Lessons from the sandbox: Collaborating to create healthy childcare environments

Introduction: Alarmingly, in 2011 more than 38% of Maine's kindergarten students were overweight or obese. Studies have shown that by changing obesogenic environments and promoting physical activity and nutrition, obesity can be affected. The Maine Center for Disease Control and Prevention partnered with other state agencies, and Let's Go!, a multi-setting childhood obesity program, to implement a state-local, public-private partnership to promote supports for increased physical activity and nutrition in Maine's licensed childcare programs. Methods: The initiative, supported by a U.S. CDC grant in 2012, uses a structured, evidence-based process to help childcare providers identify and implement changes in environments, programs, and procedures that increase physical activity and improve nutrition. The evaluation compares a site-specific assessment of physical activity and nutrition supports and procedures before and after program implementation among the 200 participating sites. The assessment has 87 items including procedures, environments, provider behaviors, and provider education. The study also documents partner experiences with the initiative. Results: Results include the changes noted in the physical activity and nutrition support inventory during the first year. These cover age-appropriate environments, strategies, and programs to increase physical activity and improve nutrition. We will also share lessons learned in implementation and partner collaboration. Discussion: The childcare setting presents an important place to implement a multi-level approach to encourage physical activity and nutrition to give children a healthy start. Leveraging existing partnerships to support caregivers dispersed across a rural state is an effective way to create and sustain healthier environments for infants and young children.