The Cooperative Extension system is uniquely positioned to lead rural community efforts to prevent obesity in early childhood. This article explores best practices in promoting healthy weights among young children and shares examples and resources relevant to Extension programming. The West Virginia (WV) Healthy Children Project aims to improve community, home, and early care and education (ECE) environments by promoting healthy eating, physical activity, outdoor play, and reduced screen time. This project primarily focuses on interventions with ECE providers serving 2-5-year-old children in three rural counties. Comprehensive assessments informed the interventions and guided Community Advisory Committees. ECE providers were trained in “I Am Moving, I Am Learning” (IMIL) and “Nutrition and Physical Activity Self-Assessment for Child Care” (Go NAP SACC) best practices and were supported with technical assistance and classroom resources. Garden-based learning, natural playscapes, painted playgrounds, and farm-to-ECE further enhanced the environments and experiences. Community leaders were engaged in advisory committees, transformative projects, and local family-focused activities. The efficacy of these practices was tracked using quantitative and qualitative evaluation strategies conducted throughout the project, including observations, ripple effects mapping, and questionnaires. This article describes the overall project strategies and reveals the lessons learned and the challenges encountered.



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