A Partnership Approach Obesity Prevention in Child Care Sandra Rhoades, MPH, RD Director, CACFP Obesity Prevention Unit NYS Dept. of Health Diane Craft, PhD Professor, Physical Activity Department State University of New York at Cortland
Objectives Obesity Prevention in Child Care Describe Early Childhood Obesity Prevention workgroup Present the proposed standards Nutrition Screen time Breastfeeding Physical activity Discuss challenges and next steps
Background NYS Dept. of Health Division of Nutrition Bureau of CACFP Division of Disease Prevention Bureau of Chronic Disease Prevention CDC Division of Nutrition, Physical Activity, and Obesity Develop an Action Guide Provide guidance to States To implement model policies and environmental strategies Nutrition Physical activity Screen time reduction
Statistics 4,000 child care centers 14,000 family day care homes 650,000 child care spaces 14,000 participate in CACFP 350,000 children served 31.5% of 2-4 year olds 32% of Upstate public school students 40% of NYC public school students Child Care Data (2010)Obesity Data (2010)
Obesity Prevention in Child Care Partnership – Steering Committee Dept. of Health CACFP Obesity Prevention Program Office of Children and Family Services Child care licensing and subsidy NYS Head Start Collaboration Physical Activity Specialist NYS Early Care Advisory Council members Early Care and Learning Council
Partnership Focus Obesity Prevention Regulations and Policies Quality Rating System Education and Training
Common Standards Increase physical activity Reduction in screen time Decrease in sedentary behavior Supporting breastfeeding mothers Expansion of required training to include topics related to obesity prevention, including CACFP’s Healthy Meal Pattern Support for CACFP Healthy Meal Pattern
Nutrition and Screen Time
CACFP Obesity Prevention Healthy Child Meal Pattern 1% or Less for children over 2 years No flavored milk for children under 5 years Juice served no more than once per day (breakfast or snack) Water served at snack if no other beverage Sweet grains limited to twice per week (breakfast or snack) EWPH Child Care Settings Child care centers Day care homes Breastfeeding Friendly Centers and Homes
NYS Day Care Licensing - Nutrition Existing Standards Adequate food must be available in appropriate portions for size and age of children Center programs must have 4 weeks of menus reviewed by nutrition professional (or CACFP) Medical, religious and personal food preferences must be accommodated Children must be helped to feed themselves Safe drinking water must be available at all times Every effort must be made to accommodate a breastfed child
NYS Day Care Licensing - Nutrition Proposed Program Standards No new nutrition or breastfeeding standards Proposed Required Training Topics Healthy menu planning Obesity prevention Benefits of and how to encourage breastfeeding for mothers returning to work
NYS Day Care Licensing – Screen Time Proposed Program Standards Screen Time Center: Infants (under 18 mo) must not be exposed to any screen time Family: TV must be off when not in use for program activities Must be part of planned, developmentally appropriate program for educational, social, physical or other learning objective Screen time during meals is prohibited Screen time should not be used solely to occupy time
Quality Stars NY – Nutrition Standards Points awarded if: Program compares revenues and expenses to budget, OR Fiscal records and budget are reviewed to ensure no deficit OR If eligible, program participates in CACFP Meals and snacks served or consumed meet the CACFP meal pattern for ages in care Program implements an obesity prevention program Staff attends training on obesity prevention Program supports breastfeeding Before PartnershipWith Partnership
Quality Stars - Screen Time Standards Only to the extent that credentialing programs address it Program must have a policy: Regarding use of TV/Video Birth-2 years: None 2-5 years:30 min/wk Educational only Commercial-free Before PartnershipWith Partnership
NYS Early Care and Education Core Body of Knowledge Framework Proposed changes: Considers developmental appropriateness of screen time Provides meals that align with NY CACFP meal patterns Limits fruit juice to 4 oz. per day Encourages exclusive breastfeeding until 6 months and accommodates breastfeeding mothers
Beyond the Partnership NYS Governor’s Race to the Top Early Care and Learning Recognized CACFP’s impact on early child care and education NYS Department of Health Commissioner Agency-wide Childhood Obesity Council Advocating for CACFP as the nutrition standard in licensing
Physical Activity
NYS Day Care Licensing – Physical Activity Proposed Program Standards Daily schedule must include “tummy time” Offer indoor activities, out door activities and variety of large muscle activities throughout the day There must be physical activity every day Proposed Required Training Topics Promoting play and physical activtiy
Quality Stars – Center & Home-based Physical Activity Standards Daily opportunities to move freely under adult supervision to Explore indoor and outdoor environment Including tummy time when awake 15 min. PA/hr in care Developmentally appropriate PA Include structured and unstructured PA Moderate to vigorous PA Both indoors and outdoors Infants/Toddlers to 18 monthChildren over 18 month
NYS Early Care and Education Core Body of Knowledge Framework Children must effectively develop small muscle skills and large muscle coordination through play Provide opportunities for gross motor and outdoor play for the development of large motor skills Recognize and respect importance of play in children’s development and growth Provides children with at least 120 min. of gross motor activity (for children attending a full day program) each day through both structured and unstructured play Existing PoliciesProposed Policies
Consider changing term to Recommend development of ‘fundamental movement skills’ instead of ‘gross motor activity’
Fundamental Movement Skills Object Control LocomotorStability
This is NOT Rocket Science
Let’s try a few fun ways to practice Fundamental Movement Skills
Partnership Challenges/Lessons There are no quantitative measures in regulations Monitoring meals of non-participating programs Monitoring amount of physical activity Access to physical activity training Breastfeeding Friendly recognition for non- participating programs Support from Early Childhood Advisory Council Influential people are important for policy changes
Next Steps Supporting implementation of regulatory changes and Quality Stars Rating System Increasing CACFP participation Revisiting EWPHCCS and DCH models Increasing Breastfeeding Friendly Child Care programs Creating a physical activity training plan Reviewing progress towards standards
Thank You!