title: How local and state regulations affect the child care food environment: A qualitative study of child care center directors' perspectives.
abstract: Almost one-third of preschoolers spend regular time in child care centers where they can consume the majority of their daily dietary intake. The child care setting influences children's dietary intake. Thus, it is important to examine factors, such as local and state regulations, that influence the food environment at the center. This qualitative study explored directors' perceptions of how regulations influence the foods available at child care centers. Ten directors of centers in Travis County, Texas completed semi-structured interviews. Directors reported that changes in local health department regulations (e.g., kitchen specifications) result in less-healthful foods being served (e.g., more prepackaged foods). Directors of centers that do not participate in the federal Child and Adult Care Food Program (CACFP) said the state licensing regulations clarify the portion size and nutritional requirements for preschoolers thereby improving the nutritional quality of the food served. Directors of centers participating in CACFP said they are not affected by state mandates, because the CACFP regulations are more stringent. These findings suggest that state regulations that specify and quantify nutritional standards may beneficially impact preschoolers' diets. However, local health department regulations enacted to improve food safety may negatively influence the nutritional value of food served in centers.
authors.affiliation: Michael and Susan Dell Foundation and National Cancer Institute (Post-doctoral Fellowship, University of Texas School of Public Health Cancer Education and Career Development Program - National Cancer Institute/NIH Grant #2 R25 CA57712).
authors.forename: C E
authors.initials: CE
authors.lastname: Byrd-Williams
authors.affiliation: Michael and Susan Dell Foundation and National Cancer Institute (Post-doctoral Fellowship, University of Texas School of Public Health Cancer Education and Career Development Program - National Cancer Institute/NIH Grant #2 R25 CA57712).
authors.forename: E J
authors.initials: EJ
authors.lastname: Camp
authors.affiliation: Michael and Susan Dell Foundation and National Cancer Institute (Post-doctoral Fellowship, University of Texas School of Public Health Cancer Education and Career Development Program - National Cancer Institute/NIH Grant #2 R25 CA57712).
authors.forename: P D
authors.initials: PD
authors.lastname: Mullen
authors.affiliation: Michael and Susan Dell Foundation and National Cancer Institute (Post-doctoral Fellowship, University of Texas School of Public Health Cancer Education and Career Development Program - National Cancer Institute/NIH Grant #2 R25 CA57712).
authors.forename: M E
authors.initials: ME
authors.lastname: Briley
authors.affiliation: Michael and Susan Dell Foundation and National Cancer Institute (Post-doctoral Fellowship, University of Texas School of Public Health Cancer Education and Career Development Program - National Cancer Institute/NIH Grant #2 R25 CA57712).
authors.forename: D M
authors.initials: DM
authors.lastname: Hoelscher
keywords: Early childhood education; early care and education; food service; nutrition