Children In Child Care Centers That Participated In The Healthy Apple Award (Haa) Program In San Francisco Had Greater Decreases In Bmi Percentile Than Children In Other Local Child Care Centers

First Lady Michelle Obama's Let's Move! Child Care initiative aims to improve nutrition and physical activity (PA) practices in child care sites to promote healthy childhood weight, nationwide. This analysis tested if a new program in San Francisco, the HAA program, designed to support implementation of Let's Move! , impacts childhood weight, locally. Child care centers served by the Child Care Health Program (CCHP) were randomly selected for early (2013) or lagged (2014) invitation to the HAA. Child care centers that enrolled in 2013 (CCHP+HAA) were offered a self‐assessment modeled on Let's Move! and the University of North Carolina's Nutrition and Physical Activity Self Assessment in Child Care (NAP SACC) in Spring, technical assistance for goal setting and staff trainings about drinking water and PA in Summer, and re‐assessment and award recognition in the Fall. All CCHP+HAA (n=18) and CCHP‐only (n=20) centers were offered child‐sized water pitchers in Fall 2013, health worker assessment of drinking water and PA resources and BMI screening for all enrolled children in Fall 2013 and Spring 2014 (n=871, 3‐4y). In CCHP+HAA centers, the proportion of children with access to visible and self‐serve drinking water (61% to 83%) and a PA curriculum (36% to 50%) increased. Corresponding changes in CCHP‐only centers were 63% to 73% and 45% to 34%. Mean BMI percentile decreased by 2.4 (1.2) more percentage points in CCHP+HAA vs. CCHP‐only centers (p<0.05). The results suggest that the HAA program supports local implementation of Let's Move! .