Multiple Roles and Children With Mixed-Age Groups Are Primary Challenges for Adoption of Responsive Feeding for Rural Family Child Care Home Providers.

Objective: To determine the perspectives of rural family child care home (FCCH) providers on the adoption of responsive feeding evidence-based practices (RF-EBPs) using the innovation-decision process from the diffusion of innovation theory.

Methods: Virtual semistructured focus groups of 19 rural FCCH providers participated in the Child and Adult Care Food Program. Data analysis followed a qualitative thematic analysis.

Results: Providers reported knowing about RF-EBPs and learned about them through communication channels such as Child and Adult Care Food Program (knowledge). The organizational structure of FCCH settings is perceived as a challenge when using RF-EBPs. These challenges include mixed-age groups of children and balancing multiple roles (persuasion and decision). Providers regularly using RF-EBPs provided strategies such as seating infants close by during mealtimes and encouraging older children to be role models and to help with setup (implementation) that influenced future use decisions. The benefits of continued use of RF-EBPs include children's healthy development and pleasant mealtimes (confirmation).

Conclusions and implications: Family child care home providers face unique challenges related to their organizational structure and mixed-age groups. Professional development training can influence a more positive attitude toward the adoption of RF-EBPs by highlighting the benefits and providing strategies to overcome commonly perceived challenges.