However, NAP SACC outcomes at the program level vary this variation may be attributed to dosage of components of the ECELC received by ECE programs and the ability of ECE programs to select their own goals within the intervention ( 9). Since its inception in 2012, the ECELC has improved ECE program practices and policies in topic areas of the Nutrition and Physical Activity Self-Assessment in Child Care (NAP SACC). The National Early Care and Education Learning Collaboratives Project (ECELC), funded by the Centers for Disease Control and Prevention and implemented by Nemours Children’s Health System, is using a train-the-trainer model to reduce childhood obesity by promoting healthy environments in ECE programs ( 8). The physical and social environment of ECE programs help shape children’s physical activity and dietary behaviors therefore, fostering effective strategies to help child care providers establish healthy environments is key ( 5– 7). Given that almost 7 million children in the United States under the age of 5 spend an average 25 hours or more per week in child care centers or Head Start, early care and education (ECE) programs are a critical setting for obesity prevention efforts ( 4, 5). Early-life dietary habits and body weight are strongly related to risk for obesity in adulthood ( 2, 3). The prevalence of obesity is 9% among preschool-aged children in the United States ( 1).
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