Barriers and facilitators for implementation of early care and education (ECE) - based nutrition and physical activity programs among children ages 0 to 5 years

Purpose: To identify perceived barriers and facilitators from ECE center directors and assistant directors towards implementing new programs targeting healthy nutrition, breastfeeding, and physical activity among children from 0-5 years of age. Approach: Secondary qualitative data analysis Setting: Houston, Texas licensed early child care (ECE) centers. Participants: ECE centers directors and assistant directors (N=26). Method: Secondary analysis of the qualitative data collected from 4 focus groups in the parent study, including a varied group of ECE centers. Participants were recruited using purposive sampling by email and phone. Thematic analysis of transcripts identified significant themes. Results: Themes perceived by the center directors as potential barriers and facilitators were identified at the household, teaching staff, organizational and community levels. Majority of the resulting themes were associated with nutrition and physical activity topics. Only a few themes were related to breastfeeding support at the ECE. Conclusion: More than half of the population of children from 0-5 years of age in the United States is enrolled in some form of ECE center. Understanding perceptions from ECE directors and assistant directors of the implementation of nutrition and physical activity programs, identifying barriers and facilitators that influence this process are vital to promote healthy nutrition and physical activity in ECE settings