Background

Changing Policy, System, and Environmental features focused on physical activity and healthy eating behaviors can play a key role in obesity prevention strategies in early childhood education settings because of their broad reach and because they can be sustained over time. The primary aims of this study were to examine the implementation and sustainability of health-promoting PSE changes after facilitation of an innovative strategic planning process in child care settings.

Methods

The evidence-based policy, system, and environment change process is a strategic planning tool derived from intervention mapping that involves convening interdisciplinary wellness teams at child care settings to implement healthy eating and physical activity-related policy changes. The process was conducted with 43 wellness teams representing 68 child care centers.

Results

The average number of health-promoting evidence-based changes implemented across all child care centers was 5.07; the most common type of changes were environment changes. Overall, 42% of changes were partially implemented and 47% of changes were fully implemented at 6 months. Head Start wellness teams implemented 1.52 fewer health-promoting changes compared to private fee-based wellness teams (p < .05).

Conclusions

Identifying health-promoting policy, system and environment changes that are most readily implemented and sustained in child care centers can inform systems-level interventions and resource allocation related to early childhood obesity. This strategic planning process is a successful tool to translate sustainable changes related to healthy eating and physical activity, improve the quality rating of diverse child care centers, and promote healthy behaviors in early childhood.

中文翻译：

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在幼儿教育环境中执行政策，系统和环境变化

背景

侧重于体育活动和健康饮食行为的不断变化的政策，系统和环境特征，由于在儿童肥胖方面的预防策略中具有广泛的影响并且可以随着时间的流逝而持续发展，因此在肥胖预防策略中可以发挥关键作用。这项研究的主要目的是在促进儿童保育环境中创新性战略计划过程之后，检查促进健康的PSE变化的实施和可持续性。

方法

基于证据的政策，系统和环境变化过程是从干预映射中衍生的战略规划工具，涉及在儿童保育场所召集跨学科的健康团队以实施健康饮食和与身体活动有关的政策变化。该过程由代表68个儿童保育中心的43个健康团队进行。

结果

在所有儿童保育中心实施的，以促进健康为依据的，基于证据的改变的平均数量为5.07；最常见的更改类型是环境更改。总体而言，在6个月时，部分实施了42％的更改，而全部实施了47％的更改。与基于私人收费的健康团队相比，Head Start健康团队实施的健康促进变更减少了1.52（p  <.05）。

结论

找出最容易在儿童保育中心实施和维持的促进健康的政策，系统和环境变化，可以为与儿童肥胖相关的系统级干预和资源分配提供信息。这一战略规划过程是一种成功的工具，可以转变与健康饮食和身体活动有关的可持续变化，提高各种托儿中心的质量等级，并促进幼儿期的健康行为。