West Virginia Early Childhood Obesity Prevention Project: EPAO Methodology

A vital time for obesity prevention is during the preschool years, when children establish healthy eating habits and physical activity (PA) patterns.  Seventy-five percent of preschool children spend 35 hours per week in child care. Therefore, early childcare settings can play a crucial role in helping to prevent obesity. The Choose to Change Project, an early childhood obesity prevention study, uses an ecological approach to explore individual, family and environmental factors that influence weight status amongst Pre-Kindergarten (Pre-K). 

The study takes place in 42 (20 intervention, 22 control) Pre-K schools in two West Virginia counties.   Environmental Policy Assessment and Observation (EPAO) was used to assess child care nutrition and physical activity environments, polices, and practices. Every childcare center was assessed once for each cohort. Data was collected in the spring of 2013, 2014 and 2015.

An EPAO was completed for all participating classrooms. Before observing the classrooms, we extensively researched the protocols and policies that pertained to nutrition and physical activity in each respective county. While working with the tool, questions were found to be subjective by the multiple team members. When working through the playground equipment portion of the tool, there were inconsistences with the playground equipment seen compared to what was listed. When recording information about the meals, certain foods (e.g. milk) could have been listed in more than one category. To address these issues, we developed a cohesive protocol among those using the tool for this study.

The EPAO tool provides a proper assessment of the children’s surroundings and activities. With this information we will evaluate the quality of health practices in Pre-K schools in Monongalia and Kanawha Counties.