Adoption of Nutrition and Physical Activity Best Practices in the Early Care and Education Setting: Examination of Differences Between Centers and Family Child Care Homes.

Background: Early childhood interventions that support the development of healthy lifestyle behaviors are key to ensuring equitable health outcomes later in life. The aim of this article is to assess the extent to which early care and education (ECE) sites adopt best practices to support healthy diet and physical activity (PA) behaviors and whether adoption differs between centers and family child care homes (FCCHs). Methods: The study is a cross-sectional analysis of best practices at Supplemental Nutrition Assistance Program-Education (SNAP-Ed)-eligible child care centers (n = 76) and FCCHs (n = 47) in California. Generalized linear models were used to estimate associations of facility type with eight best practice index measures in the following three areas: dietary intake (nutrition education, food and beverage quality, staff training in nutrition), PA (quantity of PA opportunities, quality of PA opportunities, environmental support for PA), and parent engagement and wellness policies (comprehensive, active parent engagement and support for wellness policy implementation, monitoring, and feedback). Results: Overall, ECE sites scored an average of 64.8% of maximum points possible for best practices to improve dietary intake, 81.7% for best practices to improve PA, and 51.8% in comprehensive parent engagement and wellness policies. FCCHs adhered to fewer best practices for robust nutrition education, relative to centers (β = -0.41, 95% CI [-0.70, -0.12]). Differences were also observed in individual practices between settings. Conclusion: This study highlights opportunities for programs such as SNAP-Ed to support ECE providers in implementing nutrition and PA best practices to help children ages 0-5 develop healthy habits.