Examining Readiness to Implement Nutrition-related Policy, Systems, and Environmental Interventions in Childcare Settings

LEE, EUNLYE ; MONTEBAN, MADALENA ; PARSONS, ALLISON; BEBO, PAT

Denver

Encuentro; Meeting of the American Public Health Association; 2016

American Public Health Association

IntroductionBuilding Capacity for Obesity Prevention (BCOP) is a statewide collaboration between researchers and practitioners form public health and Supplement Nutrition Assistance Program-Education (SNAP-Ed). BCOP seeks to capture perspectives about readiness and capacity for carrying out nutrition-related policy, systems, and environmental (PSE) interventions and to guide the development of tools to support implementation. We present results related to interventions in childcare settings. MethodsInterviews with public health and SNAP-Ed practitioners (n=20) and focus groups (n=23) with community residents (n=174) in nine rural and urban counties of Ohio were conducted in 2015 to identify facilitators and constraints related to implementation of PSEs in childcare. Thematic analysis of 41 transcripts was conducted using a grounded theory approach, and indicators for each theme were operationalized to inform the development of tools to assess readiness. Next, consensus modeling was conducted with an expert panel of practitioners (n=10) to prioritize themes and indicators. ResultsQualitative analysis yielded six themes connected with readiness to implement nutrition-related PSEs in childcare. The expert panel prioritized four of these themes as accounting for most of the variability related to implementation. The priority themes were: Organization capacity and infrastructure, such as staffing and budgets to support implementation; Practitioner attitudes and beliefs about nutrition-related PSEs in childcare; Social capital to collaborate with other networks for PSE implementation; and Child Social Context influencing eating habits among children. DiscussionFindings highlight multiple domains influencing PSE implementation in childcare and offer guidance for tailoring intervention approaches to the different capacities of practitioners and communities.