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support from management staff, lack of support from other child care staff, lack of support from parents, and not enough time or training to implement changes they learned about through their coaching than participants not receiving coaching, it is possible the effect of coaching would wash out in the analyses. Further analyses to take the number of challenges faced at baseline into account may be considered for teasing out the effect of coaching on participant behavior.
What are needed resources at baseline compared with follow-up? Does this differ by care type and for those who receive coaching?
Questions 40a-40h asked participants “What resources would be helpful for creating healthy practices or guidelines?” with instruction to “check all that apply.” As seen in Table 15, participants were very consistent in what they reported as helpful resources at baseline and follow-up. The following items, with those most frequently selected as helpful and selected by more than 25% of participants, included:
 More materials for parents
 More printed information
 Newsletters
 More training
 Websites
 Time with a Choose Health LA Child Care Coach
 Meeting with other child care providers making similar changes
The fact that materials for parents was the most highly endorsed item for helping to create healthy practices or guidelines aligns with other results from this survey and with findings from other evaluation components of CHLA CC. In this survey, lack of support from parents was the area most frequently endorsed by participants when asked about challenges in creating healthy practices and routines and in creating written rules or guidelines. Given that providers perceive lack of support from parents as a challenge in creating healthy practices or routines and creating written rules or guidelines, it is possible that providers are seeking resources to address that challenge order to implement positive changes in their child care programs. That the providers are seeking resources for parents may also be a positive finding in that providers may be seeking resources for parents because they recognize the importance of healthy practices at home and with the parents’ engagement. Large scale issues such as health, poverty, and education require a multi-pronged intervention strategy. The need for intervening with both child care environments and home environments is not surprising. CHLA CC has collaborated with Choose Health LA Kids to connect parents and license-exempt providers to a 6-week Healthy Parenting Workshop series.
Improving Health in Child Care Settings: 2016 40

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