Staff: One full-time equivalent (FTE) early care and education coordinator was hired with CPPW grant funds to coordinate the ABC Grow Healthy Initiative. DHEC recognized the importance of maintaining a dedicated position to provide the public health expertise for the early care and education setting. Subsequently, an early care and education coordinator continues to be funded by DHEC. This position supports the ABC Quality system and child care programs implementing the standards and collaborates with partners for additional obesity prevention efforts. DSS committed in-kind staff support, including the ABC Quality Program Manager and program assessors, during the development, pilot, and evaluation of the ABC Grow Healthy Standards. By adopting and embedding the nutrition and physical activity standards into their existing infrastructure ABC Quality took ownership of the standards. Efforts related to overseeing compliance and providing technical assistance to child care providers were incorporated into ABC Quality staff responsibilities.
Training: The assessors need to be trained in order to ensure reliable and consistent monitoring across staff so that they are fairly assessing each center. Child care directors need training to understand the new standards and how a center will be assessed for compliance. Because many of the standards are implemented at the classroom level, classroom staff need training on the standards and how to implement them. Statewide training infrastructure is necessary to meet ongoing training needs.
Materials: Few materials were needed to implement this administrative policy. The ABC assessors utilize an electronic data tablet to assess compliance during unannounced reviews. A test platform of the proposed standards was created and used by assessors during the pilot. The review tools on the electronic data tablet were updated to include the standards once finalized. Once the standards were adopted by the ABC Quality system, communication materials were developed for child care providers. These communication materials can be found in the Intervention Materials section: the ABC Grow Healthy Best Practices Checklists, invitation letter to overview sessions for Level B providers, a letter sent to Level B providers announcing the standards, and the Level B assessment tool, with changes highlighted, with the embedded standards.
Funding: DHEC received approximately $700,000 through the CPPW grant to implement this initiative. Funds were used to support project staff, contract with nutrition and physical activity experts, as an incentive for child care providers participating in the pilot, for evaluation efforts, and to update the review tools on the electronic data tablet. While DHEC received this substantial grant to establish and implement nutrition and physical activity standards, the initiative can be adopted with minimal funding as it is an administrative change above all, and maintained through existing DSS staff and capacity. However, a dedicated position in the public health agency to support obesity prevention efforts and partners in the early care and education setting is crucial to long-term success.
Other costs: A variety of outreach strategies, such as training and marketing incentives, have been used to increase awareness of ABC Grow Healthy. Promotional items, such as tote bag with partner logos, water bottles, magnets, and lunch bags, were purchased for distribution at conferences for providers, as well as community events for parents and children. DSS, DHEC, and other partners, including municipalities, have shared costs for local events.