Applying quality improvement methods to address obesity in early care and education (ECE) settings

Background: Early care and education (ECE) settings provide an optimal place of intervention for obesity prevention efforts as 27% of children 2-5 years in the U.S. are overweight or obese and 12 million children are in ECE settings. Using ECE learning collaboratives, childcare programs in Delaware achieved measurable changes in child health policies and practices. With funding from the CDC, Nemours and partners are now spreading this model to six states to improve the nutrition, physical activity, breastfeeding and screen time quality of childcare. Methods: Nemours utilizes a structured approach to train ECE providers adapted from the Institute for Healthcare Improvement. Providers engage in five learning sessions demonstrating the leadership, information sharing, and technical assistance needed to adopt policies and practices in the areas noted above. Results: In Delaware, this approach yielded significant results in center practices. 100% of centers made changes in healthy eating or physical activity and 81% made changes in both areas. These results are informing the roll-out of the model in six states, impacting nearly 85,000 children in Year 1. Conclusion: ECE collaboratives represent a tested approach for spreading impactful, sustainable policy and practice improvements in ECE programs across the nation to prevent childhood obesity.