Monica Kazlausky Esquivel1, Claudio R Nigg2, Marie K Fialkowski3, Kathryn L Braun2, Fenfang Li3, Rachel Novotny3. 1. Department of Human Nutrition, Food, and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, Hawaii. Electronic address: monicake@hawaii.edu. 2. Office of Public Health Studies, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawaii. 3. Department of Human Nutrition, Food, and Animal Sciences, University of Hawai'i at Mānoa, Honolulu, Hawaii.
Abstract
OBJECTIVE: To quantify the Head Start (HS) teacher mediating and moderating influence on the effect of a wellness policy intervention. DESIGN: Intervention trial within a larger randomized community trial. SETTING:HS preschools in Hawaii. PARTICIPANTS: Twenty-three HS classrooms located within 2 previously randomized communities. INTERVENTION: Seven-month multi-component intervention with policy changes to food served and service style, initiatives for employee wellness, classroom activities for preschoolers promoting physical activity (PA) and healthy eating, and training and technical assistance. MAIN OUTCOME MEASURES: The Environment and Policy Assessment and Observation (EPAO) classroom scores and teacher questionnaires assessing on knowledge, beliefs, priorities, and misconceptions around child nutrition and changes in personal health behaviors and status were the main outcome measures. ANALYSIS: Paired t tests and linear regression analysis tested the intervention effects on the classroom and mediating and moderating effects of the teacher variables on the classroom environment. RESULTS: General linear model test showed greater intervention effect on the EPAO score where teachers reported higher than average improvements in their own health status and behaviors (estimate [SE] = -2.47 (0.78), P < .05). CONCLUSIONS AND IMPLICATIONS: Strategies to improve teacher health status and behaviors included in a multi-component policy intervention aimed at child obesity prevention may produce a greater effect on classroom environments.
RCT Entities:
OBJECTIVE: To quantify the Head Start (HS) teacher mediating and moderating influence on the effect of a wellness policy intervention. DESIGN: Intervention trial within a larger randomized community trial. SETTING:HS preschools in Hawaii. PARTICIPANTS: Twenty-three HS classrooms located within 2 previously randomized communities. INTERVENTION: Seven-month multi-component intervention with policy changes to food served and service style, initiatives for employee wellness, classroom activities for preschoolers promoting physical activity (PA) and healthy eating, and training and technical assistance. MAIN OUTCOME MEASURES: The Environment and Policy Assessment and Observation (EPAO) classroom scores and teacher questionnaires assessing on knowledge, beliefs, priorities, and misconceptions around child nutrition and changes in personal health behaviors and status were the main outcome measures. ANALYSIS: Paired t tests and linear regression analysis tested the intervention effects on the classroom and mediating and moderating effects of the teacher variables on the classroom environment. RESULTS: General linear model test showed greater intervention effect on the EPAO score where teachers reported higher than average improvements in their own health status and behaviors (estimate [SE] = -2.47 (0.78), P < .05). CONCLUSIONS AND IMPLICATIONS: Strategies to improve teacher health status and behaviors included in a multi-component policy intervention aimed at childobesity prevention may produce a greater effect on classroom environments.
Authors: Julie C Lumeng; Niko Kaciroti; Julie Sturza; Allison M Krusky; Alison L Miller; Karen E Peterson; Robert Lipton; Thomas M Reischl Journal: Pediatrics Date: 2015-01-12 Impact factor: 7.124
Authors: Sheryl O Hughes; Heather Patrick; Thomas G Power; Jennifer O Fisher; Cheryl B Anderson; Theresa A Nicklas Journal: J Dev Behav Pediatr Date: 2007-04 Impact factor: 2.225
Authors: Wendi A Gosliner; Paula James; Antronette K Yancey; Lorrene Ritchie; Natalie Studer; Patricia B Crawford Journal: Am J Health Promot Date: 2010 Jan-Feb
Authors: Allison A Hedley; Cynthia L Ogden; Clifford L Johnson; Margaret D Carroll; Lester R Curtin; Katherine M Flegal Journal: JAMA Date: 2004-06-16 Impact factor: 56.272
Authors: Lori A J Scott-Sheldon; Larry V Hedges; Chris Cyr; Deborah Young-Hyman; Laura Kettel Khan; Mackenzie Magnus; Heather King; Sonia Arteaga; John Cawley; Christina D Economos; Debra Haire-Joshu; Christine M Hunter; Bruce Y Lee; Shiriki K Kumanyika; Lorrene D Ritchie; Thomas N Robinson; Marlene B Schwartz Journal: Child Obes Date: 2020-09 Impact factor: 2.992
Authors: Nicole S Schultz; Kenneth K H Chui; Christina D Economos; Alice H Lichtenstein; Stella L Volpe; Jennifer M Sacheck Journal: J Sch Health Date: 2019-09-08 Impact factor: 2.118
Authors: Amy Hill; Laura Alston; Cindy Needham; Anna Peeters; Anthony D LaMontagne; Melanie Nichols Journal: Health Promot Int Date: 2022-06-01 Impact factor: 3.734
Authors: Elizabeth A Parker; Patrick F McArdle; Debbie Gioia; Ariel Trilling; Mary Bahr-Robertson; Nate Costa; Brian M Berman; Christopher R D'Adamo Journal: Glob Adv Health Med Date: 2019-09-09