Assessing the implementation of healthy eating and physical activity policies and practices in the family day care setting: A cross-sectional study

Issue addressed: While the family day care setting provides a unique opportunity to improve child health, few studies have assessed obesity prevention practices of this setting. This study aimed to examine the (a) prevalence of implementation of evidence-based healthy eating and physical activity policies and practices among schemes (ie overarching governing agency) and educators in the family day care setting in Australia; and (b) associations between educator socio-demographic characteristics and implementation of healthy eating and physical activity practices. Methods: Family day care schemes (n = 16) responsible for educators (n = 174) located in the Hunter New England region of NSW participated in a telephone survey in 2018, reporting their implementation of evidence-based healthy eating and physical activity policies and practices. Linear mixed regression analyses were used to determine whether educator characteristics were associated with higher percentages of implementation. Results: Few schemes had comprehensive breastfeeding (0%) and screen time (19%) policies. However, the majority of educators (81%) communicated with families when lunchboxes were not consistent with guidelines. Educators implemented an average of 64.3% of practices assessed. Educators located in higher socioeconomic areas implemented a significantly higher percentage of practices than those in lower socioeconomic areas (P <.000). Educator years of experience was positively associated with percentage of implementation (P =.009). Conclusions: The implementation of obesity prevention policies and practices in the family day care setting is variable and associated with educator socio-demographic characteristics. So what?: There is a need to support family day care schemes to improve their obesity prevention environments, particularly those related to policies.