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Table 3 Summary of wellness programs targeting the early care and education workforce identified in a scoping review

From: The health status of the early care and education workforce in the USA: a scoping review of the evidence and current practice


Target population

Target behavior(s)/outcomes


Evaluation results (if available)

Published literature

 Esquivel et al., Children’s Healthy Living Program for

Remote Underserved Minority Populations in the Pacific Region [39]

HS teachers in Hawaii

Teacher health status and health behaviors; knowledge, misconceptions, beliefs and priorities on nutrition and childhood obesity preventions

Staff wellness classes as part of a larger, 7- month long intervention targeting policy and classroom-level changes. Monthly classes focused on benefits of physical activity (PA), stretching and PA ideas at work; benefits of healthy eating and food tasting, and; stress management.

Impact on HS teacher health not provided

 Messiah et al., Healthy Caregivers - Healthy Children (HC2) [40]

CCC in Florida


Using a train the trainer approach, policy changes regarding nutrition, physical activity and screen time were pursued with participating CCCs. Teachers and parents also received six monthly workshops to support their role as healthy role models for children.

Not available

 Arandia et al., Caring and Reaching for Health’s Healthy LIfestyles Intervention (CARE) [8]

CCC in North Carolina

Nutrition and physical activity

Multi-component, theory-based intervention includes a kick-off event and educational workshop and three 8-week campaigns (6 months total duration). Each campaign focused on a different PA-related topic and included print materials, goal setting and self-monitoring, tailored feedback, email and text prompts and coaching for CCC directors.

Pilot results suggested that the intervention resulted in significant decreases in provider BMI and smoking along with increases in physical activity and fruit/vegetable intake

 Gosliner et al. [41]

CCC in California. 98% of participants were female. 91% were aged 25 to 64 years. 49% were white, 24% Asian or Pacific Islander, 17% African American, 13% Hispanic/Latino, and 6% other. 52% of participants had attended some College education, 21% had received an associate degree or 16% had a bachelor’s degree.

Physical activity (measured via accelerometry); secondary outcomes include other health behaviors (e.g., diet, weight, smoking), physical health indicators (e.g., BMI, blood pressure, fitness tests)

Wellness program added to existing intervention focused on obesity-related policy change in CCCs. Activities offered over 9 months included day-long kick-off training, monthly newsletters and paycheck insert, and a staff walking program.

Compared to a control group, intervention participants reported significantly lower sugar sweetened beverage consumption; significantly higher ease of engaging parents in discussion of child’s eating and comfort talking to parents about child’s PA. Other differences were not significant.

 Herman et al., Eat Healthy, Stay Active! [42]

HS teachers in Pennsylvania, Texas, Arizona, Rhode Island and New York. 96% of participants were female. 56% were white, 1.4% Asian or Pacific Islander, 14.3% African American, 17.5% Hispanic/Latino, 3.6% Native American, and 2.4% other. 15% had a high school diploma or GED, 17% had an associate’s degree, and 65% had a bachelor’s degree. 60.5% of participants were married, 91% worked part-time, and 4% worked full-time

Nutrition and physical activity; weight change, knowledge and behavior

Six-month multi-component intervention targeting nutrition and PA among children, teachers and parents. Staff received 1 day of training on intervention components and then delivered workshops to parents and children.

Significant decrease in staff BMI, significant increase in knowledge, diet and physical activity.

 Jones, Teacher be well: Mindfulness based stress reduction [43]

CCC on military base in San Diego, California

Mindfulness, workplace stress

Two-hour mindfulness workshop that included lecture, discussion, exercises coupled with take-home resources. Printed materials supporting the content were available in the break room.

No significant impact on mindfulness or workplace stress among participants (n = 27). Process evaluation showed that the program was feasible and participants were satisfied with the program.

 Ostbye et al., Keys to Healthy Child Care [44]

FCC providers in North Carolina. 57.5% of providers were African American, 40% were White, and 2.5% were Asian. Mean age of providers was 46.2 years.

Physical activity, diet quality, height and weight; and FCC environment

Nine-month, three component intervention guided by Social Ecological Model and Social Cognitive Theory. Three months each are spent on: Healthy You, Healthy Home and Healthy Business concepts. A health behavior coach is paired to each participant and provides one group workshop, one in-person visit to the FCC home, three tailored phone calls and a written toolkit.

No results available


 Be Well, Care Well (Medical University of South Carolina, Boeing Center for Children’s Wellness)

CCC providers in targeted regions of South Carolina

Overall wellness, resilience, physical activity, healthy diet, stress, job satisfaction

Well-Being Coaches work with center-level committees composed of three or more members (one administrator, one or more teachers, one or more parents) to identify well-being goals. Through weekly, on-site visits the coaches work with committee to achieve selected well-being goals, provide support and incentives and connections to local resources.

Not available.

 Create Healthy Futures (Penn State Extension Better Kid Care in collaboration with UTHealth School of Public Health) [45]

ECE providers across multiple settings in Cleveland, Ohio. 97.3% of participants were female. 41.5% were African American. Mean age was 43.5 years

Improve consumption of healthy foods, raise awareness of the nutrition environment, support ECE professionals as role models for children and families

Four-hour, self-paced, online program developed using Social Cognitive Theory and the Social Ecological Model. Content includes videos, reflection activities, downloadable handouts and action planning. Topics covered include basic nutrition information, healthy eating strategies, food environment and food culture reform. Participants also receive 6 weeks of peer coaching sessions to support healthy behavior change.

One pilot study conducted with 111 ECE professionals from four facilities. Participants showed increase in nutrition knowledge, decrease in perceived barriers to promote healthy nutrition in the classroom, and improved wellness support at their workplace. Process evaluation results found the program to be helpful, acceptable and feasible. Additional study on the effect of the program is underway with a larger sample of Head Start professionals.

 Building Well-Being. Resilient Nourished Active. (Spokane Washington Regional Health District)

Early learning staff (including cooks) and directors in Spokane, Washington

Social emotional well-being and self-regulation; healthy nutrition and menus; promoting active play among children

Year-long program focused on emotional and physical well-being of both staff and children. One-on-one coaching, monthly online webinars, teaching tools provided to participants and in-person interactive trainings on healthy eating and active play for staff with an emphasis on how nutrition and physical activity influence mood, behavior and health of staff.

Pilot underway with six centers (125 teachers). Evaluation will measure impact on child- and adult-level outcomes including proportion modeling deep breathing techniques when addressing conflict and teacher engagement in physical activity with children.

 YMCA child care facilities and camp (Greater Wichita Kansas YMCA)

Staff of YMCA child care facilities and camps in Greater Wichita, Kansas

General wellness, healthy eating, physical activity and mind-body balance

Staff receive free YMCA memberships, annual biometric screenings, voucher for preventive health visits, staff games, and quarterly health challenges. Staff also have access to monthly webinars focusing on wellness topics.

Not available.