Barriers and supports to implementing a nutrition and physical activity intervention in child care: directors' perspectives.

OBJECTIVE: To explore the experiences of child care centers implementing a nutrition and physical activity (PA) program and identify supports and barriers as reported by center directors.
DESIGN: Semi-structured interviews with 20 child care center directors following program implementation.
SETTING: Twenty-two child care centers serving low-income children in Georgia. PARTICIPANTS: Twenty child care center directors who led program implementation at their respective centers. INTERVENTION: The program focused on introducing wellness policies to centers and on providing training and technical assistance to support implementation. PHENOMENON OF INTEREST: Center directors' perceptions, attitudes, and reflections on the process of implementing changes to nutrition and PA practices. ANALYSIS: Qualitative analysis of interview transcripts was conducted using NVivo 9 software. Researchers employed 2 levels of coding; 4 predominant themes emerged.
RESULTS: Directors' insights included the importance of hands-on activities and printable materials to engage children in nutrition and PA education and healthy behaviors; challenges and supports to engaging parents in child wellness; recognition that children readily accept nutrition and PA changes; and the need for program implementation efforts to prioritize the provision of support for directors and staff in modifying nutrition and PA practices. CONCLUSION AND IMPLICATIONS: Directors consider nutrition and PA policy changes to be beneficial to the child care environment. This study highlights important considerations for efforts to promote healthy weight environments in the early care setting.