Eat Well Play Hard in Child Care Settings (EWPHCCS)

Nutrition Division, NYSDOH and NYS Child and Adult Care Food Program (CACFP)

Overview

Eat Well Play Hard in Child Care Settings (EWPHCCS) is a direct education and PSE change intervention that focuses on improving the nutrition and physical activity behaviors of pre-school age children and their parents/caregivers by using educational strategies and skill building activities to promote healthy behavior change. The intervention also builds social support within the child care environment by including teachers and care providers in lessons and encouraging positive role-modeling and classroom reinforcement of nutrition and physical activity messages.

Target Behavior: Healthy Eating, Physical Activity

Intervention Type: Direct Education, PSE Change

Intervention Reach and Adoption

EWPHCCS targets families with children ages 3-5 years, participating in or eligible for the Supplemental Nutrition Assistance Program (SNAP) and children enrolled in child care centers participating in the Child and Adult Care Food Program (CACFP). Eligible centers are those in which 50% or more of enrolled families qualify for free or reduced-price meals or those that are considered eligible for At-Risk meals.  CACFP-participating child care centers provide access to a large, diverse population of low-income children and families across New York State. These families are racially, ethnically, and geographically diverse and live in urban, suburban, and rural areas.

While EWPHCCS was originally developed for English speakers of all races and ethnicities, take-home handouts are also available in Spanish, Chinese, Russian, Arabic, French, Haitian Creole, Italian, and Bengali.

Setting: Child care

Target Audience: Preschool (<5 years old), Parents/Mothers/Fathers, Adults

Race/Ethnicity: All

Intervention Components

The EWPHCCS curriculum contains 10 lesson plans tailored for preschoolers and 10 complementary lessons for their parents/caretakers.  The lessons are about nutrition, cooking, mealtime behavior, and increasing physical activity among children.  Activities, food preparation demonstrations, recipes, and take-home materials reinforce the learning objectives for each lesson.  Annually, each Full Time Equivalent (FTE) Registered Dietitian (RD) implements the intervention in 15 child care sites in New York State.

Intervention Materials

All materials needed to implement Eat Well Play Hard in Child Care Settings can be provided free of charge by emailing CACFP@health.ny.gov.

The intervention materials include:

  • Complete Curriculum
  • Training modules for child care center staff
  • Parent Newsletters in Arabic, Chinese, French, Russian, Spanish, Haitian Creole, Italian, and Bengali

Evidence Summary

In 2012, the Altarum Institute released the results of an evaluation of Eat Well Play Hard in Child Care Settings, funded by the U.S. Department of Agriculture (USDA), Food and Nutrition Service, Office of Research and Analysis.  The USDA-funded evaluation included process and outcome measures and analysis. A total of 24 childcare centers, 12 in New York City and 12 elsewhere in New York State were included in the USDA evaluation.  The 24 centers were divided into pairs and matched for center type (standard or Head Start), location (NYC or elsewhere in NY state), and size.  One of the paired centers was randomly assigned to receive the EWPHCCS intervention, while the other served as the control group.

The researchers found the following statistically significant results when they compared children in child care centers who received the EWPHCCS program to children in centers that did not receive the program:

  • Increase in children’s daily at-home consumption of vegetables
  • Increase in children’s at-home use of 1% or fat-free milk
  • Increase in reports of the rate of child-initiated vegetable snacking
  • Trend toward increased parental offerings of vegetables

Classification: Practice-tested

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
Individual MT1, MT3
Environmental Settings ST7
Sectors of Influence

Evaluation Materials

Center TRT developed an evaluation logic model and evaluation plan for Eat Well Play Hard in Child Care Settings, an intervention delivered through child care settings with the goal of influencing children’s at-home behaviors. The logic model is intended to guide the evaluation process; the evaluation plan focuses on the extent of implementation, acceptability, and effectiveness of the EWPHCCS program. This evaluation plan is intended to be used in combination with the template, which details the process of implementing EWPHCCS, and the Center TRT evaluation logic model, both posted on the Center TRT website. The evaluation is a pre-post design with no comparison group. The evaluation plan provides guidance on evaluation questions and types and sources of data for both process and outcome evaluation.

The New York State EWPHCCS program developed data collection tools that were used in program evaluation prior to the 2011 formal evaluation study. The Parent baseline– and follow-up survey includes questions about milk consumption, how often fruits, vegetables, and milk are offered, TV viewing and physical activity patterns of children, and confidence in their ability to perform healthy lifestyle behaviors. Additional evaluation tools are posted on the Center TRT website.

 

Additional Information

Website: The EWPHCCS website (http://www.health.ny.gov/prevention/nutrition/cacfp/ewphccs.htm) includes an overview of the program. Additional information can be found on the EWPHCCS Center TRT Template.

Contact Person(s):
Lisa Borden, Director
CACFP Obesity Prevention Unit
NYS Department of Health
Riverview Center FL6W
Albany, NY 12204-2719
Email: lisa.borden@health.ny.gov