<div class="section">
<a class="named-anchor" id="S1">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4802112e173">Background:</h5>
<p id="P1">Developing healthy eating behaviors and food preferences in early childhood
may help
establish future healthy diets. Large numbers of children spend time in child care,
but little research has assessed the nutritional quality of meals and snacks in family
child care homes. Therefore, it is important to assess foods and beverages provided,
policies related to nutrition and feeding children, and interactions between providers
and children during mealtimes. We examined associations between the nutrition environments
of family child care homes and children’s diet quality.
</p>
</div><div class="section">
<a class="named-anchor" id="S2">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4802112e178">Methods:</h5>
<p id="P2">We assessed the nutrition environments of 166 family child care homes using
the Environment
and Policy Assessment and Observation (EPAO) (scores range: 0-21). We also recorded
foods and beverages consumed by 496 children in care and calculated healthy eating
index (HEI) (scores range: 0-100). We used a mixed effects linear regression model
to examine the association between the EPAO nutrition environment (and EPAO sub-scales)
and child HEI, controlling for potential confounders.
</p>
</div><div class="section">
<a class="named-anchor" id="S3">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4802112e183">Results:</h5>
<p id="P3">Family child care homes had a mean (standard deviation, SD) of 7.2 (3.6)
children
in care, 74.1% of providers were black or African American, and children had a mean
(SD) age of 35.7 (11.4) months. In adjusted multivariable models, higher EPAO nutrition
score was associated with increased child HEI score (1.16; 95% CI: 0.34, 1.98; p =
0.006). Higher scores on EPAO sub-scales for foods provided (8.98; 95% CI: 3.94, 14.01;
p = 0.0006), nutrition education (5.37; 95% CI: 0.80, 9.94; p = 0.02), and nutrition
policy (2.36; 95% CI: 0.23, 4.49; p = 0.03) were all associated with greater child
HEI score.
</p>
</div><div class="section">
<a class="named-anchor" id="S4">
<!--
named anchor
-->
</a>
<h5 class="section-title" id="d4802112e188">Conclusions:</h5>
<p id="P4">Foods and beverages served, in addition to nutrition education and nutrition
policies
in family child care homes, may be promising intervention targets for improving child
diet quality.
</p>
</div>