Comparing nutrition and physical activity policies and practices between center and family preschool sites in Los Angeles County

Introduction: Given rising rates of obesity among young children, preschools have emerged as a promising venue for obesity prevention and control efforts. The Nutrition And Physical Activity Self-Assessment for Child Care (NAP SACC) guidelines represent best-practices with regard to organization and policy-level strategies to promote nutrition and physical activity in preschools. We assess implementation of best-practice guidelines in a diverse sample of preschool sites in Los Angeles County. In particular, we were interested in potential differences in implementation between center-based (24-100 children) and family-based (12-24 children) preschools.

Methods: The NAP SACC instrument was administered to site directors of Los Angeles Universal Preschool (LAUP) (n = 110, 73 center-based, 37 family-based sites) in May 2013 to assess adherence to best-practice guidelines for nutrition and physical activity policies.

Results: All recommendations for serving fruits and vegetables were met in 7.3% of schools, while 8.2% met all recommendations for active play and inactive time. Compared to center-based sites, family-based preschools reported better adherence for guidelines related to child and staff nutrition education (39% vs. 14%), the play environment (27% vs. 11%), and child and staff physical activity education (33% vs. 17%). While many site directors reported that their schools met guidelines for individual components, no sites met all best-practice guidelines. 

Conclusion: Although family-based sites reported slightly higher adherence to NAP SACC guidelines than center-based preschools, overall compliance with recommendations was low. Efforts to assist preschool sites should account for the unique features of these sites and develop appropriate strategies to implement best-practice guidelines.