Sarah E Messiah1, Cynthia Lebron2, Rhoda Moise2, M Sunil Mathew3, Krystal Sardinas2, Catherina Chang4, Joanne Palenzuela3, Jennifer Walsh5, Karla P Shelnutt6, Rachel Spector7, Fiorella Altare8, Ruby Natale3. 1. Department of Pediatrics, University of Miami Miller School of Medicine, United States; Department of Public Health Sciences, University of Miami Miller School of Medicine, United States. Electronic address: smessiah@med.miami.edu. 2. Department of Public Health Sciences, University of Miami Miller School of Medicine, United States. 3. Department of Pediatrics, University of Miami Miller School of Medicine, United States. 4. College of Public Health, Florida International University, Miami, FL, United States. 5. Department of Health Sciences, James Madison University, Harrisonburg, VA, United States. 6. Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL, United States. 7. The Children's Trust, Miami, FL, United States. 8. Early Learning Coalition, Miami, FL, United States.
Abstract
OBJECTIVE: Despite the high prevalence of obesity among preschool-aged children, most states lack childcare center (CCC) nutrition and physical activity policies. The Healthy Caregivers, Healthy Children (HC) Phase 2 project is examining the relationship between the CCC nutrition and physical activity environment and child dietary intake/physical activity patterns and body mass index (BMI). PARTICIPANTS: A total of 24 "Quality Counts" (Miami Dade County, Florida's Quality Rating Improvement System [QRIS)]) CCCs serving low resource families with ≥50 2-to-5year olds attending have been randomized to either intervention (n=12) or control (n=12). INTERVENTION: The HC2 intervention arm CCCs receive implementation of a daily curricula for (1) teachers/parents; (2) children; (3) snack, beverage, physical activity, and screen time policies; and (4) technical assistance with menu modifications. Control arm schools receive an attention control safety curriculum. HC2 is delivered once a month in year 1, quarterly in year 2 and will be disseminated throughout the Quality Counts network in year 3. MAIN OUTCOME MEASURES: Primary outcome measures include the Environment and Policy Assessment and Observation tool (EPAO), standardized dietary intake and physical activity patterns surveys, and child BMI. The 'Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)' framework will guide the interpretation of outcome measures. CONCLUSIONS: CCCs are in need of evidence-based standardized nutrition and physical activity policies. The intersection of RE-AIM and early childhood obesity prevention in the childcare setting could generate robust and new information to the field about potential barriers, facilitators, adoption, and sustainability in this setting.
RCT Entities:
OBJECTIVE: Despite the high prevalence of obesity among preschool-aged children, most states lack childcare center (CCC) nutrition and physical activity policies. The Healthy Caregivers, Healthy Children (HC) Phase 2 project is examining the relationship between the CCC nutrition and physical activity environment and child dietary intake/physical activity patterns and body mass index (BMI). PARTICIPANTS: A total of 24 "Quality Counts" (Miami Dade County, Florida's Quality Rating Improvement System [QRIS)]) CCCs serving low resource families with ≥50 2-to-5year olds attending have been randomized to either intervention (n=12) or control (n=12). INTERVENTION: The HC2 intervention arm CCCs receive implementation of a daily curricula for (1) teachers/parents; (2) children; (3) snack, beverage, physical activity, and screen time policies; and (4) technical assistance with menu modifications. Control arm schools receive an attention control safety curriculum. HC2 is delivered once a month in year 1, quarterly in year 2 and will be disseminated throughout the Quality Counts network in year 3. MAIN OUTCOME MEASURES: Primary outcome measures include the Environment and Policy Assessment and Observation tool (EPAO), standardized dietary intake and physical activity patterns surveys, and child BMI. The 'Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)' framework will guide the interpretation of outcome measures. CONCLUSIONS: CCCs are in need of evidence-based standardized nutrition and physical activity policies. The intersection of RE-AIM and early childhood obesity prevention in the childcare setting could generate robust and new information to the field about potential barriers, facilitators, adoption, and sustainability in this setting.
Authors: Jennifer C Sanchez-Flack; Annie Herman; Joanna Buscemi; Angela Kong; Alexis Bains; Marian L Fitzgibbon Journal: Transl Behav Med Date: 2020-10-12 Impact factor: 3.046
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