NAP SACC Intervention in Child Care Centers Improves Nutrition and Physical Activity

Background. Since preschool-age children are becoming overweight at an alarming rate, interventions are needed in child care programs where the majority of these children spend time. Methods. A two-year randomized-control trial of the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) was conducted in 18 child care centers with 581 three to five year old children in California, Connecticut, and North Carolina. Nurse child care health consultants conducted workshops for child care providers on healthy eating and physical activity for young children, personal health and wellness, and working with families, and provided at least monthly on-site visits, along with one parent workshop. Results. Hierarchical linear models were conducted comparing intervention versus control centers' outcomes controlling for state, teacher education, family income, and household crowding. There was a significant increase in knowledge of nutrition and physical activity after four of five provider workshops and one parent workshop. Intervention centers' nutrition and physical activity policies significantly improved in meeting National Health and Safety standards. Children's time spent in sedentary behaviors, based a objective observations, was lower for children in intervention centers. Diet Observations indicated a significant decrease in servings of whole and flavored milk, increase in 1% and fat-free milk, and increase in healthy snacks in the intervention centers. There was a decrease in the percent of obese children in intervention compared to control centers. Conclusions. Child care health consultants can provide nutrition and physical activity interventions in child care programs to help reduce the prevalence of childhood obesity.