title: Comparing the nutrition environment and practices of home- and centre-based child-care facilities.
abstract: OBJECTIVE
  To assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities.
  
  
  METHODS
  Using a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered.
  
  
  METHODS
  Child-care facilities in London, Ontario, Canada.
  
  
  METHODS
  Child-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes.
  
  
  RESULTS
  The mean total nutrition environment EPAO scores for centre- and home-based facilities were 12·3 (sd 1·94) and 10·8 (sd 0·78) out of 20 (where a higher score indicates a more supportive environment with regard to nutrition), respectively. The difference between the total nutrition environment EPAO score for centre- and home-based facilities was approaching significance (P=0·055). For both types of facilities, the highest nutrition subscale score (out of 20) was achieved in the staff behaviours domain (centre mean=17·4; home mean=17·0) and the lowest was in the nutrition training and education domain (centre mean=3·6; home mean=2·0).
  
  
  CONCLUSIONS
  Additional research is needed to confirm these findings. In order to better support child-care staff and enhance the overall nutrition environment in child care, modifications to food practices could be adopted. Specifically, the nutritional quality of foods/beverages provided to pre-schoolers could be improved, nutrition-related training for child-care staff could be provided, and a nutrition curriculum could be created to educate pre-schoolers about healthy food choices.
authors.affiliation: 1Health and Rehabilitation Sciences, Faculty of Health Sciences,University of Western Ontario,London,Ontario,Canada.
authors.forename: Olivia J M
authors.initials: OJ
authors.lastname: Martyniuk
authors.affiliation: 1Health and Rehabilitation Sciences, Faculty of Health Sciences,University of Western Ontario,London,Ontario,Canada.
authors.forename: Leigh M
authors.initials: LM
authors.lastname: Vanderloo
authors.affiliation: 2School of Health Studies, Faculty of Health Sciences,University of Western Ontario,London,Ontario,Canada.
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Irwin
authors.affiliation: 2School of Health Studies, Faculty of Health Sciences,University of Western Ontario,London,Ontario,Canada.
authors.forename: Shauna M
authors.initials: SM
authors.lastname: Burke
authors.affiliation: 3School of Occupational Therapy, Faculty of Health Sciences,University of Western Ontario,1201 Western Road,Elborn College,Room 2547,London, ON,Canada,N6G 1H1.
authors.forename: Patricia
authors.initials: P
authors.lastname: Tucker
mesh_terms: D017028:Caregivers / Q000193:education; D002654:Child Care; D002656:Child Day Care Centers; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D004777:Environment; D005247:Feeding Behavior; D005522:Food Services; D006266:Health Education; D006801:Humans; D009753:Nutritive Value; D009864:Ontario
keywords: Child-care environment; Child-care staff practices; Nutrition; Pre-school children