Open AccessA Healthy Start: National Trends in Child Care Regulations and Uptake of Obesity Prevention Standards (2010–2018)
Author(s) -
Amy Lowry Warnock,
Carrie Dooyema,
Heidi M. Blanck,
Seung Hee Lee,
Kelly Hall,
Nora Geary,
Deborah A. Galuska
Publication year - 2021
Publication title -
childhood obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 38
eISSN - 2153-2176
pISSN - 2153-2168
DOI - 10.1089/chi.2020.0298
Subject(s) - obesity , medicine , childhood obesity , environmental health , public health , health care , gerontology , overweight , family medicine , political science , nursing , law
Background: Obesity remains a significant public health issue in the United States. Each week, millions of infants and children are cared for in early care and education (ECE) programs, making it an important setting for building healthy habits. Since 2010, 39 states promulgated licensing regulations impacting infant feeding, nutrition, physical activity, or screen time practices. We assessed trends in ECE regulations across all 50 states and the District of Columbia (D.C.) and hypothesized that states included more obesity prevention standards over time. Methods: We analyzed published ratings of state licensing regulations (2010-2018) and describe trends in uptake of 47 high-impact standards derived from Caring for Our Children's, Preventing Childhood Obesity special collection. National trends are described by (1) care type (Centers, Large Care Homes, and Small Care Homes); (2) state and U.S. region; and (3) most and least supported standards. Results: Center regulations included the most obesity prevention standards (∼13% in 2010 vs. ∼29% in 2018) compared with other care types, and infant feeding and nutrition standards were most often included, while physical activity and screen time were least supported. Some states saw significant improvements in uptake, with six states and D.C. having a 30%-point increase 2010-2018. Conclusions: Nationally, there were consistent increases in the percentage of obesity prevention standards included in ECE licensing regulations. Future studies may examine facilitators and barriers to the uptake of obesity prevention standards and identify pathways by which public health and health care professionals can act as a resource and promote obesity prevention in ECE.