obesity prevention needs and readiness among early ......ward d, morris e, mcwilliams c, vaughn a,...
TRANSCRIPT
A Statewide Assessment of
Obesity Prevention Needs and Readiness among Early Childhood Education Sites
Theresa LeGros MA,1 Laurel Jacobs DrPH MPH,1 Kathryn Orzech PhD,1 Noelle Veilleux RDN2
1The University of Arizona, Department of Nutritional Sciences 2Arizona Department of Health Services, Bureau of Nutrition and Physical Activity
BackgroundThe USDA’s Supplemental Nutrition Assistance Program-Education
(SNAP-Ed) promotes obesity prevention programming in Early
Childhood Education centers (ECEs). In Arizona, SNAP-Ed local
implementing agencies (“agencies”) support nutrition and physical
activity in ECEs with a combination of policy, systems, and
environmental (PSE) improvements and direct education. These efforts
align with the state’s Empower program,1 which offers discounted
licensing fees for ECEs that agree to implement wellness standards.
Conclusion
Objective
This statewide assessment
describes needs, barriers,
and opportunities related
to the nutrition and physical
activity policies and
procedures of Arizona’s
SNAP-Ed qualifying ECEs.
We assessed needs and readiness among Arizona’s SNAP-Ed qualifying ECEs using mixed methods:
ARIZONA DEPARTMENT OF HEALTH SERVICES
Empower ProgramSNAP-Ed Program
• Nutrition PSE Support
• Physical Activity PSE Support
• Direct Education
• Discounted Licensing Fees
• 6 Wellness Standards for
Nutrition & Physical ActivityObesity Prevention
in Arizona ECEs
OPPORTUNITIES
QUANTITATIVE DATA
We trained SNAP-Ed agencies
in 10 Arizona counties to use the
Go NAP SACC Child Nutrition
and Infant & Child Physical
Activity2 instruments to collect
information related to ECEs’
current practices and policies.
Descriptive statistics were used
to summarize data.
QUALITATIVE DATA
At the project close, we
collected written narrative
reports of agency experiences
with ECEs and held a debrief
with agency staff who
completed Go NAP SACCs.
Nvivo 10.0 software was used
for coding and theme analysis.
Go NAP SACC
Scores
Narrative
Reports &
Debrief
Data
Triangulation References
Results
1
2Ward D, Morris E, McWilliams C, Vaughn A, Erinosho T, Mazzuca S, Hanson P, Ammerman A, Neelon S, Sommers J, Ball S. (2014) Go NAP SACC: Nutrition and Physical
Activity Self-Assessment for Child Care, 2nd Edition. Center for Health Promotion and Disease Prevention and Department of Nutrition, University of North Carolina at
Chapel Hill. Available at: www.gonapsacc.org.
The USDA is an equal opportunity employer.
Empower Guidebook, Third Edition: Ten Ways to Empower Children to Live Healthy Lives, Standards for Empower Child Care Facilities in Arizona. Available at:
http://azdhs.gov/documents/prevention/nutrition-physical-activity/empower/resources-policies/empower-guidebook.pdf.
38%
27%
27%8%
Competing demands on ECE
ECE staff turnover or closings
Agency staff turnover or lack of capacity
Cannot systematically track ECEs
“The [ECE] is already highly inspected, required to
meet multiple standards and submit numerous
detailed reports… they are NAC accredited, ADHS
licensed, EMPOWER registered, and a designated
First Things First site.”
Agencies collected Go NAP SACC assessments from 40 ECEs in 10
counties. Triangulated data revealed these emergent themes:
• Greater need for physical activity vs. nutrition support. Lower physical activity scores
(Figures 1a,b) were corroborated by narrative reports (Figure 2).
• Recognized need for family education and professional development of ECE staff
(Figures 1,2). Narratives revealed that ECEs sought training specific to Empower
standards but that barriers sometimes inhibited progress (Figure 3).
• Unrecognized need for improved policy. The need to improve written ECE policies
identified in Figures 1a,b was not addressed in narrative reports.
53%
22%
14%
4%7%Education & professional
development
Improvements to PA
practices/environments
Improvements to nutrition
practices/environments
Establishing or improving
written policies
Unspecified
FIGURE 2. REFERENCES TO ECE NEEDS BY SNAP-ED AGENCIES,
N=77
“Administrators were familiar with
Empower, solely based on the licensure
discount, but not a single individual was
specifically familiar with the standards.”
This study revealed a need to improve written policies, family education, and professional staff
development at ECEs. When ECE time and resources are limited, Arizona’s SNAP-Ed agencies may wish
to prioritize physical activity programming and Empower Trainings.
MIXING METHODS
After all analyses were completed, quantitative and qualitative findings were triangulated to identify ECEs’
wellness-related needs, barriers, and opportunities.
FIGURE 3. REPORTED BARRIERS TO COLLABORATION BETWEEN
ECES AND SNAP-ED AGENCIES, N=48
3.4
3.5
3.7
3.5
3.5
3.6
3.2
2.8
0 1 2 3 4
All Sections
Foods Provided
Beverages Provided
Feeding Environment
Feeding Practices
Menus & Variety
Ed & Prof Development
Policy
FIGURE 1A. MEAN GO NAP SACC
CHILD NUTRITION SCORES, N=34
3.3
2.9
3.3
3.5
3.3
3
0 1 2 3 4
All Sections
Time Provided
Indoor Play Environment
Teacher Practices
Ed & Prof Development
Policy
FIGURE 1B. MEAN GO NAP SACC
INFANT & CHILD PHYSICAL ACTIVITY
SCORES, N=34
1 = weakest practice, 4 = best practice
RED: < 3.0 ORANGE: 3.1-3.4 GREEN: > 3.5