​Summary: Since food preferences develop during early childhood and contribute to dietary patterns that can track into adulthood, it is critical to support healthy food environments in places where children spend significant amounts of time, such as childcare. It is important to understand what factors influence the diet quality of children cared for in family childcare homes (FCCH). This study used baseline data from a cluster-randomized trial in FCCH, Healthy Start/Comienzos Sanos. Surveys capturing providers’ socio-demographic characteristics were completed. Food and beverage consumptions were estimated using the Dietary Observation in Childcare protocol, and diet quality was calculated using the Healthy Eating Index (HEI)-2015. 

Findings: Significant differences in mean HEI-2015 scores were found for provider income level, ethnicity, language spoken outside of childcare (English vs. Spanish), and language spoken in childcare (English vs. Spanish). In linear regression models, a higher provider income ($75,001 or more) was negatively and significantly associated with the total HEI-2015 vs. lower income (less than $25,000). When entering provider income and ethnicity to the same model, adjusting for Child and Adult Food Program (CACFP), only ethnicity was significant, with Latinx being positively associated with total HEI-2015 scores vs. non-Latinx. Statistically significant differences were found by ethnicity and language for greens/beans, total protein, and seafood and plant protein HEI-2015 component scores. 

Lower income, and Latinx providers cared-for children had higher diet quality in FCCH compared to the other providers. Future studies should better understand what specific foods contribute to each of the HEI-2015 components in order to better tailor trainings and interventions.

This study cites 2007 California Health Interview Survey (CHIS) data.