부산대학교 도서관

Preschool children's obesity rate in Nebraska is fifth in the U.S. Rural areas tend to have more health disparities comparing to urban area. Limited research has identified the differences of the policy, systems and nutrition environment between rural and urban childcare centers. To investigate differential effectiveness of the Nutrition and Physical Activity Self-Assessment in Child Care (Go NAP SACC) in urban and rural areas in Nebraska. With a sample (N = 171) childcare centers in Nebraska ([N = 102] urban and [N = 69] in rural areas), a quasi-experimental longitudinal study was conducted from 2014 to 2017. Paired sample t-tests were conducted to compare pre- and post-test scores within urban and rural centers, separately. Independent sample t-tests was also used to examine differential effectiveness between urban and rural centers. Go NAP SACC was found to improve the nutrition environment in most assessment items (30 out of 42 items) including food provision and feeding environment. While rural centers showed significant improvement in the beverage provision section (P <.05), urban centers presented high improvement in the sections of feeding practice and menu variety (P <.05). At the pre-test assessment, there were significant differences in the scores between rural and urban centers, specifically in some items regarding beverage provision, feeding environment, and feeding practices. However, there was no longer a significance difference in the scores of those items (P >.05) at the post-test assessment. Go NAP SACC program is an effective program to enhance the child nutrition environment in both rural and urban centers as well as decrease disparity in nutritional environments between urban and rural centers. Future research is needed to examine how to provide more adaptive obesity intervention program based on the multiple data such as poverty, isolation and neighborhood status in rural areas. CDC. [ABSTRACT FROM AUTHOR]