Consistency of compliance with nutrition-related regulations among Delaware child care centers.

Background: As more calls are made in the literature for nutrition interventions to be delivered in child care settings, research on the implementation of these interventions becomes more important. This study examined compliance with Delaware's regulations related to nutrition in child care settings, which are designed to improve the nutrition-related environment in these settings.

Methods: A stratified random sample of licensed child care centers (n=233) was created from the total population of eligible centers in Delaware (N=450). Study staff visited each center and distributed self-administered surveys to the director and two randomly selected teachers. Surveys contained items about classroom-level compliance with the regulations along with center-level characteristics. Bivariate analyses were conducted to explore relationships between consistent compliance with each regulation component and center-level characteristics.

Results: A total of 179 of the 233 centers in the selected sample participated in the study. Compliance with the regulations varied within centers and across components; the highest levels of consistent compliance were reported for juice type (88.3%) and the lowest levels for whole grains (18.6%). Center characteristics, such as participation in the Child and Adult Care Food Program, were associated with consistent compliance for certain regulations components.

Conclusions: Our results suggest that these types of regulations can be implemented across a diversity of centers, but that certain components (e.g., those relating to whole grains and water) may need further clarification. Our results also suggest that there are certain types of centers on which to focus training efforts to maximize compliance.