Published: July 2016

ID #: CAS020

Publisher: Nemours Children's Health System

Authors: Julie Shuell, MPA

See more related research

Share


In the early 2000s, states began developing Quality Rating and Improvement Systems (QRIS) as a structural approach to improve the quality of Early Care and Education (ECE) programs. QRIS are voluntary or required systems designed to reach large numbers of ECE providers, particularly those serving lower-income children receiving child-care subsidies. The topics covered by QRIS (e.g., curriculum, workforce development, health and safety) vary by state. This study aimed to learn about strategies to promote healthy eating, breastfeeding, physical activity, and limit screen time (referred to as “HEPA”) in state QRIS implementation. The purpose of this report is to provide data, recommendations, and case study examples to state-level administrators and stakeholders on how to more effectively use QRIS as a lever for change in childhood obesity prevention. It also identifies opportunities for continued research to advance childhood obesity prevention in ECE settings. This report summarizes information learned from 24 states that have identified practices related to HEPA they want to promote via the state QRIS. Case studies from seven states (Arizona, Georgia, Idaho, Indiana, New Jersey, Oklahoma, and Wisconsin) highlight strategies to support ECE providers’ childhood obesity prevention efforts.

Related Research

June 2015

State Quality Rating and Improvement Systems: Analysis of Strategies to Support Achievement of Healthy Eating and Physical Activity Best Practices in Early Care and Education Settings

In the 1990s, states began developing Quality Rating and Improvement Systems (QRIS) as a structural approach to improve the quality of early care and education (ECE) programs. Nemours’ experience implementing obesity prevention efforts in nine states has demonstrated that QRIS systems may be leveraged to promote childhood obesity prevention in addition to school readiness and More

September 2023

Screening for Beverage Consumption in Early Childhood using Electronic Health Records

Establishing healthy beverage patterns during early childhood (ages 0 to 5 years) is important for promoting healthy growth and development in childhood and reducing risk of chronic diseases as an adult. Health care providers play an essential role in identifying and addressing unhealthy beverage consumption patterns in young children and helping families develop healthy beverage More

May 2023

Toddler milk: a scoping review of research on consumption, perceptions, and marketing practices

Toddler milk is an ultra-processed beverage consisting primarily of powdered milk, caloric sweeteners, and vegetable oil. Pediatric health authorities do not support the use of toddler milk, and emerging evidence suggests that toddler-milk marketing practices may mislead consumers. However, studies have not synthesized the extent of toddler-milk marketing practices or how these practices affect parents’ More