Page 7 - Demo
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Although these areas showed a statistically significant increase from baseline to follow-up, further intervention may be merited because of the lower percent of providers engaging in these practices at follow-up compared to other feeding practices:
 Children serve themselves from serving dishes at mealtime. (72.0%)
 Special occasions and holidays are celebrated with healthy foods or with non-food
treats. (79.3%)
Items that had lowest rates of participants reporting engagement in and high rates of participants stating the item does not apply to their site (even if their site serves infants/toddlers), indicating areas for further intervention include:
 Breastfeeding mothers are provided access to a private area for breastfeeding or pumping with appropriate seating.
 Staff are trained in proper handling and storage of breast milk.
 Parents are aware that they could leave breast milk at the child care site for their child.
Nutrition: Food Served. There was positive change in the foods served with 20% to 62% providers reporting positive change in the foods they serve in their programs. The greatest amount of change was reported in serving flavored or sweetened milk with 62.3% of participants reporting that they serve less of it at follow-up than at baseline . With about 23% of providers still serving processed meats 2-3 times a week or more, this may be an area to consider for intervention.
Physical Activity There were relatively high rates of participants who reported recommended amounts of structured and unstructured play with children and staff participating in physical activities with the children (over 90% at follow-up). These areas seem to be a strength for these programs. Fewer participants reported sending information home to parents about the physical activities their children engage in during the day or information to encourage physical activity at home (less than 85% at both baseline and follow-up). The least common form of information going out to parents was a written physical activity policy at enrollment (less than 60% at baseline and about 70% at follow-up) with center-based providers more likely to report engaging in this practice than family child care providers. Finally, limiting screen time to 30 minutes per week was the area reported by the smallest percentage of participants with less than 60% reporting doing this at their child care setting and approximately one-third reported that it was not applicable to their site (at baseline and follow-up).
Improving Health in Child Care Settings: 2016 3

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