Towards greater understanding of healthy food access among childcare workers

Introduction: Early childhood education settings are a major focus of childhood obesity efforts.  Front-line childcare providers – predominantly low-wage earning females – are expected to implement healthy eating guidelines. Yet, workers’ own food access and experiences that shape their contexts and behaviors have not been well-addressed. We explored perceptions of local food environments and access to healthy foods among childcare workers in New Jersey.

Methods: Semi-structured guides were developed using a socioecological framework. Focus groups and interviews were conducted with childcare workers (n = 25) about their food shopping practices, foods available at their regular stores, and affective and interpersonal experiences while shopping.

Results: Major themes affecting food needs and access were: household composition, life stage, convenience, budget constraints, satisfying multiple children, and coping with overweight/obesity. Experiences of discrimination (“they’re like, do you have money for that?”) and perceived unsafe environments (“I won’t go to [supermarket] because I’m uncomfortable driving there”) were reported as disincentives to shopping at particular stores. Themes of judgment were prevalent – both perceived judgments (“they look at you like you don’t belong there”) and judgments about other shoppers (“they don’t want people to see them using their [EBT] card” or “they’re loud”). Some participants avoided stores due to such experiences and perceptions, while others pushed through barriers to satisfy family food priorities.

Discussion: Childcare workers have complex, heterogeneous histories, practices, and perceptions regarding food. Understanding and supporting their healthy food access could both reduce nutrition disparities and strengthen their effectiveness in implementing childcare center policies.