Three in five children from birth through age 5 are in nonparental care arrangement(s) at least once a week, making Early Childcare and Education (ECE) influential for child health. This evaluation used the Site-Level Assessment Questionnaire (SLAQ), developed by The Nutrition Policy Institute (NPI), as a mechanism to assess and enhance Policy, Systems, and Environmental (PSE) work in the ECE setting.

Methods

Recruited ECE sites were required to complete a SLAQ to assess sites on 7 sections: Wellness Policies, Meal and Snack and Beverages, Food Environment, Gardens and Nutrition Education, Physical Activity and Screen Time, Family Involvement, and Breastfeeding Support. Results were used to tailor interventions to each site’s needs. Reassessments were completed one year after the baseline assessment.

Results

Across 3 fiscal years (20-21, 21-22, 22-23), 45 sites (3 cohorts) completed the program. Significant increases were observed in average scores of Gardens and Nutrition Education (+33%; p<0.01), Family Involvement (+31%; p<0.01), Wellness Policies (+29%; p<0.01), Breastfeeding Support (+11%; p=0.01), Physical Activity and Screen Time (+10%; p<0.01), and Food Environment (+6%; p<0.01).

Conclusion

Using structured tools, such as the SLAQ, is a valuable way to identify needed improvements and guide program planning in ECE settings. The NPI also developed the SLAQ Action Planning Tool that can be paired with SLAQ results to create a tailored action plan for each site. Since site-level assessments are best used to measure Policy, Systems, and Environmental (PSE) work, we recommend using additional tools to measure individual behavior change.