Graduation Date

Summer 8-13-2021

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Promotion and Disease Prevention Research

First Advisor

Amy L. Yaroch

Second Advisor

Courtney Parks

Third Advisor

Jennie Hill

Fourth Advisor

Brandon Grimm


Serving more than 1.7 million children under five years of age, family child care (FCC) programs are an advantageous setting for early childhood obesity prevention efforts given that attending children receive a large proportion of their nutrition and perform much of their physical activity in this settings. FCC programs are subset of early care and education (ECE) programs in which providers care for children in their own home rather than a commercial facility (e.g., center-based programs) and tend to care for children living in low-income households, rural communities, and or those who are of a racial or ethnic minority, which amplifies their importance in public health efforts aimed at reducing health inequities in children. Healthy eating and physical activity-based (HEPA) interventions have demonstrated success in promoting best practices and policies that support healthy environments in ECE settings. However, FCC providers care for children in their home, thus no two programs are identical. Variability across FCC settings may impact the adoption and implementation of HEPA practices and policies, which may not be captured by existing measurement tools.

This dissertation consisted of three studies that helped to develop a mobile application that uses photos to capture HEPA best practices and policies in family child care settings. The first study was a scoping review to identify existing measurement tools that capture policy, systems, and environmental characteristics related to HEPA in FCC settings and to identify how these measurement tools are employed in FCC settings. The second study explored how FCC providers implement HEPA practices and policies within their programs. The final study described the process and lessons learned of applying a user-centered framework to develop a mobile app that uses photos to capture HEPA best practices and policies in FCC settings.