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group differences were found in level of preparedness to change for any of the questions. It may be that the one or two sessions did not provide enough program intensity to result in group differences. Past research conducted at the Child Care Resource Center has shown that it takes a minimum of six coaching sessions and six months for changes to the child care environment to be seen. It is recommended therefore that future program design include a higher level of coaching intensity to be able to evaluate its effectiveness.
Knowledge Change
To what extent does knowledge change as a result of the program and does coaching make a difference? Does it differ by care type?
Questions 37a-37e asked participants “In your opinion, how much does each of the following activities in child care affect a child’s growth and health?” along five activities (Drinking breast milk as an infant, Doing teacher-led physical activity, Drinking beverages with no added sugar, Eating a variety of healthy foods, Having active free play) with the categorical options of “Not at All,” “A Little,” “A Lot,” or “Not Sure.”
The percent of participants who endorsed each of the five activities as having an influence on the child’s growth and health was similar between baseline and follow-up. The percent of participants who agreed that these areas affect a child’s growth and health from highest to lowest at follow-up are indicated below as seen in Figure 6:
 Eating a variety of healthy foods (95.3%)
 Having active free play (93.8%)
 Drinking beverages with no added sugar (91.6%)
 Doing teacher-led physical activity (87.5%)
 Drinking breast milk as an infant (75.4%)
 Improving Health in Child Care Settings: 2016 34

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