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.
State Quality Rating and Improvement Systems: Strategies to Support Healthy Eating and Physical Activity Practices in Early Care and Education Settings
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 … More
Breastfeeding protects against overweight and obesity, asthma, eczema, and type-II diabetes, and has long-term health benefits for women. The health benefits of breastfeeding are so valuable that in 1981, the World Health Organization established the International Code of Marketing of Breast-Milk Substitutes (WHO Code) that prohibits marketing infant formula to … More
Effect of a Home-Visiting Intervention to Reduce Early Childhood Obesity Among Native American Children
The objective of this study was to assess the impact of a brief home-visiting approach, Family Spirit Nurture (FSN), on sugar-sweetened beverage (SSB) consumption, responsive parenting and infant feeding practices, and optimal growth through 12 months post partum. This study was a 1:1 randomized clinical trial comparing FSN with an … More