Family child care home providers' self-reported nutrition and physical activity practices, self-efficacy, barriers and knowledge: baseline findings from happy healthy homes

Objective: Describe nutrition and physical activity practices, nutrition self-efficacy and barriers and food programme knowledge within Family Child Care Homes (FCCH) and differences by staffing. Design: Baseline, cross-sectional analyses of the Happy Healthy Homes randomised trial (NCT03560050). Setting: FCCH in Oklahoma, USA. Participants: FCCH providers (n 49, 100 % women, 30 center dot 6 % Non-Hispanic Black, 2 center dot 0 % Hispanic, 4 center dot 1 % American Indian/Alaska Native, 51 center dot 0 % Non-Hispanic white, 44 center dot 2 +/- 14 center dot 2 years of age. 53 center dot 1 % had additional staff) self-reported nutrition and physical activity practices and policies, nutrition self-efficacy and barriers and food programme knowledge. Differences between providers with and without additional staff were adjusted for multiple comparisons (P < 0 center dot 01). Results: The prevalence of meeting all nutrition and physical activity best practices ranged from 0 center dot 0-43 center dot 8 % to 4 center dot 1-16 center dot 7 %, respectively. Average nutrition and physical activity scores were 3 center dot 2 +/- 0 center dot 3 and 3 center dot 0 +/- 0 center dot 5 (max 4 center dot 0), respectively. Sum nutrition and physical activity scores were 137 center dot 5 +/- 12 center dot 6 (max 172 center dot 0) and 48 center dot 4 +/- 7 center dot 5 (max 64 center dot 0), respectively. Providers reported high nutrition self-efficacy and few barriers. The majority of providers (73 center dot 9-84 center dot 7 %) felt that they could meet food programme best practices; however, knowledge of food programme best practices was lower than anticipated (median 63-67 % accuracy). More providers with additional staff had higher self-efficacy in family-style meal service than did those who did not (P = 0 center dot 006). Conclusions: Providers had high self-efficacy in meeting nutrition best practices and reported few barriers. While providers were successfully meeting some individual best practices, few met all. Few differences were observed between FCCH providers with and without additional staff. FCCH providers need additional nutrition training on implementation of best practices.