Prev Chronic Dis

IntroductionA quality rating and improvement system (QRIS) is a fundamental component of most states\u2019 early care and education infrastructures. States can use a QRIS to set standards that define high-quality care and award child care providers with a quality rating designation based on how well they meet these standards. The objective of this review was to describe the extent to which states\u2019 QRIS standards include obesity prevention content.MethodsWe collected publicly available data on states\u2019 QRIS standards. We compared states\u2019 QRIS standards with 47 high-impact obesity prevention components in Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition, and 6 additional topics based on the Centers for Disease Control and Prevention\u2019s Spectrum of Opportunities for Obesity Prevention in the Early Care and Education Setting.ResultsThirty-eight states operated a state-wide QRIS in early 2015. Of those, 27 states\u2019 QRIS included obesity prevention standards; 20 states had at least one QRIS standard that aligned with the high-impact obesity prevention components, and 21 states had at least one QRIS standard that aligned with at least one of the 6 additional topics. QRIS standards related to the physical activity high-impact obesity prevention components were the most common, followed by components for screen time, nutrition, and infant feeding.ConclusionThe high proportion of states operating a QRIS that included obesity prevention standards, combined with the widespread use of QRISs among states, suggests that a QRIS is a viable way to embed obesity prevention standards into state early care and education systems.29215976PMC572499