Technical Assistance for Child and Adult Care Food Program in Family Child Care Home

Study Overview
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Brief Summary
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This study evaluates the effect of a nutrition technical assistance training program for family child care home providers on the food they serve young children in their care and the food environment in their home. Half the providers will be assigned to the nutrition program and the other half will receive a comparison on environmental health.

Detailed Description
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Early care and education (ECE) providers play a vital role in ensuring that young children have access to nutritious foods. Over 25% of children in ECE (1.2 million children) attend Family Child Care Homes (FCCH). Improvements in the Child and Adult Care Food Program (CACFP) may introduce new barriers for FCCH, which have limited meal preparation capacity. Limited research has examined foods served by FCCH providers, and no group randomized trials have been conducted using a Community-Based Participatory approach in FCCH and including an evaluation of intervention costs. Goals: 1. Determine compliance of menus and meals provided in FCCH with CACFP guidelines. 2. Determine the effectiveness of a pilot community-based Nutrition Technical Assistance intervention to enhance meeting CACFP best-practices. 3. Determine the effectiveness of a statewide community-based Nutrition Technical Assistance Intervention to enhance meeting CACFP best-practices. 4. Expand university student opportunities for participation in health research. Methods: Conduct a cross-sectional assessment of a random sample of FCCH providers' (n=52) menus and meals served. Foods will be evaluated against the CACFP requirements and best-practices. After the cross-sectional examination, providers in the pilot will be randomly assigned to a Nutrition Technical Assistance (n=26) or attention comparison intervention (n=26). Following the pilot, trained Extension Educators will implement both interventions (n=27 intervention, n=27 comparison) in six selected counties, reaching underserved rural and low-income populations. The intervention is based on theoretical foundations and formative interviews, and will consist of two 60-90-minute visits to the FCCH and one group class lasting approximately 3 hours.

Official Title
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Compliance and Technical Assistance for Child and Adult Care Food Program in Family Child Care Homes

Conditions
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Nutrition Poor, Health Behavior

Intervention / Treatment
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* Behavioral: Nutrition assistance
* Behavioral: Children's environmental health


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Family child care home providers within 60 minutes of Oklahoma City who participate in the Child and Adults Care Food Program Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized trial where family child care home providers (the participant) are randomized to either nutrition or environmental health technical assistance intervention. Interventions are matched for time and contact
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Behavioral: Nutrition assistance<br>three encounters with Intervention team over three months: two home-based visits for 90 minutes each scheduled at the convenience of the provider and a 3- hour group class session with other providers. | Behavioral: Nutrition assistance<br>* Participating family child care home providers in and around the Oklahoma City (OKC) area will be randomized to either the Nutrition (n=26), or an environmental health comparison group (n=26). Briefly, the Nutrition Technical Assistance Intervention and comparison group will consist of three encounters with the intervention team: two home-based, 90-minute visits scheduled at the convenience of the family child care home provider and a 3-hour group class session that will be conducted on a weekend. Total contact time with intervention staff will be 6 hours. All participants will receive a toolkit. Providers will complete either intervention over a period of three months.<br>|
| Experimental: Behavioral: Children's environmental health<br>three encounters with Intervention team over three months: two home-based visits for 90 minutes each scheduled at the convenience of the provider and a 3- hour group class session with other providers. | Behavioral: Children's environmental health<br>* Participating family child care home providers in and around the OKC area will be randomized to either the Nutrition (n=26), or an environmental health intervention (n=26) that will receive an Integrated Pest Management and Green Cleaning intervention with the same format and visit frequency. Briefly, the Intervention will consist of three encounters with the intervention team: two home-based, 90-minute visits scheduled at the convenience of the family child care home provider and a 3-hour group class session that will be conducted on a weekend. Total contact time with intervention staff will be 6 hours. All participants will receive a toolkit. Providers will complete either intervention over a period of three months.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in self-reported nutrition practices | Providers report the frequency of fruit and vegetables, milk, and salty snacks served | baseline, post 3-months, post 12-months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Provider knowledge and self efficacy | providers will self report nutrition and environmental health knowledge and self efficacy | baseline, post 3-months, post 12-months | 
| Change in Environmental health observation | observation of household cleaners and chemicals and signs of pests | baseline, post 3-months, post 12-months | 
| Change in nutrition environment using the Environment and Policy Assessment Observation | observation of food environment during lunch on 2 unannounced days | baseline, post 3-months, post 12-months | 
| Change in compliance of menu and meal with Child and Adult Care Food Program | menus and meals are compared to the requirements and best practices of the CACFP | baseline, post 3-months, post 12-months | 
| Change in children's dietary intake | observation of children's dietary intake on 2 unannounced days | baseline, post 3-months, post 12-months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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early childhood education, family child care home, food environment