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most frequently selected by participants. Given that providers perceive lack of support from parents as challenges in creating healthy practices or routines and creating written rules or guidelines, it is possible that providers are seeking resources to address the challenge of lack of parental support in order to implement positive changes in their child care programs.
Economics and Marketing. One third (33.1%) of participants indicated that creating healthy practices or guidelines in their programs increased their costs, while 5.5% reported that creating healthy practices and guidelines decreased their costs. However, only 12.4% charge more or are considering charging more. Specific factors leading to increased costs are not known but worth exploring to help providers implement and sustain healthy practices and policies in their programs without an added burden of cost.
About a fifth of participants used program information in their marketing and over three quarters shared rules and guidelines with parents. The majority (73.0%) reported that parents were generally positive about the rules and guidelines for healthy practices of their program and 35.1% saw an increased interest in their child care program.
Recommendations for the future are included in the Conclusions and Recommendations section of this report.
 Improving Health in Child Care Settings: 2016 6

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