Potential Public Health Impact
Reach: The Eat Well Play Hard in Child Care Settings program (EWPHCCS) has the potential to reach large numbers of at-risk, pre-school age children (3-5 years) and their primary caregivers through implementation in child care centers participating in the Child and Adult Care Food Program (CACFP). Eligible centers are those in which 50% or more of enrolled families qualify for free or reduced-price meals. In 2012 EWPHCCS reached 10,304 children at 225 child care centers across the state. Children and their families participating in the program are racially, ethnically, and geographically diverse. Other communities with infrastructure to support program implementation could have similar reach to New York State
Effectiveness: The EWPHCCS program has the potential to effect change in at-home vegetable intake and consumption of 1% or fat-free milk. Evaluation outcomes included statistically significant results for an increase in children’s daily at-home consumption of vegetables and 1% or fat-free milk, an increased rate of child-initiated vegetable snacking, and increased parental offerings of vegetables. Children’s consumption of fruit and their participation in at-home snack and meal preparation did not significantly change as a result of the program. The EWPHCCS program did not measure impact on children’s physical activity.
Adoption: In 2010, the intervention was adopted in 246 child care centers in New York State; in 2012 the number of child care centers was 225. Since findings from the process evaluation indicate the curriculum enjoys high acceptability, child care center directors are often eager to adopt the program when approached by direct educators (RDs).
Implementation: The design of EWPHCCS, including the format of the lesson plans and its emphasis on quality improvement, is easy for the EWPHCCS direct educators (RDs) to follow. Caregivers are highly satisfied with the program materials, and report using them often at home. However, some modifications may be needed to engage more parents in the caregiver/parent education classes. Those who attended classes reported high levels of satisfaction but attendance was very low, especially outside of New York City. The program’s implementation costs are an estimated $296.36 per child.
Maintenance: There is strong institutional support for this intervention. Begun in 2006, EWPHCCS continues to demonstrate stability each year. It is likely that the intervention can be maintained as long as funding is available to support infrastructure.