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

January 2023

Policy, system, and environmental interventions addressing obesity and diet-related outcomes in early childhood education settings: A systematic review

Early childhood education (ECE) settings play an important role in child dietary intake and excess weight gain. Policy, systems, and environment (PSE) approaches have potential to reduce disparities in children at higher risk for obesity. The purpose of this review was to (1) characterize the inclusion of populations at higher risk for obesity in ECE More

December 2022

Water is K’é: A Community-Based Intervention to Increase Healthy Beverage Consumption by Navajo Preschool Children

This research brief gives an overview of the Water is K’é intervention, conducted among Navajo Nation families. The intervention was delivered by early care and education teachers to households with children ages 2-5, and covered the cultural importance of water, health benefits of water, and alternatives to sugary drinks. At baseline, more than 70% of children already More