Supporting the healthy development of rural children: an ecologically based investigation of barriers and facilitators identified by early years caregivers in the promotion of physical activity and healthy eating

Abstract

Physical activity and healthy eating are key components of healthy living, and they reduce the risk of developing chronic diseases. Current research indicates that Canadian early years children are not active enough for healthy growth and development. Additionally their diets are high in processed foods and lack fresh and locally grown foods. Parents play a key role in establishing healthy behaviours; however caregivers also have a strong influence, as many early years children spend a large portion on their day in care centres. To date, very little is known about the factors influencing rural caregivers in the provision of healthy opportunities for early years children in their care. Purpose: The purpose of this study was to use an ecological framework to identify facilitators and barriers that rural caregivers face when providing physical activity and healthy eating opportunities in care centres. Methods: Caregivers (N = 8) in rural settings participated in one on one semi-structured interviews. Perceived facilitators and barriers reported by caregivers were categorized using the ecological model as (intrapersonal, interpersonal, institutional, community, and policy). Results: Caregivers identified facilitators and barriers. (i.e., personal health and wellness, caregiver perceptions of lack of parental knowledge, parental support and access to facilities and local foods in the community), that influenced their ability to provide physical activity and healthy eating opportunities for children in their care. Similar barriers and facilitators were clustered together to create themes within each ecological category. A total of 12 key themes emerged from the data. Conclusion: Rural caregivers identified a number of factors that facilitated and inhibited their ability to provide opportunities for engaging in health promoting behaviours. Interestingly caregivers did not identify any intrapersonal barriers. Factors in the interpersonal category were the most commonly reported. Thus behaviours of others were the often indicated as a key factor influencing caregivers in the provision of healthy opportunities. In the institutional and community categories caregivers identified a number of facilitators that supported them in the provision of healthy opportunities. Additionally, some caregivers discussed practices they used to overcome barriers and this in turn, facilitated the promotion of physical activity and healthy eating within the care centres. Research in rural areas is limited and the majority of studies focus the barriers to living in rural areas. This study contributes to the literature because it identified, not only challenges, but also benefits to living in rural areas. Furthermore, the use of an ecological framework allowed barriers and facilitators to be classified into distinct categories. This is important, as classification of specific factors can aid in designing initiatives that target facilitators and alleviate barriers. Such initiatives can then support early years caregivers in the provision of healthy opportunities for children. In turn, this will aid Canadian early years children in establishing lifelong physical activity eating and healthy eating patterns.