Relevant Research/Reports Relating to Child Care
First Lady Michelle Obama unveiled her “Let’s Move” campaign against childhood obesity on February 9, 2010. The program’s main antiobesity strategies are empowering parents and consumers by revamping the nutritional labeling of products by the U.S. Department of Agriculture (USDA), improving the nutritional standards of the National School Lunch Program, increasing children’s opportunities for physical activity, and improving access to high-quality foods in all U.S. communities (www.letsmove.gov). This innovative multifactorial approach has potential for altering the course of the childhood obesity crisis — changing our country’s approach to eating, nutrition, and physical activity by simultaneously targeting individuals, neighborhoods, and larger communities. Current data on obesity in school-age children are sobering. Almost one third of U.S. children over 2 years of age are already overweight or obese, according to the 2007–2008 National Health and Nutrition Examination Survey, and among low-income children 2 to 5 years of age who are enrolled in federally funded health programs, the proportions range as high as 39% . But systematic reviews indicate that, at best, behavioral and nutrition interventions in schools or within the home have limited success in preventing weight gain in children. At as early as 3 years of age, obese children have elevated levels of inflammatory markers that have been linked to heart disease that is manifested later in life. To be a truly comprehensive and successful program, then, the Let’s Move campaign must stimulate prevention efforts targeting the youngest Americans — those under 2 years of age and preschoolers. Indeed, prevention must start as early as possible, since school-age children already have an unacceptably high prevalence of obesity and associated medical conditions.
- National Governer’s Association. (2010). Shaping a Healthier Generation: Healthy Kids, Healthy America State Profiles in Progress. Washington, D.C. John Thomasian. Retrieved from: http://www.nga.org/Files/pdf/1003HEALTHYKIDSPROFILES.PDF
Through the Healthy Kids, Healthy America program, the NGA Center supported 15 states as they worked to develop policies to prevent childhood obesity. The recognizable progress of each of these states is detailed in this report. Strategies used by the states, and assessed in the report, are grouped into three main categories: child care settings; policy planning and prioritization; and school-based efforts. Tennessee and Kentucky are highlighted for their efforts in child care settings.
- New Resources Analyze What Child-Care Setting Are, and Are Not, Doing to Provide Children With Healthy Foods and Opportunities for Physical Activity: Today more than 24 percent of U.S. children ages 2 to 5 are overweight or obese. Because almost three quarters of children ages 3 to 6 attend some form of child care, such settings have an important role to play in ensuring children have access to healthy foods and opportunities for physical activity from a young age. Two RWJF studies examine the opportunities for healthy eating and physical activity in child-care settings.a. Benjamin SE, Cradock A, Walker EM, Slining M, Gillman MW. Obesity prevention in child care: a review of US state regulations. BMC Public Health. 2008;8:188. http://cfm.mc.duke.edu/wysiwyg/downloads/State_Report-MD.pdf
A collection of state-by-state ratings of child-care settings, Preventing Obesity in the Child-Care Setting: Evaluating State Regulations, has less encouraging findings regarding state regulations. The report examines policies regulating healthy eating and physical activity in child-care settings in all 50 states, the District of Columbia, Puerto Rico, the Virgin Islands and Department of Defense programs, comparing them to model regulations. It found that many states could be doing more to support healthy eating and physical activity in child care, but also that making such changes should be straightforward given widespread agreement among experts on the model regulations.
b. Whitaker RC, Gooze RA, Hughes CC and Finkelstein DM. A National Survey of Obesity Prevention Practices in Head Start. Archives of Pediatrics & Adolescent Medicine, 2009. 163(12), pp.1144-1150. http://archpedi.ama-assn.org/cgi/content/short/163/12/1144?home
An RWJF-funded study published recently in the Archives of Pediatrics and Adolescent Medicine finds that the majority of the nation’s Head Start programs report doing more to support healthy eating and physical activity among children than is required by existing federal regulations. For instance, 70 percent of programs reported serving only non-fat or 1 percent fat milk, and three quarters of programs reported providing children with at least half an hour of adult-led physical activity each day.
Early care and education can prepare children for school, but while some preschool and child care programs do an excellent job, others are inadequate and some may even harm healthy development. This study focuses on child care center directors to better understand why there is so much variation, and how public initiatives can better help poor-quality programs improve. Using data from in-depth interviews and classroom observations, the research considers how various factors—including director and program characteristics, market forces, and federal state and local policies—are associated with each other, director decision making, and program quality.
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