Development of a Community Coalition to Influence Nutrition and Physical Activity in Early Childhood Education.

BACKGROUND: Recognizing insufficient support for healthy eating and physical activity in early childhood education centers in Greenville, South Carolina, a group of stakeholders formed a workgroup as an organizing structure. Members developed and implemented a 2-year community-based participatory research initiative aimed at nutrition and physical activity policy, systems and environment change in 10 early childhood education centers. OBJECTIVES: This article 1) describes engagement efforts and partnerships leading to formation of the workgroup and initiative, 2) presents data on Workgroup members' knowledge and engagement, and 3) shares lessons learned. METHODS: Workgroup member knowledge and engagement related to obesity prevention was measured at two time points during the ECE initiative using the "Stakeholder-driven Community Diffusion Survey." LESSONS LEARNED: Knowledge and engagement scores increased over the measurement period. Scores for engagement were higher than scores for knowledge at both time points. There was a substantial increase in perceived leadership and stewardship, knowledge of intervention factors and how to intervene sustainably, and understanding of local resources and roles. An important strength was stakeholder buy-in and ownership of planning and implementation processes.

LiveWell in early childhood: results from a two-year pilot intervention to improve nutrition and physical activity policies, systems and environments among early childhood education programs in South Carolina.

BACKGROUND: Early childhood education (ECE) settings are critical intervention targets for obesity prevention. This study evaluated a pilot two-year community-based participatory research (CBPR) project designed to assist ECE center directors and caregivers in policy, systems and environmental (PSE) change for improving healthy eating (HE) and physical activity (PA). METHODS: A two-year CBPR study was conducted in 10 licensed ECE centers in Greenville, South Carolina. The intervention consisted of five steps: [1] baseline data collection and self-assessment using the Nutrition and Physical Activity Self-Assessment for Child Care (Go-NAP SACC), [2] tailored goal setting and action planning, [3] technical assistance and access to resources, [4] post intervention data collection and re-assessment, and [5] celebration of success. Main outcome measures (HE and PA environments, practices and policies) were assessed using the Environment and Policy Assessment and Observation (EPAO) tool at baseline and 24 months. One classroom of 3-5-year-olds was randomly selected for observation from each center (mean of 12 children per classroom). Means and standard deviations were calculated for total PA, total nutrition and each subscale of PA and nutrition. Paired sample t-tests were calculated to assess changes in EPAO scales from baseline to post intervention. RESULTS: Ten ECE centers enrolled in the pilot study and eight completed the two-year intervention. Center-based goals were accomplished across all 8 ECE centers over the two-year intervention: 16 child nutrition goals, 6 outdoor play goals, 11 physical activity goals and 8 screen time goals across the entire sample. Nutrition policy and PA policy significantly improved (p < 0.05), with greater improvements in PA (10.0 point increase, p = .048) as compared to nutrition (3.3 point increase, p = 0.02). CONCLUSIONS: Utilizing a CBPR approach, this two-year nutrition and PA PSE intervention in ECE centers improved ECE center HE and PA policies.