Serving Their Needs: A Qualitative Examination of Nutrition Policy Implementation in the Early Care and Education Setting

Background: ​Childhood obesity is a growing problem in the United States and results in increased risk for chronic diseases such as diabetes, heart disease, and hypertension. Thirteen percent of youth in Georgia are obese. Identifying strategies to assist children in establishing healthy habits is essential to reduce the risk of childhood obesity. The Early Care and Education (ECE) setting is ideal for the implementation of obesity prevention practices. However, there are barriers present for implementing nutrition policies in this setting. This report explores the implementation of food and beverage best practices in the ECE setting and highlights barriers to and facilitators for adopting these policies. Methods: ​We conducted 24 interviews and 6 focus groups with ECE program directors and teachers in 6 regions in Georgia. The statewide sample included directors from child care learning centers, family child care homes, and license-exempt programs. A trained qualitative researcher facilitated focus groups and interviews. Data were audio recorded and transcribed verbatim. Qualitative data analysis software, NVivo 10, was used to code data and identify emergent themes. Results: ​Several key themes related to barriers to food and beverage policy implementation emerged including the need for: 1) enhanced parent communication, 2) resources to limit juice consumption, and 3) financial support to decrease food costs. Facilitators of nutrition policy implementation included: 1) ease of access to water, 2) children’s preferences for fruits and vegetables, and 3) availability of existing nutrition resources. Findings will inform the development of resources to support nutrition policy implementation as well as policy training for ECE teachers in Georgia. Conclusions: ​Study themes may provide insight about how to improve current resources and develop new solutions to improve adoption and implementation of nutrition policies in the ECE setting in the future.