focus for advocates of physical activity recommendations within the family child care environment.

Preparing Leaders in Maternal-Child Health Nursing.

OBJECTIVE: To describe leadership and patient outcomes from an international leadership development program undertaken by a nursing organization (Sigma Theta Tau International Honor Society of Nursing) in partnership with Johnson & Johnson Corporate Contributions to strengthen the leadership base of maternal-child bedside nurses. DESIGN: Pretest/posttest design with no control group program evaluation. SETTING: Health care facilities, academic institutions, and public health clinics. PARTICIPANTS: Mentor/fellow dyads (N = 100) of the Maternal-Child Health Nurse Leadership Academy (MCHNLA). INTERVENTION/MEASUREMENTS: The MCHNLA engaged participants in an 18-month mentored leadership experience within the context of an interdisciplinary team project. Each mentor/fellow dyad was paired with a faculty member during the program. RESULTS: One hundred dyads have participated and conducted projects to improve health care for childbearing women and children up to age 5 years during the past decade. For the two cohorts for which consistent data were obtained, mentors and fellows enhanced leadership knowledge, skills, and behaviors. Review of 2010 to 2011 cohort project reports revealed they had the potential to influence more than 1000 students, 4000 nurses, and 1300 other health care students or professionals during the project period. CONCLUSIONS: This leadership development model is replicable in other areas of nursing and other professions.