Abstract
Objective
Identify factors perceived to influence implementation of healthy eating policy, systems,
and environmental strategies (PSEs) in child care settings serving low-income children.
Design
This mixed-methods study, conducted in 2015–2016, used semi-structured interviews
(n = 18), focus groups (n = 23), and an expert panel.
Participants
Public health (n = 11) and Supplemental Nutrition Assistance Program–Education practitioners (n = 9) and community residents (n = 174) from 9 counties in Ohio.
Expert panelists (n = 10) had experience implementing PSEs in child care settings.
Phenomenon of Interest
Implementation factors influencing healthy eating PSEs in child care settings.
Analysis
Qualitative thematic analysis of 41 transcripts using a grounded theory approach.
Indicators for each theme were operationalized. Consensus feedback from an expert
panel weighted themes and indicators based on perceived importance for implementation.
Results
Identified themes relevant to implementation of PSEs included (1) organizational and
practitioner capacity, (2) child care capacity, (3) networks and relationships, and
(4) community resources and motivations. Nineteen indicators related to the 4 themes
were identified and weighted.
Conclusions and Implications
Findings highlighted key factors within domains of influence and informed the operationalization
of the indicators and the development of an assessment tool. The assessment tool is
designed to tailor PSE implementation to the realities of different child care settings.
Key Words
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Article info
Publication history
Published online: November 08, 2018
Accepted:
September 17,
2018
Footnotes
Conflict of Interest Disclosure: The authors have not stated any conflicts of interest.
Identification
Copyright
© 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
