The Journal of Extension -

October 2013 // Volume 51 // Number 5 // Tools of the Trade // v51-5tt9

Using Current Resources to Implement Wellness Programming for Preschoolers

Currently, there is a nationwide effort to include preschool-aged children in wellness efforts for the prevention of obesity. National resources include guidelines, best practices, and tip sheets to assist in the implementation of these interventions. The Let's Move! Child Care Checklist is a resource that can be used to assess the level at which early care sites (ECS) are meeting recommendations, and a number of preschool-specific curricula exist to consider for implementation. Extension educators are well positioned to provide wellness interventions that can work towards meeting current standards for ECS.

Sherri M. Cirignano
Family & Community Health Sciences Educator and Assistant Professor
Rutgers Cooperative Extension
Belvidere, New Jersey


With a focus on working towards obesity prevention in children of all ages in recent years, a concentrated effort has emerged with an emphasis on nutrition policy, education, and environmental change for preschool-aged children (Obama, 2013). This is due to evidence that indicates particularly high rates of childhood obesity in the preschool age group (Ogden, Carroll, Curtin, Lamb, & Flegal, 2010) and that obese preschoolers are more likely to be obese as adolescents and as adults (Whitaker, Wright, Pepe, Seidel, & Dietz, 1997). Research also suggests that this age group responds better to prevention interventions than their older counterparts (Swinburn, 2010).

Extension educators have long collaborated with early care sites (ECS), including child care centers and preschools, to provide wellness interventions for children aged 2-5, (Boeckner, Hendricks, & Steffens, 1993; Walker, 2003; Niemeier, Tande, Hwang, Stastny, & Hektner, 2010), and recent Extension efforts indicate that this need continues to be warranted (Gunter, Rice, & Trost, 2012). The current focus on preschoolers has resulted in a number of resources that can be used by Extension educators to update existing, or develop new, programming for implementation in ECS, thereby assisting them in meeting current standards.

Preschool Age-Specific Resources

Following the release of the Dietary Guidelines for Americans, 2010 (DGA) (U.S. Department of Agriculture [USDA] & U.S. Department of Health and Human Services, 2010) and the Healthy Hunger Free Kids Act (HHFKA) (United States Department of Agriculture, 2010), both encouraging the inclusion of child care centers and preschool-aged children when implementing obesity prevention practices, a number of preschool age-specific resources have emerged. These resources can be used by Extension educators to guide the preparation of programming and to assist ECS in developing and/or monitoring wellness-focused policies. In tandem with the DGA and the HHFKA, the Let's Move! initiative was launched in 2010, with population specific offshoots, such as Let's Move! Child Care (U. S. Department of Agriculture, U.S. Department of Health and Human Services & Nemours, 2010) following closely behind.

National Resources

Let's Move! Child Care promotes five behaviors, four of which are specific to preschoolers: These behaviors, 1) promoting physical activity; 2) decreasing screen time; 3) serving fruits and vegetables; and 4) providing water as the main beverage, work towards promoting healthy lifestyles and a decrease in obesity in ECS. To help sites achieve these behaviors, educators can use the Let's Move! Child Care Checklist (LMCC) (U. S. Department of Agriculture, et al., 2010,) which includes recommendations in a progressive checklist that assesses the level at which a site is meeting the recommendations. Using the LMCC can be a starting point when planning a training or programming at an ECS.

Resources, including guidelines, best practices, and tip sheets, are available to assist Extension educators in implementing the LMCC recommendations in ECS. The following is a listing of national resources and a matrix (Table 1) that matches the resource to the associated LMCC recommendation. Preceding letters can be used to locate each resource in Table 1.

  1. Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program 
    • Includes recommendations in the form of tip sheets;
    • Information is helpful in all LMCC behaviors.
      (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2012)
  2. Preventing Childhood Obesity in Early Care and Education Programs, 2nd edition
    • Developed from selected standards from Caring for Our Children: National Health and Safety Performance Standards, 3rd Edition; 
    • Evidence-based best practices on nutrition, physical activity and screen time. (American Academy of Pediatrics, American Public Health Association & National Resource Center for Health and Safety in Child Care and Early Education, 2012)
  3. Position of the American Dietetic Association: Benchmarks for Nutrition in Child Care
    • Provides educators with guidance through identified benchmarks regarding meeting children's nutrition and physical activity needs at ECS (Neelon, & Briley, 2011)
  4. Choose Health and Nutrition Information for Preschoolers
    • Preschool-specific website with extensive information on many topics including snack ideas, kitchen activities and portion sizes;
    • Limited preschool-specific printable tip sheets available.
      (U. S. Department of Agriculture)
Table 1.
Let's Move! Child Care Checklist (LMCC) Recommendations With Resources to Assist in Implementation

LMCC Recommendations Guidelines / Best Practices Implementation Resources
Offer at least 120 minutes of active time each day A,B,C A, D
Limit screen time to 30 minutes/week in child care; 1-2 hours/week of quality viewing at home. A,B A, D
Serve a fruit (no juice) and/or a vegetable at every meal A,B,C A, B, D
Serve all meals family style B,C D
Never serve fried foods A A, D
Water is freely accessible A A, D
Limit 100% juice to 4-6 oz. daily A,C A, D
Sugar-sweetened beverages are never served A,B,C A, B, D
Milk is low-fat or nonfat A,B,C A, B, D


The following is a listing of curricula (not intended to be inclusive) that can be implemented by Extension educators in ECS to work towards the LMCC recommendations.

CATCH ® Early Childhood

  • Nine lesson curriculum promotes physical activity and healthy food choices in a "holistic approach to child health";
  • Multilingual tip sheets in English and Spanish;
  • Adaptable for children with physical or learning disabilities. (Luton, Pica, Sharma, & Veinotte, 2011)

Color Me Healthy

  • With "color, music and exploration of the senses", teaches young children and their caregivers about healthy living. (Dunn, Thomas, & Pegram, 2012)

Early Sprouts: Cultivating Healthy Food Choices in Young Children/p>

  • Gardening and nutrition curriculum that focuses on the lifespan of 6 vegetables over a 24-week period
  • Offers multiple exposures to several fruits and vegetables through sensory exploration, tasting sessions, and cooking activities (Kalich, Bauer, & McPartlin, 2009)

Grow It, Try It, Like It: Preschool Fun with Fruits and Vegetables

  • Garden-based curriculum with lessons and activities based on three fruits and three vegetables (U. S. Department of Agriculture, Food and Nutrition Service, 2009)

Healthy Start: Healthy Lifestyle Education

  • Twelve-unit curriculum including the units "My Amazing Body" with a nutrition focus, "GO Foods" and "Fitness Fun" (Hark, et al., 2011)

LANA – Learning About Nutrition through Activities

  • Promotes fruit and vegetable intake through a focus on menu and mealtime, activities, and family involvement (Minnesota Department of Health, 2010)

Sesame Street Healthy Habits for Life: We Have the Moves!

  • Physical activity resource with ideas for adding activity throughout the day
  • Multilingual booklet in English and Spanish (Sesame Workshop & U.S. Department of Health and Human Services, 2012)


From childcare centers to the population at large, there is a nationwide effort to focus on the critical need to be proactive in providing wellness efforts for our youngest children. Extension educators are well positioned to use current resources to deliver effective wellness programming to work towards meeting national recommendations.


American Academy of Pediatrics, American Public Health Association & National Resource Center for Health and Safety in Child Care and Early Education. (2012). Preventing childhood obesity in early care and education: Selected standards from caring for our children: National health and safety performance standards; Guidelines for early care and education programs (3rd ed.) Retrieved from: 

Boeckner, L., Hendricks, P. A., & Steffens, P. E. (1993). Training for quality child care. Journal of Extension [On-line], 31(2) Article 2FEA4. Available at: 

Dunn, C., Thomas, C., & Pegram, L. (2012). Color me healthy: Preschoolers moving and eating healthfully. Retrieved from: 

Gunter, K. B., Rice, K. R., & Trost, S. G. (2012). Nutrition and physical activity policies and practices in family child care homes in Oregon: baseline findings from the healthy home child care project. Journal of Extension [On-line]. 50(3) Article 3FEA3. Available at: 

Hark, L., Bozza-Geroge, K. L., Carter, B. J., Williams, C. L., Lucca, C. J., Pica, R., & Beer, J. T. (2011). Healthy start. Retrieved from: 

Kalich, K., Bauer, D., & McPartlin, D. (2009). Early sprouts: Cultivating healthy food choices in young children. St. Paul, MN: Red Leaf Press.

Luton, S., Pica, R., Sharma, S., & Veinotte, S. S. (2011). CATCH ® Early childhood. Retrieved from:

Minnesota Department of Health. (2010). LANA – Learning about nutrition through activities. Retrieved from:

Neelon, S. E. B., & Briley, M. E. (2011). Position of the American Dietetic Association: benchmarks for nutrition in child care. Journal of the American Dietetic Association. 111(4), 607-615.

Niemeier, B. S., Tande, D. L., Hwang, J., Stastny, S., & Hektner, J. M. (2010). Using education, exposure, and environments to increase preschool children's knowledge about fruit and vegetables. Journal of Extension [On-line], 48(1) Article 1IAW6. Available at: 

Obama, B. The White House, Office of the Press Secretary. (2013). Remarks by the president in the state of the union address. Washington, D.C.: Retrieved from 

Ogden, C. L., Carroll, M. D., Curtin, L.  R., Lamb, M. M., & Flegal, K. M. (2010). Prevalence of high body mass index in U.S. children and adolescents, 2007-2008. JAMA. 303(3),242-249.

Sesame Workshop & U.S. Department of Health and Human Services. (2012). Sesame Street healthy habits for life: We have the moves! Retrieved from: 

Swinburn, B. A. (2010). Are community-based interventions working? Obesity Reviews. 11(S1), S16.

U.S. Department of Agriculture. Choose, health and nutrition information for preschoolers. Retrieved from:

U. S. Department of Agriculture, Food and Nutrition Service. (2009). Grow it, try it, like it: Preschool fun with fruits and vegetables. Retrieved from: 

U.S. Department of Agriculture, Food and Nutrition Service. (2010). Healthy hunger-free kids act of 2010. Retrieved from:

U.S. Department of Agriculture & U.S. Department of Health and Human Services. (2010). Dietary guidelines for Americans, 2010 (7th ed.) Washington, DC: Government Printing Office. Retrieved from 

U.S. Department of Agriculture & U.S. Department of Health and Human Services. (2012). Nutrition and wellness tips for young children: Provider handbook for the child and adult care food program. Alexandria, VA.

U. S. Department of Agriculture, U.S. Department of Health and Human Services & Nemours. (2010). Let's move! child care. Retrieved from:

Walker, S. K. (2003) Building a state child care initiative: Applying principles of teamwork and collaboration. Journal of Extension [On-line], 41(3), Article 3FEA2. Available at: 

Whitaker, R. C., Wright, J. A., Pepe, M. S., Seidel, K. D., & Dietz, W. H. (1997). Predicting obesity in young adulthood from childhood and parental obesity. The New England Journal of Medicine. 337(13), 869-873.