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Title: Best practices and barriers to obesity prevention in head start: Differences between director and teacher perceptions

Author
item BYRD-WILLIAMS, COURTNEY - UNIVERSITY OF TEXAS AT AUSTIN
item DOOLEY, ERIN - UNIVERSITY OF TEXAS AT AUSTIN
item SHARMA, SHREELA - UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER
item CHUANG, RU-JYE - UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER
item BUTTE, NANCY - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item HOELSCHER, DEANNA - UNIVERSITY OF TEXAS AT AUSTIN

Submitted to: Preventing Chronic Disease
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/1/2017
Publication Date: 12/1/2017
Citation: Byrd-Williams, C., Dooley, E.E., Sharma, S.V., Chuang, R., Butte, N., Hoelscher, D.M. 2017. Best practices and barriers to obesity prevention in head start: Differences between director and teacher perceptions. Preventing Chronic Disease. 14:170294. https://doi.org/10.5888/pcd14.170297.
DOI: https://doi.org/10.5888/pcd14.170297

Interpretive Summary: Head Start, the largest federally funded early care and education (ECE) program for preschoolers in the United States, provides comprehensive education, social, and health services to low-income families. Approximately one-third of children who attend Head Start centers are overweight or obese. As part of health services, Head Start providers are required to incorporate efforts to combat childhood obesity in their programs. The purpose of this study was twofold: 1) to describe best practices and perceived barriers to promoting nutrition and physical activity in Head Start centers and 2) to examine differences in perceptions as reported by directors and teachers at 23 Head Start centers participating in the Texas Childhood Obesity Research Demonstration.In general, directors and teachers reported meeting most best practices. Areas needing improvement included helping children to attend to satiety cues and providing adequate opportunities for physical activity. More teachers than directors reported barriers to healthy eating, citing lack of food service staff support, limited time, and insufficient funds.Because teachers are the direct caregivers responsible for implementation of policies, programs, and practices in the classroom, it is important to assess their perceptions of barriers and best practices. More barriers to healthy eating were reported than were barriers to physical activity indicating that more support may be needed for healthy eating in ECE program.

Technical Abstract: Practices and barriers to promoting healthy eating and physical activity at Head Start centers may influence children's energy balance behaviors. We examined differences between directors' and teachers' perspectives on best practices and barriers to promoting healthy eating and physical activity in Head Start centers.We conducted a cross-sectional study of directors (n=23) and teachers (n=113) at 23 Head Start centers participating in the baseline assessment of the Texas Childhood Obesity Research Demonstration study. Participants completed surveys about practices and barriers to promoting healthy eating and physical activity. Multilevel regression models examined differences between director and teacher responses.More than half of directors and teachers reported meeting most best practices related to nutrition and physical activity; few directors or teachers (<25%) reported conducting physical activity for more than 60 minutes a day, and less than 40% of teachers helped children attend to satiety cues. Significantly more directors than teachers reported meeting 2 nutrition-related best practices: “Teachers rarely eat less healthy foods (especially sweets, salty snacks, and sugary drinks) in front of children” and “Teachers talk to children about trying/enjoying new foods” ( P<.05). No barrier to healthy eating or physical activity was reported by more than 25% of directors or teachers. Significantly more teachers than directors reported barriers to healthy eating, citing lack of food service staff support, limited time, and insufficient funds ( P<.05).More barriers to healthy eating were reported than were barriers to physical activity indicating that more support may be needed for healthy eating. Differences between responses of directors and teachers may have implications for future assessments of implementation of best practices and barriers to implementation related to nutrition and physical activity in early care and education centers.