title: An assessment of nutrition practices and attitudes in family child-care homes: implications for policy implementation.
abstract: BACKGROUND
  Family child-care homes (FCCHs) provide care and nutrition for millions of US children, including 28% in Rhode Island. New proposed regulations for FCCHs in Rhode Island require competencies and knowledge in nutrition. We explored nutrition-related practices and attitudes of FCCH providers in Rhode Island and assessed whether these differed by provider ethnicity or socioeconomic status of the enrolled children.
  
  
  METHODS
  Of 536 licensed FCCHs in Rhode Island, 105 randomly selected FCCH providers completed a survey about provider nutrition attitudes and practices, demographics of providers, and characteristics of the FCCH, including participation in the federal Child and Adult Care Food Program (CACFP). No differences between CACFP and non-CACFP participants were found; responses were compared by provider ethnicity using χ(2) tests and multivariate models.
  
  
  RESULTS
  Nearly 70% of FCCHs reported receiving nutrition training only 0 to 3 times during the past 3 years; however, more than 60% found these trainings to be very helpful. More Hispanic than non-Hispanic providers strongly agreed to sitting with children during meals, encouraging children to finish their plate, and being involved with parents on the topics of healthy eating and weight. These differences persisted in multivariate models.
  
  
  CONCLUSIONS
  Although some positive practices are in place in Rhode Island FCCHs, there is room for improvement. State licensing requirements provide a foundation for achieving better nutrition environments in FCCHs, but successful implementation is key to translating policies into real changes. FCCH providers need culturally and linguistically appropriate nutrition-related training.
authors.affiliation: Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island 02881. Email: alison_tovar@mail.uri.edu.
authors.forename: Alison
authors.initials: A
authors.lastname: Tovar
authors.affiliation: Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, and Human Development and Family Studies Department and Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut.
authors.forename: Patricia
authors.initials: P
authors.lastname: Risica
authors.affiliation: Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island.
authors.forename: Noereem
authors.initials: N
authors.lastname: Mena
authors.affiliation: Chronic Disease Prevention and Control Initiative, Rhode Island Department of Health, Providence, Rhode Island.
authors.forename: Eliza
authors.initials: E
authors.lastname: Lawson
authors.affiliation: Office of Minority Health, Rhode Island Department of Health, Providence, Rhode Island.
authors.forename: Angela
authors.initials: A
authors.lastname: Ankoma
authors.affiliation: Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, and Human Development and Family Studies Department and Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Gans
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002648:Child; D002654:Child Care / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005247:Feeding Behavior / Q000208:ethnology / Q000523:psychology*; D005260:Female; D063105:Food Assistance / Q000706:statistics & numerical data; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006284:Health Plan Implementation; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D033181:Information Dissemination; D008297:Male; D015999:Multivariate Analysis; D018673:Nutrition Policy; D009749:Nutrition Surveys; D052756:Nutritional Sciences / Q000193:education; D016487:Parenting / Q000208:ethnology / Q000523:psychology; D063766:Pediatric Obesity / Q000517:prevention & control; D012237:Rhode Island; D012923:Social Class; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors