Multisector Approach to Improve Healthy Eating and Physical Activity Policies and Practices in Early Care and Education Programs: The National Early Care and Education Learning Collaboratives Project, 2013-2017.

PURPOSE AND OBJECTIVES: Embedding healthy eating and physical activity best practices in early care and education settings is important for instilling healthy behaviors early in life. A collaborative partnership between Nemours Children's Health System and the Centers for Disease Control and Prevention was created to implement the National Early Care and Education Learning Collaboratives Project (ECELC) in childcare settings in 10 states. We measured improvement at the program level by the self-reported number of best practices implemented related to healthy eating and physical activity. INTERVENTION APPROACH: The ECELC implemented a collaborative model with state-level partners (eg, child care resource and referral networks) and early care and education programs. Intervention components received by program directors and lead teachers included 1) self-assessment, 2) in-person learning and training sessions, 3) action planning and implementation, 4) technical assistance, and 5) post-reassessment. EVALUATION METHODS: A pre-post design assessed self-reported policies and practices related to breastfeeding and infant feeding, child nutrition, infant and child physical activity, screen time, and outdoor play and learning as measured by the validated Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) best practices instrument. The sample included 1,173 early care and education programs. RESULTS: The number of best practices met for each of the 5 NAP SACC areas increased from pre-assessment to post-assessment approximately 6 months later and ranged from 1.5 to 4.7 best practices (P < .001). Almost all increases occurred regardless of participation in the Child and Adult Care Food Program, Quality Rating Improvement System, Head Start/Early Head Start, and/or accreditation status. IMPLICATIONS FOR PUBLIC HEALTH: The innovative and collaborative partnerships led to broad implementation of healthy eating and physical activity-based practices in early care and education settings. Development, implementation, and evaluation of policy and practice-based partnerships to promote healthy eating and physical activity among children attending early care and education programs may contribute to obesity prevention in the United States.

Effectiveness in adapting the implementation of the Early Care and Education Learning Collaboratives Project (ECELC) using real-world conditions.

The National Early Care and Education Learning Collaboratives Project (ECELC) was a multistate intervention that was highly effective in implementing best practices for healthy eating physical activity (HEPA) in early care and education (ECE) programs across the USA. The ECELC included didactic in-person learning sessions, technical assistance, and self-assessment-guided action planning. This study aimed to describe the effectiveness of adaptions to the self-assessments, learning sessions, and overall support, and also aimed to compare the effectiveness of each to the Original ECELC Model, when applicable. This study utilized a pre-poststudy design using data collected via the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) instrument for ECE programs that adapted the Original ECELC Model. Adaptations to the Original ECELC Model were found to promote best practices and policies with regard to Breastfeeding & Infant Feeding, Child Nutrition, Infant & Child Physical Activity, Outdoor Play & Learning, and/or Screen Time as demonstrated by the NAP SACC (p < .05), with some exceptions of nonstatistically significant increases. Improvements were found to be statistically similar to improvements made among participants of the Original ECELC Model. Partner-driven, scalable, and customizable policy- and practice-based interventions to promote HEPA among children in ECE settings may serve as a key strategy to work toward reducing risk for childhood obesity.