Dinkel, D., Dev, D., Guo, Y., Hulse, E., Rida, Z., Sedani, A., & Coyle, B. (2018). Improving the Physical Activity and Outdoor Play Environment of Family Childcare Homes in Nebraska Through Go Nutrition and Physical Activity Self-Assessment for Childcare. Journal of Physical Activity and Health, 15(10), 730-736.

In this article, Dinkel et al. (2018) described the effectiveness of Go NAPSACC intervention in improving best practices in the areas of infant and child physical activity and outdoor play and learning in 201 NE family childcare homes caring for 0-5-year-old children. During post-intervention, childcare providers reported significant higher implementation of best practices in 85% of the Infant and Child Physical Activity items (17 of 20) and 80% of the Outdoor Play and Learning items (12 of 15). Significant differences in best practices between urban and rural providers were also found directing the importance of considering geographical differences in case of program implementation.

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Dev, D. A., Williams, N., Iruka, I., Garcia, A. S., Guo, Y., Patwardhan, I., ... & Sedani, A. (2018). Improving the Nutrition and Screen Time Environment Through Self-Assessment in Family Childcare Homes in Nebraska. Public health nutrition, 21(13), 2351-2359.;

Dev et al. (2018) discussed how participation in Go NAP SAAC intervention has improved nutrition and screen time environment in 208 family childcare homes in 93 counties of Nebraska. After six months of training, participants demonstrated significant improvement in 14 of the 44 Child Nutrition items and 11 of the 12 Screen Time items. However, several best practices were not met after the intervention. For Child Nutrition: serving meals family-style, promoting visible support for healthy eating, planned nutrition education and written policy on child nutrition. For Screen Time: availability of television, offering families education onscreen time and having a written policy on screen time.

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Snyder, K., Rida, Z., Hulse, E., Dev, D., & Dinkel, D. (2019). Exploring Rural and Urban Go NAPSACC Trained Childcare Providers Perceptions and Needs Regarding the Promotion of Physical Activity and Healthy Eating. Cogent Social Sciences, 5(1), 1650412.

In this article, the authors utilized a qualitative cross-sectional design to assess the nutrition and physical activity reported practices and perceptions of rural and urban providers in Nebraska. The interview questions were framed upon constructs of the Social Cognitive Theory (i.e., personal behaviors, cognitive factors, and socioenvironmental factors). Findings indicated Go NAPSACC trained providers in both rural and urban areas felt they had the resources and knowledge needed to promote physical activity and healthy eating. However, they still struggled with barriers related to adequate space for activity, funding for equipment, parent engagement, and health promotion among staff and parents.

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Dinkel, D., Dev, D., Guo, Y., Sedani, A., Hulse, E., Rida, Z., & Abel, K. (2020). Comparison of Urban and Rural Physical Activity and Outdoor Play Environments of Childcare Centers and Family Childcare Homes. Family & Community Health. DOI: 10.1097/FCH.0000000000000267

The purpose of this study was to compare achievement of meeting evidence-based physical activity childcare standards between: (1) Childcare centers and family childcare homes in urban areas; (2) Childcare centers and family childcare homes in rural areas; (3) Childcare centers across geographic location (urban-rural); and (4) Family childcare homes across geographic location (urban-rural). This was a cross-sectional study using the results from the Go NAPSACC baseline self-assessments for the physical activity sections. Both urban and rural childcare centers reported higher levels of offering portable play equipment, family education on children’s physical activity and outdoor play, and professional development compared to the family childcare homes. Family childcare homes reported higher supervision, verbal encouragement, participation in children’s physical activity, and offering enough portable play equipment for each child compared to the childcare centers in urban area. Rural family childcare homes reported higher amount of daily time provided for children’s indoor and outdoor physical activities, and availability of a large space for outdoor activities compared to the childcare centers. Lastly, urban childcare centers and family childcare homes reported higher adherence to the best practices than their rural counterparts. These findings provide evidences rural childcare settings in particular may be in need of unique and creative approaches to improve child health outcomes.

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Kohel, K., Hatton-Bowers, H., Williams, N., Dev, D., Behrends, D., Hulse, E., Rida, Z., Dingman, H., Dinkel, D., & Gebhart, L. (2021). Improving Breastfeeding Environments and Feeding Practices in Family Child Care Homes with the Go NAPSACC Program. Maternal and Child Health Journal, 0123456789.

Kohel et al. (2021) examined the outcomes for the Go NAPSACC intervention in urban and rural family child care homes regarding best practices for breastfeeding and infant feeding. The article presents the results for 201 family child care home providers who completed the Go NAPSACC intervention between August 2014 and March 2018. Paired sample t-tests and ANCOVA were conducted to examine pre- to post-test differences in best practice scores. Significant changes in the score were reported for 18 out of 22 items regarding best practices for breastfeeding and infant feeding, after controlling for CACFP participation and the length of time between pre-and post-intervention data collection. Moreover, family engagement was improved after the Go NAPSACC intervention, which is a crucial area for family childcare homes. Lastly, no significant difference was found for the geographical variation of the participating family childcare homes.

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Dinkel, D., Rech, J.P., Guo, Y., Bice, M., Hulse, E., Behrends, D., Burger, C., & Dev, D. (2021). Examining Differences in Achievement of Physical Activity Best Practices Between Urban and Rural Child Care Facilities by Age. Early Childhood Education Journal, epub ahead of print, 1-11.

The purpose of this study was to examine differences in the achievement of physical activity best practices between 207 urban and 218 rural childcare facilities who had completed the Go NAPSACC process by age-specific recommendations (infants, toddlers, and preschoolers) and in the overall physical activity environment. A majority of facilities reported exceeding best practices (79.5%); however, significant differences were found on 18 best practices with urban facilities outscoring their rural counterparts on 17 of these items. A comparison by age found that urban facilities reported higher achievement of best practices among infants (60%) in comparison to toddlers (40%) or preschoolers (30%). Future efforts should continue to explore the rural–urban context of physical activity practices across the early childhood age groups to ensure healthy physical development of children, with a special emphasis on supporting rural facilities.