Association of the Quality Rating and Improvement System, Texas Rising Star, on Physical Activity and Screen Time Policies and Practices in Texas Child Care Centers.

PURPOSE: Quality rating and improvement systems (QRIS) are systems approaches to assist states in providing high quality early childhood education. Texas Rising Star (TRS), a voluntary QRIS, exceeds state licensing standards and meets some obesity prevention guidelines. This study examines differences in physical activity, screen time, and outdoor policies and practices by QRIS certification. DESIGN: Cross-sectional. SETTING: Online. SAMPLE: After exclusion criteria, respondents were 431 Texas childcare centers. MEASURES: 2016 survey of policies and Go NAPSACC best practices. ANALYSIS: Chi-square and t-tests indicated differences in 1) practices and 2) policies by QRIS status. RESULTS: TRS-certified centers reported more policies for physical activity (M = 4.57 ± 3.07 vs. 3.61 ± 2.95, p = 0.009) and screen time (M = 1.91 ± 1.84 vs. 1.28 ± 1.56, p < 0.001) than non-certified centers. TRS-certified centers reported significantly higher frequencies for 7 of 14 physical activity practices, however no significant differences for screen time practices were found. Additionally, TRS-certified centers reported more outdoor practices, including more classrooms/storage (p < 0.001) and vegetable gardens (p = 0.025). CONCLUSION: TRS-certified centers reported more physical activity policies and practices, more screen time policies, and more outdoor practices. TRS certification was not associated with screen time practices. QRIS can be a practical way to insert obesity prevention in early care and education. Using items from a widely used survey enables comparisons, however future research is needed in larger-scale studies. Some COVID-19 implications are discussed.