Provider Adherence to Nutrition and Physical Activity Best Practices Within Early Care and Education Settings in Minnesota, Helping to Reduce Early Childhood Health Disparities

Katie Loth, Amy Shanafelt, Cynthia Davey, Allison Anfinson, Marguerite Zauner, Anna Ayers Looby, Natasha Frost, Marilyn S. Nanney

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Licensed child care providers, and the early care and education settings in which they operate, are uniquely situated to influence children’s healthy eating and physical activity through practices, attitudes, and supportive physical and social environments. However, preliminary research indicates that child-, family-, and provider-level characteristics affect adherence to best practices across early care and education settings. The current article used survey data (n = 618) to characterize differences in child care providers’ adherence to nutrition, physical activity, and mealtime best practices, based on child-, family- and provider-level characteristics, and to describe secular trends in adherence to nutrition and physical activity best practices between 2010 and 2016. Results indicate that differences exist across certain characteristics, including child race/ethnicity, family’s use of child care assistance, language spoken at home, and provider educational attainment; however, it is notable that in most cases providers serving children of minority race and children in low-income families have a higher rate of compliance with the nutrition and physical activity best practices studied. Additionally, the comparison of adherence to best practices from 2010 to 2016 suggests that, while there was an increase in mean adherence from 2010 to 2016, overall trends in adherence across child-, family- and provider-level characteristics have been consistent across time. Public health professionals should continue to advocate for opportunities for providers to learn how to best incorporate best practices within their setting (e.g., education and training opportunities) as well as for the development and adoption of systems-level changes (e.g., expansion of food assistance programs) to reduce barriers to adherence to best practices.

Original languageEnglish (US)
Pages (from-to)213-223
Number of pages11
JournalHealth Education and Behavior
Issue number2
StatePublished - Apr 1 2019

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The original study (2010) was funded by the University of Minnesota and University of Wisconsin Clinical and Translational Science Institutes (Co–Principal Investigators: Nanney, MS and LaRowe, T). Through a cooperative agreement, the Center for Prevention at Blue Cross and Blue Shield Center provided funding ($76,000) for the current (2016) study (Principal Investigator: Nanney, MS). Additional unspecified funds were provided by Minnesota Hunger Impact Partners and used to increase the provider incentive ($2,500).


  • child health
  • community-based participatory research
  • diet
  • health disparities
  • health promotion
  • nutrition
  • obesity
  • school-based health promotion

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

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