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
Engaging Fathers in Early Obesity Prevention During the First 1,000 Days: Policy, Systems, and Environmental Change Strategies
Fathers are critical stakeholders in childhood obesity prevention but are difficult to engage. This review presents a new approach to engaging fathers in obesity prevention during the first 1,000 days. The review focuses on five existing health and social service programs, including prenatal care, pediatric care, the Special Supplemental Nutrition … More
Parental and Provider Perceptions of Sugar-Sweetened Beverage Interventions in the First 1,000 Days: A Qualitative Study
Novel approaches to reduce sugar-sweetened beverage (SSB) consumption during the first 1,000 days – pregnancy through age 2 years – are urgently needed. This study examined perceptions of SSB consumption and acceptability of potential intervention strategies to promote SSB avoidance in low income families in the first 1,000 days. Themes … More