PA Nutrition and Physical Activity Self-Assessment for Child Care: Implementing change in nutrition and physical activity in early childhood education centers

‘LiveHealthyPA’, funded by CDC, is a multiple domain approach anchored to the social-ecological model to address chronic diseases in Pennsylvania. Our initiative uses strategies to affect change at the organizational, community and public policy levels.   One of our policy change interventions was implemented within early childhood education centers (ECEs, hereafter) to improve healthy eating and physical activity within preschool children.  In year one, 29 ECEs serving 1,447 preschool children in numerous Health Districts participated in the PA Nutrition and Physical Activity Self-Assessment for Child Care (PA-NAP-SACC).  As ECEs adopted policy changes, the NAP-SACC self-assessment provided staff with a continuous quality improvement tool to assess strengths and weaknesses.  Through these self-assessments, ECE staff continued to improve upon the nutritional and physical activity environment for children.   ECEs were scored on a 13 nutritional and physical activity areas.  ECEs scored highest on: N2- serving leaner meats, whole grain foods, and lower fat foods (88%); N3- serving 100% fruit juice, drinking water, and milk (83%); N4- maintaining a feeding environment where teachers serve as role models in healthy eating, TV/video viewing in not allowed, and educational content is available about healthy and unhealthy foods (80%).  ECEs scored lowest on: N-7 establishing formal written policies on child nutrition (62%); PA-1 establishing sufficient time for physical activity each day (65%); and PA-5 establishing formal written policies on physical activity (69%). The authors discuss the self-assessment findings within the context of ECE staff reported barriers/supports for implementing change in nutrition and physical activity for preschool children.