Happy Healthy Homes is a randomised controlled trial (RCT) studying the efficacy of in-person and virtual interventions on family child care home (FCCH) providers’ nutrition practices, self-efficacy, and Child and Adult Care Food Program (CACFP) knowledge. FCCH were randomly assigned to the intervention (NUT) or attention control (CON). Cohort1 (in-person 2017–2018) included 45 (NUT n = 24; CON n = 21) FCCHs. Cohort2 (virtual 2020) included 36 (NUT n = 15; CON n = 21) FCCHs. Outcomes included self-reported nutrition practices, confidence, barriers, and CACFP best practice knowledge. Measures were collected at 3 and 12 months. The primary 12-month analyses accounted for intent-to-treat and used a mixed model on all providers with 3-month outcomes including those who withdrew prior to 12-month assessments. At 12 months, both cohorts demonstrated significant effects. In Cohort1, NUT improved self-reported beverages provided and feeding environment, and confidence in serving healthy foods, while CON remained unchanged. No changes were observed for CACFP best practice knowledge. In Cohort2, NUT did not demonstrate a group effect over time for self-reported nutrition practices. NUT did increase confidence in serving healthy foods and decreased barriers related to food waste, whole grain service, children’s healthy eating habits, and CACFP best practice knowledge while CON experienced minimal changes. This study demonstrated that in-person and virtual interventions can help FCCHs improve their nutrition practices, confidence, and barriers in serving optimal foods, and knowledge in CACFP best practices. The utilisation of virtual interventions may increase reach in rural areas and be appealing to FCCH providers.

Clinicaltrials.gov, NCT03560050. Retrospectively registered on 23 May 2018. First participant enrolled October 2017. Trial protocol and analyses plan can be accessed on clinicaltrials.gov.