Revised - Formative Research to Develop Educational Materials for Parents, Caregivers, and Child Care Providers of Children Ages 2-5 (SLT)

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Discussion Guide for Child Care Provider IDIs - Draft

(BRONX, NY & MD)

Attachment N: Interview Facilitator’s Guide: Child Care Provider (English)

Note: A discussion guide is a tool used to facilitate the flow of discussion. The guide is not a script and will not be used verbatim. The moderator will explore opportunities as they present themselves during the discussion. The guide should be viewed as a framework for discussion.

I. Introduction 2 minutes

Hello, my name is _______ and I’ll be conducting our interview today/tonight. My client for this research is the United States Department of Agriculture/Food and Nutrition Service. The purpose of this research is to learn about the experiences of child care providers of young children ages 2-5, as well as to show you some health education materials and hear your thoughts about them.

Thank you for being here. Before we get into the formal part of our discussion:

Explain the purpose of the interview. Go over the features of the interview, including:

• Completely private: Your full name will never be used, so please express your opinions freely.

• Please turn off cell phone during the time we are in the interview. Thanks.

• This discussion is being audio taped so that I do not have to take notes. This is strictly for research purposes. Everything will be kept private, except as otherwise required by law. I am required by law to report cases of child maltreatment.

• If there are observers – They are here to remind me if I have missed anything.

• While it can be hard for some people to feel comfortable being completely honest when asked their opinion, you have been invited here because we really value your thoughts.

• Please speak up when you talk so that I can hear you clearly, and so that the recorder accurately picks up your voice.

• Further, I am an independent researcher, so whatever your view, I will neither judge nor be offended. So please be honest! You have valuable individual experiences, positive and negative, and I want to hear about them all. There are no right or wrong answers.

• If you have any questions or additional comments, please ask at any time.

II. EXPLORATORY SECTION 16 minutes

GENERAL CONCERNS REGARDING YOUNG CHILDREN

So let’s start from the beginning …

• Please tell me about the issues of greatest interest, challenge or concern to you regarding your role as a child care provider of 2-5 year-olds at this center or home.

• How do you feel about the food and nutrition that the children receive? Please explain.

  • Does the nutrition that the children receive reflect your center or home’s general feeding standards and practice? IF NO, How are they different?

• Does managing the nutrition or feeding of the 2-5 year-olds in your care present any issues or challenges for you? Tell me more.

• What has been your experience in working for a program that participates in the Child and Adult Care Food Program (CACFP)?

• Does the fact that your program participates in CACFP make it unique from other child care programs that you know of? How so?

CONCERNS AND CHALLENGES SPECIFIC TO NUTRITION

• Do you understand, feel comfortable, and motivated to practice proper food safety guidelines in preparing and serving meals to the children in your care? [PROBE to be sure they have been provided with this type of information]

  • Please explain what makes it easy or challenging to follow food safety guidelines.

  • Is there anything that would make it easier for you to do this?

• Do you understand, feel comfortable, and motivated to provide well-balanced meals to the children in your care, according to the CACFP Meal Pattern for children ages 2 -5? [PROBE to be sure they have been provided with this type of information]

  • Please explain what makes it either easy or challenging to provide meals that meet CACFP Meal Patterns?

  • Is there anything that would make it easier for you to do this?

  • How do you feel it will be to provide meals that meet the updated CACFP meal patterns?

• What are some of the barriers or challenges you have seen the parents enrolled at your site face in providing their young children with well-balanced meals, if any?

• Do you feel you can play a positive role in helping parents achieve better nutrition for their children enrolled in your care?

  • PROBE: Why or why not?

  • Specifically, what have you done or could you do to assist parents in this way?

SOURCES OF HEALTH-RELATED INFORMATION

• From whom and/or where do you receive your child nutrition-related information and guidelines for use within the child care setting (PROBE: child care center or home, Web sites, social media, news, TV, friends, family, books, other sources)?

• What do you consider to be the most trustworthy sources of information related to child nutrition?

• How important is it to you to recognize the source of the information?

Level of Interest in Child Care Providers as a Source of Nutrition Information

• In what ways (formats and delivery methods) do the parents at your child care site receive information from the center or home? (not necessarily nutrition-specific) (PROBE around hardcopy flyers, emails, robo calls, web site postings, etc.)

• How do you communicate information related to health and nutrition to parents and caregivers?

• What would help you communicate better with parents and caregivers about nutrition-related matters?

• If you were provided with information about nutrition-related practices for parents and caregivers, how motivated would you be to share these materials?

  • PROBE: Tell more why you responded that way.

• How do you think this information would be received by parents and caregivers? Why?

III. MATERIALS TESTING- FINAL SELECTION FROM NIBBLES FOR HEALTH NEWSLETTERS and NUTRITION AND WELLNESS TIPS FOR YOUNG CHILDREN: PROVIDER HANDBOOK FOR THE CHILD AND ADULT CARE FOOD PROGRAM (CACFP) 40 minutes

23 minutes

A. Review of Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program

Now we’re going to discuss tip sheets from the Provider Handbook, a resource and training guide produced by USDA for child care providers participating in the CACFP. Keep in mind that these tip sheets are always being updated. Your thoughts and suggestions will help shape future versions. As you look at each tip sheet, think about the topic that it covers and how the information is presented on the pages.

[Moderator shares test materials and instructs participants to review all pages. Allow 7 minutes for review.]

TEST MATERIALS

Table of Contents

Build a Healthy Plate with Less Salt and Sodium

Meat and Meat Alternates: Build a Healthy Plate with Protein

Build a Healthy Plate with Whole Grains

Supplement D: Create a Positive Meal Environment*

Build a Healthy Plate with Vegetables

Best Practices/Success Stories

[Materials found in Attachment R: Stimulus: Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program (CACFP) (English).]

*Supplement D is not included in the Table of Contents being tested. This Table of Contents came from the original version of the Provider Handbook, which was published in 2013. Supplement D was published two years later, in 2016. The Table of Contents will be updated to include this supplement, and other additions to the Provider Handbook, in late 2017/early 2018.

REVIEW OF MATERIALS

Now that you’ve had a chance to review the materials, let’s discuss.

Content

• Have you seen and/or used these tip sheets in the past?

• Is the purpose of these materials clear to you? Explain.

• After reading the Table of Contents, what information is of particular interest to you? (PROBE: Are there topics that you would like to see added to the Provider Handbook?)

• Do you find the content of the Provider Handbook easy to read and understand?

  • Is the tone and language appropriate and easy to understand?

• Which parts of the handbook are most useful to you?

• PROBE: What nutrition, physical activity, or electronic media use topics do parents ask about the most? Which topics do you feel parents could most benefit from learning more about?

• What type of information would you like to see included in the “Connect with Parents” section that you see in some Tip Sheets? These provide suggestions on how to convey nutrition education messages and information to parents. [Moderator points to “Connect with Parents” sections on page 21 and page 23 of Attachment R.]

Now I’d like for you to consider the specific tip sheets that you reviewed and tell me if you feel the information provided is “useful” or “not useful” in your role as a child care provider for each of the following:

Ask for FIRST item from “tips sheet list” below:

• Would you say the [NAME OF TIP SHEET HERE] tip sheet was “Useful”? OR “Not Useful.”

  • If “Useful,” tell me what about the content you read was particularly useful.

  • If “Not useful,” tell me why you feel the information provided in that tip sheet was not particularly useful to you, and what could make it more relevant to your current practice?

REPEAT THE SERIES OF QUESTIONS ABOVE FOR EACH ADDITIONAL ITEMS IN THE LIST BELOW.

Tip Sheet List:

• Build a Healthy Plate with Less Salt and Sodium

• Meat and Meat Alternates: Build a Healthy Plate with Protein

• Build a Healthy Plate with Whole Grains

• Supplement D: Create a Positive Meal Environment

• Build a Healthy Plate with Vegetables

• Best Practices/Success Stories

• Would you like to see these stories in the Success Stores section of the handbook, or would you prefer them integrated into the tip sheets (for example: “active play” stories in the tip sheet about active play, etc.)?

• Is there information that was left out that you feel would be helpful in your role as a child care provider or that could help you communicate better with parents and caregivers?

• Is there any information presented in Provider Handbook that is confusing, or could be improved?

• Is any of the information presented in the Provider Handbook contrary to your beliefs? Explain.

Design and Layout

• What do you think of the printed format (three-hole punched with O-ring provided)? Are there other formats that you would prefer?

  • PROBE: Web site, video, interactive eBook, etc.

  • Would a video or web site be helpful to go along with it?

• In what format would you like to see the “Connect with Parents” section of the Tip Sheets? PROBE: Newsletters? Texts? Web sites?

• What do you think of the format and layout of the information presented in the handbook?

• PROBE: Would you like more activities to help you apply this information?

• Do you find some sections more helpful or useful than others? Which ones?

The Provider Handbook uses different types of pictures. I will you show you different examples and would like to know what you think. Each group of pages is coded with a letter and number. As we review, please be sure to tell me the letter and number of the page that you are referring to. [Moderator distributes pages with samples of three styles.]

[Materials found in Attachment T: Stimulus: Sample illustrations for use in Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program (CACFP)]

• How appealing are the pictures, illustrations and graphics in the Provider Handbook?

• PROBE: Do you have a preference for the pictures in Group A, Group B, or Group C? Why?

• PROBE: Within each group, are there individual pictures that you prefer? Please specify the letter and number of the page where the picture appears. What do you like about this (these) pictures?

• Do the pictures of people featured in the handbook look like the people you work with or see at your child care site?

• Do the pictures, illustrations, and graphics in the handbook help with understanding the concepts presented?

• What recommendations can you share to make the Provider Handbook more useful?

BEHAVIORAL INTENT

• Do you anticipate using the Provider Handbook in your work as a child care provider or to support the parents and caregivers at your site? PROBE: Please explain.

• If someone gave you this handbook, would you be likely to use it on your own?

• PROBE: Why or why not?

• Do you think you would need to have an in-person or online training first to show you how to use it? Why or why not?

• How frequently do you think you would reference it? Explain how and when.

B. Review of Nibbles for Health Newsletters Test Materials 17 minutes

Now we’re going to review some materials from the USDA newsletter series for parents/caregivers of young children called Nibbles for Health. Keep in mind that these are not finished. Your thoughts and suggestions will help shape the final versions. As you look at each newsletter, think about the topic that it covers and how the information is presented on the pages.

[Moderator distributes test materials and instructs participant to review all pages. Allow 5 minutes for review. Materials found in Attachment P: Stimulus: Nibbles for Health Newsletters (English)]

Specific newsletters to be reviewed will include:

• Newsletters at a Glance

• Milk Matters

• Child Care: What Will My Child Eat?

• MyPlate for Preschoolers

• Cutting Back on Added Sugars

• Feeding Your Preschooler

REVIEW OF MATERIALS

Now that you’ve had a chance to review the newsletters, let’s discuss.

• What do you think about the information presented in the newsletters?

• PROBE: Did you find any information in the newsletters confusing or could be improved?

• PROBE: Is any of the information contrary to your beliefs? Please explain.

• PROBE: Is there other information or topics that parents or caregivers ask for or would be helpful for them to have? Please explain.

• Are these Nibbles for Health newsletters easy to read and use? Explain why or why not.

  • PROBE: How could the newsletters be made easier to use? (e.g., length, format differently, color-code by theme, provide space for notes, etc.)

  • PROBE: What format would you prefer to receive the newsletters? For example, hard copy, download from a web site, digital (such as CD, DVD, or USB flash drive)?

• How do you feel about the titles of the newsletters?

  • PROBE: Do they give you an idea of the information covered in the newsletter?

• Do you feel the information presented in the newsletters is realistic for the parents/caregivers of the children your program serves? Why or why not?

Now I will show you another set of newsletters. This time, you don’t need to read the text. Focus on the graphics, including the colors, illustrations, and how the newsletters look in black and white.

Moderator distributes test materials and allows 1-2 minutes for review.

[Materials to be found in Attachment Y: Stimulus: Sample Illustrations for use in Nibbles for Health Newsletters].

Specific materials to be reviewed will include:

• Nibbles for Health front cover (in color)

• Learning about Hand Washing (in color)

• Active Play Everyday (in color)

• Healthy Celebrations (in color)

• Whole Grains Make a Difference (in color)

• Portions for Preschoolers (black and white)

• Let’s Cook Together (black and white)

• How appealing are the graphics and illustrations?

  • PROBE: Are there any graphics or illustrations that stand out in particular? Which ones? (Probe around both positive and negative aspects, including cultural relevancy, illustration style, etc.)

  • Are you able to identify what the food items are?

• Do you think the characters in the newsletters will resonate with parents and caregivers? Why or why not? Circle the characters that you think parents and caregivers will relate to or like the most and put an X by the characters that you think they won’t like or won’t relate to.

• Are the black and white newsletters appealing? Do you have a need for black and white versions?

• What recommendations can you share to make the newsletters more useful?

BEHAVIORAL INTENT

• Did you learn new information from these newsletters that you will consider sharing with parents (or using yourself) to feed the young children enrolled at your child care site? PROBE: Which information specifically?

• Can you see distributing the Nibbles for Health newsletters to parents/caregivers at your child care site?

  • PROBE: If yes, How likely? How often? (weekly, monthly, etc.)

  • If no, please describe the issues or challenges that would keep you from distributing the newsletters to the parents and caregivers at your site.

• Do you think providing this information in hardcopy format, such as what you’ve reviewed here, would work for the parents and caregivers your program serves?

• PROBE: If you were to print to distribute, would you likely use color or black and white?

• PROBE: What other formats might be helpful? (digital, such as CD, DVD, or USB flash drive; web site, email, video, etc.)

IV. Wrap up 2 minutes

• Is there anything that was not discussed that you would like to bring up now? If so, what?

Thanks so much for your time and for sharing your thoughts.