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Early Care and Education (ECE) programs offer ideal settings for young children to develop healthy dietary intake. Implementation of responsive feeding evidence-based practices (EBPs) are a promising avenue to promote healthy eating in young children while supporting children's autonomy and self-regulation. However, implementation of responsive feeding EBPs is low, especially in rural family childcare homes (FCCH). Little is known about how organizational structure in FCCH impact implementation of responsive feeding EBPs in this unique setting.
To determine FCCH providers’ perspectives for implementing evidence-based responsive feeding practices using the Diffusion of Innovations Theory's innovation-decision process.
Study Design, Setting, Participants
Six qualitative, semi-structured focus group interviews were conducted with 19 rural FCCH providers.
Interviews were analyzed using thematic analysis.
Providers reported having knowledge regarding responsive feeding EBPs and had learned about them through various communication channels such as the Child and Adult Care Food Program, Go Nutrition and Physical Activity Self-Assessment for Child Care, and Step Up to Quality (Knowledge). Providers reported perceived challenges to implementing responsive feeding related to the organizational structure of the FCCH settings, such as the mixed age groups of children and balancing multiple roles such as administrator, cook and teacher during mealtimes (Persuasion and Decision). Additionally, providers who were implementing responsive feeding EBPs provided strategies used to overcome these challenges (Implementation). Finally, providers reported the benefits of using responsive feeding EBPs, such as supporting children's healthful development and more pleasant mealtimes, as reasons for their continued use of responsive feeding EBPs (Confirmation).
Results indicate that organizational structure impacts successful implementation of responsive feeding EBPs in ECE programs. Programming and policy efforts should consider these factors when targeting children's healthful dietary needs.