Child care health consultants improve teacher and parent nutrition and physical activity knowledge

663 children 2-5 years old and their families in 18 child care centers in three states were enrolled in a study, randomized at the center level, of NAPSACC, the Nutrition and Physical activity Self-Assessment in Child Care program. Pairs of centers were matched and randomly assigned to control or intervention groups by coin toss. Child care health consultants in each state, specially trained in nutrition and physical activity consultation, delivered the NAPSACC intervention over a six month period, and each intervention center received a financial incentive for play equipment to promote physical activity. The intervention included five workshops for child care teachers and one workshop for families plus on-site consultation, education and technical assistance activities. Teachers and parents were administered short answer tests before and after the workshops. Three-level hierarchical linear modeling, controlling for state, was applied to assess changes in nutrition and physical activity knowledge from pre-tests to post-tests. On four of five post-tests, teacher knowledge scores were significantly higher than the pre-test scores (p<0.01 for workshops on Obesity, Healthy Eating, Personal Health, and Families). The parent group showed statistically significant improvement in knowledge after the Growing Healthy Kids workshop (p<0.01). There is strong evidence that within the treatment group, the knowledge of providers and parents on most nutrition and physical activity topics improved significantly after they experienced the intervention. Implications for child care center policies and practices and children's diets and physical activity will be discussed.