Impact of Childcare Licensing Regulations Related To Childhood Obesity on the Home Environment: A Study of the New York City Childcare Regulations Öffentlichkeit

Abstract

Early childhood obesity is an emerging public health concern. In the United States, 26.2% of children ages 2-5 are either overweight obese and research has shown that children who are overweight at an early age are at higher risk of negative health outcomes throughout life. One promising avenue for intervention with this age group is changing the childcare environment, a setting where many young children spend time. While interventions delivered in this setting have impact on child behavior while in childcare, the overall impact of these interventions on child weight status rests in the combination of their behavior in that setting and at home; the extent to which these interventions impact the home environment has yet to be determined. This research considered the extent to which childcare-based obesity prevention interventions have a spillover effect on the home environment first through
a review of the published literature and second through original research considering the effect of a policy-level intervention on the home nutrition, physical activity and screen viewing environment of young children in New York City.

This exploration into the possible spillover effect of childcare-based obesity prevention interventions showed that there is little evidence to support the translation of program effect into the home. Across twelve existing studies and the two original studies, there were little data to support a spillover effect of programs without direct-to-parent components. The review considered twelve studies of ten different interventions designed to intervene in exercise, nutrition and/or screen viewing and the two original studies considered the potential impact of one all-encompassing environmental intervention on the home nutrition environment and the home physical activity/screen viewing environment. Thus across eleven interventions, very little impact was seen on the home environment of
participating children. In the review paper, only seven intervention studies assessed the home environment and only three found a significant spillover effect. In both the original studies, there was no effect of the intervention on the home environment. Some reasons for the lack of spillover may be the focus of the interventions, inadequate measurement of spillover, and
unknown or unmeasured neighborhood factors.

Table of Contents

Table of Contents


Item Page

Introduction 1

Unintended Consequences: The potential effect of childcare-based 18
obesity prevention interventions on the home

The impact of childcare regulations on aspects of the home 39
nutrition environment

The impact of childcare regulations on aspects of the home 54
environment related to screen time and physical activity

Conclusion 69

About this Dissertation

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School	Laney Graduate School
Department	Behavioral Sciences and Health Education
Degree	PhD
Submission	Dissertation
Language	English
Research Field	Health Sciences, Public Health
Stichwort	childcare nutrition obesity physical activity
Committee Chair / Thesis Advisor	Cooper, Hannah, Emory University
Committee Members	Argeseanu, Solveig, Emory University Frisvold, David, Emory University Jernigan, Jan, Centers for Disease Control and Prevention

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