title: Nutrition and physical activity policies and practices in family child care homes.
abstract: BACKGROUND
  Family child care homes (FCCHs) are the second-largest provider of nonrelative care in the U.S. However, despite providing care for nearly 1.9 million children aged <5 years, little is known about the nutrition and physical activity practices of FCCHs.
  
  
  OBJECTIVE
  To address this gap, this study aims to describe policies and practices related to nutrition and physical activity in a representative sample of FCCHs.
  
  
  METHODS
  A stratified random sample of registered FCCHs operating in Kansas (N=297) completed the Nutrition and Physical Activity Self Assessment for Child Care (NAPSACC) instrument. Prevalence estimates and 95% CIs for meeting or exceeding accepted child care standards were calculated using SAS PROC SURVEYFREQ.
  
  
  RESULTS
  Most providers either met or exceeded child care standards related to serving fruit and vegetables and provision of daily physical activity. Very few providers reported serving fried meats or vegetables or unhealthy snack foods on a regular basis. Areas of concern included infrequent servings of low-fat milk, frequent use of unhealthy foods for celebrations, widespread use of TV and video games throughout the day, restricting physical activity for children who misbehave, and lack of appropriate indoor spaces for physical activity. Only a small percentage of providers reported receiving regular training in nutrition or physical activity. Relatively few providers had written guidelines on nutrition or physical activity.
  
  
  CONCLUSIONS
  Some strengths were exhibited by FCCHs, but substantial weaknesses were shown with respect to meeting established child care standards for nutrition and physical activity. Interventions to promote healthy eating and regular physical activity in FCCHs are thus warranted.
authors: Department of Nutrition and Exercise Sciences, Oregon State University, Corvallis, Oregon 97331, USA. stewart.trost@oregonstate.edu
authors: Stewart G
authors: SG
authors: Trost
authors: Lana
authors: L
authors: Messner
authors: Karen
authors: K
authors: Fitzgerald
authors: Barbara
authors: B
authors: Roths
mesh_terms: D002654:Child Care; D002675:Child, Preschool; D003625:Data Collection; D015444:Exercise; D005247:Feeding Behavior; D006801:Humans; D007615:Kansas; D015596:Nutrition Assessment; D016134:Organizational Policy; D011998:Recreation