Challenges and opportunities in implementing Delaware's nutrition and physical activity standards for child care: Findings from focus groups with providers and parents

Delaware recently enacted enhanced nutrition and physical activity standards as part of its child care licensing regulations and nutrition standards for the Child and Adult Care Food Program. These policies promote child health and prevent obesity by improving access to healthier foods and physical activity in child care settings. Approximately 1400 child care centers and homes are affected by Delaware's standards.

This study explores how providers and parents have responded to the new standards and what they need to help them comply. Ten focus groups were held with 83 providers and parents. In-depth qualitative analyses were performed.

Key findings include: • There is widespread support for the goals of Delaware's child care standards. • Providers' common challenges include: meal planning, preparation, and shopping; inadequate capacity developmentally appropriate, physical activity; financial and time constraints; and staff and parent resistance. • Providers strategies for implementing the standards include: preparing meals in a kid-friendly way, obtaining assistance from store staff, buying in bulk, engaging staff in lesson and meal planning, and holding family-oriented educational events. • Providers have concrete suggestions for training and other supports they need to comply with these standards.

Helping child care providers comply with nutrition and physical activity standards for child care hinges on the availability of adequate training, informational materials, and other practical resources including those needed to gain support and engagement of staff and parents. Compliance can also be promoted through public policies and public/private partnerships that improve provider access to healthy foods, physical activity equipment, and outdoor play space.