Physical Activity Practices, Policies and Environments in Washington State Child Care Settings: Results of a Statewide Survey.

Objectives Child care is an important setting for the promotion of physical activity (PA) in early childhood. The purpose of this study was to examine the associations between specific PA environments and recommended practices in child care settings as well as the degree to which child care settings met recommended standards for total PA time. Methods In 2013, all programs licensed to care for children ages 2-5 in WA state were surveyed about their PA related practices. Logistic regression was used to determine odds of meeting best-practice standards for outdoor time and PA. Results The response rate was 45.8 % from centers (692/1511) and 32.1 % from homes (1281/3991). Few programs reported meeting best-practice standards for the amount of time children spend being physically active (centers: 12.1 %, homes: 20.1 %) and outdoor time (centers: 21.8 %, homes: 21.7 %). Programs where children go outside regardless of weather and those reporting more adult-led PA had higher odds of meeting best-practice standards for both PA and outdoor time. Meeting best-practice standards for outdoor time was the strongest predictor of meeting best-practice standards for total PA time [centers: OR 15.9 (9.3-27.2), homes: OR 5.2 (3.8-7.1)]. Conclusions for Practice There is considerable room for improvement in licensed child care settings in WA to meet best-practice standards for young children's outdoor and PA time. Initiatives that create policies and environments encouraging outdoor play and adult-led PA in child care have the potential to increase physical activity in substantial numbers of young children.

Assessment of Healthy Food Availability in Washington State-Questioning the Food Desert Paradigm.

OBJECTIVE: To assess the geographic distribution of healthy food retailers in Washington State and estimate the number of Washington State residents with restricted availability of healthy food. METHODS: Street network service areas were drawn around Special Supplemental Nutrition Program for Women, Infant, and Children retailers for multiple drive times and walking distances in urban and rural Washington State. Population characteristics inside and outside each service area were examined. RESULTS: Nearly all Washington State residents in urban areas lived within a 10-minute drive of a Special Supplemental Nutrition Program for Women, Infant, and Children retailer. Among rural residents, 4.6% were in census blocks outside a 20-minute drive, but the populations were dispersed. Differential access related to income was attributable to a lack of transportation. CONCLUSIONS AND IMPLICATIONS: Disparities in nutrition described in the published literature may not be due to the geographic distribution of healthy food retailers. Programs for improving nutrition should consider broader interventions to increase access to healthy food.