Harvard School of Public Health (HSPH)
The goal of this cluster-randomized, controlled trial is to learn if a professional development program for childcare educators, called the Boston Healthy Child Care Initiative, can help improve the nutritional quality of meals/snacks served and the availability of physical activity opportunities in childcare programs, and also to learn if this results in improved diet quality and physical activity for young children who attend childcare, especially in under-resourced settings. The main questions it aims to answer are: Do childcare programs that receive professional development through the Boston Healthy Child Care Initiative improve the nutritional quality of the meals they serve, as measured by the Healthy Eating Index (HEI-2020), and do they also provide more physical activity opportunities to young children throughout the day? Do young children (ages 2-5 years) attending childcare programs that receive the Boston Healthy Child Care Initiative eat more nutritious foods/beverages (as measured by the HEI-2020) and engage in less sedentary time at childcare? Researchers will compare a group of childcare programs who participate in the Boston Healthy Child Care Initiative, and a sample of children who attend those programs, to a similar group of childcare programs who do not participate to see if the quality of meals served, the amounts of physical activity opportunities scheduled, young children's dietary quality, and the minutes/day spent in physical activity increase from before to after the Boston Healthy Child Care Initiative. Childcare educator participants will: * Complete the Boston Healthy Child Care Initiative professional development program (for the intervention group only) * Share copies of menus, schedules, and written policies about nutrition and physical activity in the childcare program Child participants will: * Wear ActiGraph wGT3X-BT accelerometers for two days while at childcare to measure physical activity levels. They will do this for two days each at baseline, midline, and follow-up after the initiative concludes. * Be observed during mealtimes by trained researchers to visually estimate how much they consume at meals and snacks in childcare.
Inclusion Criteria: * Aged 2-5 years old; attends early care and education program located in the city of Boston; at least one parent/guardian reads English or Spanish Exclusion Criteria: * Ages \<2 or \>5 years; does not attend early care and education or attends a program outside of the city of Boston; parent/guardian cannot read English or Spanish
The Boston Healthy Child Care Initiative is a professional development and peer-networking program offered by the Boston Public Health Commission for ECE programs in Boston. Building on the evidence-based Go NAP SACC program, it helps ECE educators set goals and create action plans to implement policies and practices that support healthy eating and physical activity for young children. Facilitators, in English and Spanish, share practical, real-world advice and teach skills for how to boost nutrition and physical activity at childcare, and educators connect with one another to share their own tips and help each other problem-solve. BHCCI covers three areas: Nutrition in the First Five Years, Physical Activity Learning Session, and Farm-to-ECE. Programs also receive stipends to support healthy changes.