Food Outlet Density, Distance, and Food Quality Offered to Preschool-Aged Children at Family Child Care Homes.

Objective: To examine how food environments around family child care homes (FCCHs) are associated with the healthfulness of foods served to children.

Design: Cross-sectional data from a mail survey of FCCH providers, InfoUSA.

Participants: The study included 132 Mississippi FCCHs (26% response).

Main Outcome Measures: Dependent: compliance with nutrition best practices for 9 food categories; composite healthfulness score. Independent: counts of supermarkets, small-medium grocery stores, produce stores, convenience stores within 5 miles; distance to supermarket.

Analysis: Logistic regression estimated associations between best-practice compliance and food environment. Linear regression estimated associations between composite food healthfulness and food environment. Models stratified by rural/urban location.

Results: Rural FCCHs with higher counts of supermarkets, convenience stores, and produce stores had lower compliance with selected best practices (fried/prefried potatoes, high-sugar/high-fat foods). Urban FCCHs with more supermarkets had higher compliance with fruit not canned in syrup; those with more small-medium grocery stores and convenience stores had lower compliance with selected best practices (fried/prefried potatoes, vegetables, low-fat meats).

Conclusions And Implications: Food environment measures were associated with some nutrition best practices, though not consistently in the expected direction. Future research could examine food quality at stores near rural FCCHs. Programs that improve local food environments may improve foods served at FCCHs.