Access to Healthy Environments

sp-accessAccess to healthy environments is a key component of obesity prevention in early childhood. Without access to nutritious foods and space for active play, ECE providers have an impaired ability to comply with enhanced regulations, QRIS, and facility-level interventions. Moreover, pre-service, professional development, and technical assistance may help improve knowledge and intentions, but become less meaningful and successful if the environment does not support obesity prevention efforts. Access to healthy environments for children in ECE and their families can be promoted in a number of ways. We discuss three in this section: Centralized Kitchens, Farm to Preschool initiatives, and Joint Use.

Centralized Kitchens

A centralized kitchen model is one in which all the cooking activities of a particular location are concentrated within one large kitchen to achieve economies of scale. Although the concept of centralized kitchens is not new, particularly for school systems, it has not been used much for the ECE setting. The following three examples describe centralized kitchens serving ECE facilities that are committed to providing high-quality, nutritious, and affordable food:



Farm to Preschool

Farm to school is broadly defined as efforts and activities that connect schools to local agriculture. In the context of ECE, farm-to-school efforts have the purpose of serving healthy meals and snacks to preschoolers; providing experiential learning opportunities in nutrition, agriculture, health, and other topics; and supporting local and regional farmers by focusing on purchasing fruits, vegetables, eggs, grains, meat, beans, and other foods from local producers. Most of the available farm-to-school resources are focused on K–12; however, many organizations are creating materials for ECE settings as the demand for farm-to-school initiatives for younger children increases. The primary source of information on farm-to-preschool programs is the National Farm to School Network’s preschool program website.   Additional information on farm-to-school programs is available at USDA’s Farm to School website, including a 2011 summary report on farm-to-school initiatives that discusses common farm-to-school challenges and solutions and provides examples of USDA funding support for farm to school initiatives.

CDC promotes farm-to-where-you-are initiatives to increase access and availability of high-quality, regionally grown produce to community institutions such as ECE facilities. Local goods can be supplied directly to the ECE facility from the producer or through cooperatives, aggregators, distributors, or farmers’ markets. Focusing on local sources enhances use of fresh, seasonal produce. Another advantage of local procurement is that the money spent stays within the region, supporting the local economy. For ECE facilities and state agencies purchasing for CACFP, USDA regulations allow application of geographic preference when procuring unprocessed, locally grown or locally raised agricultural products. The preference applies only to foods that retain their inherent character (i.e., have not been cooked, seasoned, frozen, canned, or combined with any other products including additives or fillers).

Challenges in sourcing food locally include identifying local growers that can provide the desired foods and accommodating the seasonality of local products. Several strategies for connecting foods and farmers to ECE facilities are currently in use. For example:

  • Online marketplaces have been designed to facilitate “farm to fork”.  MarketMaker is a national partnership of land grant institutions and state departments of agriculture dedicated to the development of a comprehensive interactive database of food industry marketing and business data. Developed at the University of Illinois, it is currently one of the most extensive collections of searchable food industry-related data in the country. In Oregon, another online marketplace called FoodHub has been developed by Ecotrust to connect wholesale buyers and sellers of Pacific Northwest regionally grown food.
  • In many states, local and regional farm-to-school advocates hold workshops and training sessions for both the farming community and the school foodservice community to understand the needs and expectations of each other in direct purchasing.

There are multiple approaches states can take to facilitate farm to preschool initiatives. One tactic is to facilitate interactions between state-level government entities, such as departments of agriculture (for providing support to producers), departments of education (for administration of CACFP), and agencies providing oversight for ECE licensing and administrative regulations, in order to support farm-to-preschool infrastructure. Other stakeholders should also be involved, including farmers, food producers, distributors, and ECE food service personnel, to identify policies and procedures needed to bring local, fresh farm foods into ECE facilities. In many communities, local organizations focused on sustainable agriculture and food systems issues can help facilitate these interactions. These public and private partners can be organized to help overcome barriers, provide technical support, and take action to support legislation and policy change to facilitate farm-to-school efforts. Although much of the current legislation focuses on K–12, ECE facilities can benefit from farm to school as well. The National Farm to School Network maintains lists of state farm to school legislation and policies here.

Joint Use Agreements

Joint use agreements can provide access to safe places for play and physical activity. A joint use agreement is a type of limited liability legal agreement between two parties that establishes terms and conditions for shared use of property or facilities. These two parties are most frequently government agencies such as a school district and a town. The goal of a joint use agreement is simple: to share resources. The agreement allows one group access to another’s facilities, but waives liability of injury or damage. Joint use agreements come in a number of shapes and sizes, and reaching agreement requires substantial effort and cooperation. These agreements, however, can build successful partnerships that help promote physical activity in communities.

Generally, joint use agreements are put in place to provide families a safe and protected place to engage in physical activity. Typically, joint use agreements involve school playgrounds, basketball courts, fields, and gymnasiums. The legal agreement provides the community access to these facilities, but releases the school district from liability due to injury. A number of states encourage or even require schools to provide the community access to their facilities after school hours. Yet, some school districts fear injury, theft, and property damage. Joint use agreements help alleviate these concerns by clearly defining roles and responsibilities.

Joint use agreements address the following key issues (adapted from

  • Operational logistics—Who will open and close the facility/space?
  • Liability—Who is responsible if someone gets hurt?
  • Maintenance—Who pays for upkeep and repair?
  • Decision—Who makes decisions regarding the facility/space?
  • Cost—How are expenses divided among partners?

A number of stakeholders must be considered when exploring the possibility of joint use agreements, including school officials, parks and recreation managers, local government leaders, businesses, civic organizations, ECE providers, and community members. Joint use agreements can be put in place to provide access to recreational facilities for both community members and ECE facilities in the community. See the section of this guide Building State-level Partnerships.

California has been a state leader in the creation of joint use agreements. A 2008 survey in California found that nearly 60% of responding school districts had a joint use agreement in place. Visit and for more information on joint use agreements.


State Example: Oregon Farm to Head Start

In 2005, Ecotrust’s Farm to School initiative began promoting farm to school programs at the K–12 level to positively influence the school food environment, increase children’s access to and consumption of healthy local foods, and stimulate new markets for regional food producers and processors. As this work gained in popularity and started to become institutionalized at local, state, and regional levels, Ecotrust used this momentum to engage in similar work with ECE facilities. Along with a handful of other practitioners across the country, Ecotrust’s Farm to School team was not only concerned about high rates of obesity amongst preschoolers, but had also taken note of a growing body of evidence showing that children form their longest lasting habits and attitudes towards food before they enter kindergarten. Since many preschoolers consume the majority of their daily nutrients in childcare, farm to preschool seemed like a strategic way to address this multitude of concerns. The intention of this new work was to leverage and extend the best practices learned in the K-12 program to this most vulnerable population of children at a point in their development when fresh food and healthy eating habits have the greatest potential to positively impact the trajectory of their long-term health and productivity.

In 2008–09, in partnership with the Oregon Child Development Coalition (OCDC), Ecotrust piloted one of the first farm to preschool initiatives in the country. OCDC is one of the largest ECE networks in Oregon, administering Head Start and Early Head Start, and is a state grantee of the federal Migrant Seasonal Head Start program. Each year, OCDC serves more than 3,000 children and families in need throughout 12 Oregon counties. Ecotrust is an organization based in Portland whose mission is to foster a natural model of development that creates more resilient communities, economies, and ecosystems. Ecotrust’s Farm to School initiative works to build more resilient regional food economies and ensure that all children have access to healthy, local food by: connecting family farmers with new and reliable markets, including schools and preschools; partnering with a wide range of districts and early child care settings, with a focus on low-income schools and preschools; and by advocating for policies that strengthen the regional agricultural economy and create local jobs.

The Farm to Head Start pilot project aimed to:

  • Build relationships between Head Start and local food producers;
  • Explore opportunities for local product development to meet Head Start meal program needs;
  • Increase Head Start procurement of locally grown and processed foods;
  • Promote food- and garden-based education to reinforce locally grown foods served as part of the USDA meal program;
  • Engage the community in implementing garden-enhanced educational programs. Increase children’s and caregivers’ exposure to and modeling of healthy lifestyle behaviors including fruit and vegetable consumption; and
  • Increase children’s and caregivers’ access to locally produced fruits and vegetables.

Outcomes from the project include:

  • Farm-to-preschool initiatives (including local foods procurement and garden-based education) at three OCDC Head Start sites, with ongoing expansion of the efforts to other sites.
  • A replicable model that has been shared locally and nationally
  • Stimulation of new markets for regional food producers and processors in Oregon.

How It Came About

Ecotrust chose to partner with Head Start (HS) for this first pilot project for several reasons: (1) HS serves a vulnerable population; (2) HS encourages parental involvement and engages parents both in their children’s learning and in program administration, a critical component in helping to sustain farm to school programming in the long-term; (3) HS uses experiential education models, which are a great fit with typical farm to school activities such as garden-based education, sensory exploration, and cooking; and (4) HS is a visible leader among ECE facilities, and thus an excellent model for child care delivery. Initially, Ecotrust had difficulty getting the project underway. To generate interest and secure a commitment from a partner administering Head Start in Oregon, Ecotrust created a request for proposals (RFP) with a small amount of funding attached. The RFP outlined the project’s objectives and activities, as well as partner roles.


Ecotrust worked with OCDC to establish pilot farm to school initiatives at three sites in Cornelius (Washington County), Odell (Hood River County), and Silverton (Marion County). Activities included:

  • Facilitating farm-to-school program design via meetings with the Nutrition Services director and the lead education specialist and by inviting OCDC staff participation in Farm to School conferences and events.
  • Helping ECE facilities to make connections with local food suppliers to begin purchasing more local products by:
    • Evaluating current meals and menu planning tools and facilitating conversations about local procurement with OCDC’s current wholesaler; and
    • Facilitating field trips to regionally appropriate farms and food processors.
  • Promoting food- and garden-based education by identifying existing resources and curricular activities to support the inclusion of garden-based education into Head Start program areas. Ecotrust identified five existing food- and garden-based education resources for preschoolers for OCDC’s review. OCDC selected the curriculum Early Sprouts: Gardening and Nutrition Experiences for the Young Child  as the best fit for their educational requirements. It addresses young children’s inherent fear of new foods through multiple exposures to target fruits and vegetables in activities such as sensory exploration, tasting sessions, cooking activities, and family recipe kits.

At the culmination of the pilot project, spurred on by success implementing simple garden-based activities in the classroom, OCDC forged ahead by constructing raised beds at each pilot site to support garden-based education and increase the ability of its students, teachers, and parents to make the connection between the food they eat and the land it comes from. OCDC has continued to move forward with its work, installing more gardens and continuing to purchase directly from local farmers.

Working on behalf of the National Farm to School Network, Ecotrust has continued to help systematically grow the Farm to Preschool movement at a national level, coordinating a network of over 20 influential national stakeholders (including members from CDC, USDA, the Office of Head Start, and Food Research Action Center) and engaging a national community of practice around farm to preschool, conducting a national survey of farm to preschool programs in 2012, and publishing an Ecotrust-based monthly farm to preschool e-news (Taking Root). Mirroring this national work, Ecotrust also convened the first ever statewide farm to preschool coalition in its home state of Oregon in 2012 and is currently working to grow farm to preschool programs at ECE facilities in Oregon via a farm to preschool mini-grant program, which includes a peer-to-peer learning community for grantees and encourages connections to the broader farm to school movement.  

Lessons Learned

General Lessons:

  • Farm to preschool differs significantly from Farm to School in the K–12 setting given that it must address many diverse models of ECE delivery.
  • Farm to preschool presents  a huge opportunity; there is significant and growing interest from communities and parents, and logistically, ECE facilities may be easier to work with than K–12 schools (e.g., higher budgets, fewer regulations, more parental involvement, greater flexibility with programming, more likely to have scratch kitchens).
  • Project documentation and evaluation are critical, both in terms of collecting evidence on the impacts of programming as well as sharing models of success.

Lessons about Program Implementation:

  • If securing a commitment from potential partners is a challenge, consider issuing formal RFP with some funding attached.
  • Do not underestimate the impact of a small financial investment (in this case, a few thousand dollars) and some hands-on facilitation with partners (e.g., sitting with food service staff and looking through menus, taking field trips to local farms).
  • Meet partners where they are and see what they need to move forward; be flexible with program design and activities.
  • Explore where farm to school and school garden concepts will fit most naturally into pre-existing programs (e.g., OCDC used one curriculum that was a natural fit because it required instruction about nutrition twice per week).
  • Ensure that program design and materials are culturally relevant.
  • Consider the different ways to engage community partners and the many resources that may be tapped to maximize program implementation (e.g., OCDC hired an AmeriCorps member to sustain their gardens after the pilot project ended).
Vermont Works for Women (VWW) FRESH Food Program  prepares nutritious meals for ECE centers in Vermont. In the first two years after its launch in January 2011, FRESH Food provided more than 60,000 nutritious meals, creating food security for the Burlington and Greater Burlington 2- to 5-year-old population. FRESH Food supports early childhood nutrition by creating healthy menu items that exceed CACFP standards. The program is committed to feeding Vermont’s children home-style meals that are balanced, vegetable-infused, and attractive to children. FRESH Food’s fruits and vegetables are secured through local and regional vendors and are incorporated into all meals. Food delivery is made possible through a local partnership with Good News Garage, a nonprofit organization that repairs donated cars in order to provide them to low-income individuals and families.

As an extension of VWW’s Transitional Jobs program, a unique aspect of FRESH Food is the workforce that prepares the meals. The program employs a crew of VWW Transitional Jobs program graduates, teaching basic workplace and food service skills, including fundamental food safety and sanitation, knife handling, and operation of food service equipment. FRESH Food’s social mission is to provide a rich training experience for under- or unemployed women while offering predominantly locally sourced, highly nutritious meals to children at ECE centers that serve a high percentage of low-income families. Through their work in the kitchen and in the classroom, the women develop self-confidence, work experience, and marketable skills needed to transition into permanent employment.

Early Nutrition Matters (ENM), a program of the Child Care Services Association (CCSA) in North Carolina, provides 1) high-quality, affordable, nutritious meals and snacks to ECE facilities; and 2) nutrition education to ECE teachers, children, and their families in order to promote positive child development and life-long healthy eating habits. The ENM program is able to provide nutrition information, training, and technical assistance to ECE providers.

ENM emphasizes the importance of fresh fruits, vegetables, and whole grains while limiting children’s consumption of excess salt, sugar, fat, and preservatives. CCSA also works to include local products in the menu items. In 2013, meals were served to more than 2,100 children in ECE programs each day in Durham and Orange counties. In fiscal year 2011–2012, CCSA served over 623,000 nutritiously balanced meals to 1175 children in 26 ECE facilities. CCSA, a nonprofit child care resource and referral agency, has operated a Nutrition Services Program to sponsor ECE programs on the Child and Adult Food Program (CACFP) and to provide meals to regulated ECE Facilities in Orange County, North Carolina, since 1989. The program was expanded to Durham County in 2007.

In 2013, Utah’s Salt Lake Community Action Program (SLCAP) Head Start served approximately 2,000 nutritious meals to children every day from its Northstar Kitchen. The kitchen began operation in 2010 with the goal of giving every child in their program an opportunity to eat healthy meals and prides itself on serving nutritious meals for children ages birth to 5 years. The kitchen serves Head Start children and has gained accounts with private ECE centers because of the delicious, made-from-scratch meals that exceed the CACFP guidelines at a price of only $2 per child. In addition to serving food low in fat, sugar, and sodium, Head Start’s kitchen team includes ethnically diverse foods, whole grains, and organic foods when possible. At-risk youth assist with meal preparation, and drivers deliver meals to individual classrooms with special equipment that keeps the food’s temperature consistent during delivery.

The success of the kitchen has garnered funding from corporate sponsors to support its efforts in the community. “Sauté,” a job training program, gives Head Start parents the opportunity to receive a culinary certificate for those interested in pursuing work in the culinary field. The program, which operates three sessions per year, consists of 40 hours of instruction, which is completed in 6 weeks. The students learn kitchen etiquette, knife skills, cooking techniques, Serve Safe Certification, kitchen sanitation safety, and cost-effective meal planning and preparation. Parents are assisted with job placement after completing the Sauté course. The SLCAP Head Start kitchen also offers cooking classes for working parents and teen mothers and training for dietitians and staff at other ECE centers.

Kitchen director, Chef Brian Ralph, has been featured sharing tips on having children eat and enjoy their vegetables during the cooking segment on Good Things Utah, and he appeared in the January 2012 issue of Salt Lake Magazine discussing Head Start’s involvement in the fight against childhood obesity. SLCAP Head Start is a comprehensive early childhood development program serving low-income children from birth to age 5 and their families.