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Barriers and facilitators to obesity prevention dissemination and implementation efforts in the childcare centre
Cynthia N Lebron1, Ashley Ofori2, Krystal Sardinas3
1Department of Public Health, University of Miami Miller School of Medicine, Miami, Florida.
Insights
Childcare providers see benefits in early childhood obesity prevention programs like HC2, but perceive parents as barriers. Understanding these perspectives is key for successful implementation and scalability in diverse, low-income settings.
Area of Science:
- Public Health
- Child Development
- Nutrition Science
Background:
- Childcare centers (CCCs) are suitable settings for promoting healthy weight in children.
- Understanding barriers and facilitators for early childhood obesity prevention from CCC providers' perspectives is crucial for scalability, especially in diverse, low-income populations.
Purpose of the Study:
- To explore childcare providers' perspectives on implementing and disseminating early childhood obesity prevention programs.
- To identify barriers and facilitators to the implementation of the Healthy Caregivers-Healthy Children (HC2) program in childcare settings serving low-resource families.
Main Methods:
- Focus groups were conducted in English and Spanish with providers from six childcare centers (rural and urban).
- The HC2 program, targeting 2- to 5-year-olds from low-resource backgrounds, was implemented in these centers.
- A thematic analysis combining deductive and inductive approaches was used to analyze audio-recorded, transcribed focus group data.
Main Results:
- Childcare providers reported that children understood nutritional benefits and experienced improved cognitive development with HC2.
- Providers identified parents as barriers to implementation, particularly regarding cooperative healthy lifestyle efforts.
- Modeling healthy eating and creating healthy environments in childcare settings facilitated program implementation.
Conclusions:
- Childcare providers offer valuable insights for disseminating and implementing early childhood healthy weight promotion programs.
- While providers value the HC2 program, parental involvement is perceived as a significant barrier.
- Incorporating childcare provider viewpoints is essential for maximizing the scalability and sustainability of obesity prevention efforts in childcare settings, especially for low-resource families.
Background:
It has been established that the childcare centre (CCC) is a setting suitable for healthy weight promotion efforts. As the field advances, it is important to understand the barriers and facilitators to early childhood obesity prevention implementation and dissemination efforts from the CCC providers' perspective. This is especially true among those who serve low-income and diverse populations to maximize scalability success.
Methods:
Focus groups were held in English or Spanish with CCC providers across six CCCs who implemented healthy caregivers-healthy children (HC2), an early childhood healthy weight promotion programme targeting 2- to 5-year-olds from low-resource backgrounds. Centres represented both rural and urban environments. Focus groups were audio recorded, transcribed, and coded. A thematic analysis that combined a deductive and inductive approach was conducted. Codes were analysed using Dedoose to identify general themes and subthemes.
Results:
CCC providers stated that (a) children understood the nutritional benefits of healthy foods; (b) improved cognitive development as a result of HC2; (c) parents were barriers to HC2 implementation efforts, particularly in terms of cooperative healthy lifestyle efforts; and (d) modelling healthy eating and making healthy CCC environmental changes facilitated HC2 implementation. Overall, HC2 was well received by CCC teachers, and they shared creative classroom HC2 adaptions and improvements.
Conclusions:
CCC providers can provide valuable insight to guide early childhood healthy weight promotion programme dissemination and implementation efforts. Although they value the implementation of HC2 programme in their classroom settings, they perceive parents as somewhat obstructive. This information is critical to informing future healthy weight promotion efforts in this setting, especially among low-resource families. It is important to continue to include the CCC provider viewpoint in future obesity prevention efforts to maximize scalability and sustainability efforts.
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