Barriers and supports to implementing a nutrition and physical activity intervention in child care: Director's perspectives

Introduction: Child care (CC) centers are an ideal setting for efforts to prevent childhood obesity. Twenty-four CC centers in Georgia participated in a year-long program aimed at improving nutrition/physical activity (PA) practices through the training of caregivers and the implementation of wellness policies. This study evaluated center directors' perceptions of program implementation to understand supports, barriers, and experiences of (CC) staff implementing a nutrition and (PA) program. Methods: Twenty directors of centers serving low-income children participated in a semi-structured interview lasting 60 minutes. An interview guide was used to produce center directors' perceptions, attitudes, and reflections on the process of implementing changes to nutrition and PA practices. Transcripts were analyzed with qualitative software. Researchers employed three levels of coding; four predominant themes emerged. Results: Interviews with directors provided valuable practitioner insights on the importance of hands-on activities and printable materials for engaging children in nutrition and PA education; challenges and supports to engaging parents in child wellness, and a need to prioritize the support of directors and staff in changes to nutrition and PA practices. Discussion: Findings suggest that refocusing efforts on building parent-teacher relationships and creating opportunities for families to engage in activities at child care centers may lead to greater parent involvement; programs stressing experiential learning around nutrition and PA will likely lead to children's engagement; and a relatively simple set of resources with a process of planning can have a positive impact.