Association of the Quality Rating and Improvement System, Texas Rising Star, on Physical Activity and Screen Time Policies and Practices in Texas Child Care Centers.

TRS-certified centers reported more physical activity policies and practices, more screen time policies, and more outdoor practices. TRS certification was not associated with screen time practices. QRIS can be a practical way to insert obesity prevention in early care and education. Using items from a widely used survey enables comparisons, however future research is needed in larger-scale studies. Some COVID-19 implications are discussed.