Gaps in Nutrition Policy Implementation in Childcare Centres in The Edmonton Metropolitan Region: A Cross-Sectional Survey.

Purpose: To describe ( i ) nutrition policies in childcare centres, ( ii ) the resources and processes used to enable policy implementation, and ( iii ) the association between policy implementation and childcare centres' or administrators' characteristics. Methods: Between October 2018 and June 2019 a web-based survey that addressed nutrition policy, policy implementation, and sociodemographic characteristics was sent to eligible childcare programs (centre-based and provided meals) in the Edmonton (Alberta) metropolitan region. The survey was pretested and pilot tested. Statistical tests examined the relationship between policy implementation with centres' and administrators' characteristics. Results: Of 312 childcare centres that received the survey invitation, 43 completed it. The majority of centres had a nutrition policy in place (94%). On average, centres had about 9 of the 17 implementation resources and processes assessed. Most often administrators reported actively encouraging the implementation of the nutrition policy (n = 35; 87%) and least often writing evaluation reports of the implementation of the nutrition policy (n = 9; 22%). Administrator's education level was associated with implementation total score ( p  = 0.009; Kruskal-Wallis). Conclusion: Most childcare centres had a nutrition policy in place, but many lacked resources and processes to enable policy implementation. Additional support is required to improve nutrition policy development and implementation.