Jacob P Beckerman1, Alyssa Aftosmes-Tobio2, Nicole Kitos3, Janine M Jurkowski4, Kindra Lansburg5, Crystal Kazik6, Adam Gavarkovs7, Adrienne Vigilante8, Begum Kalyoncu3, Roger Figueroa9, Rachel Klabunde10, Rachel Barouch3, Sebastien Haneuse11, Elsie Taveras12, Kirsten K Davison13. 1. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: jbeckerman@g.harvard.edu. 2. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: aaftosme@hsph.harvard.edu. 3. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. 4. Department of Health Policy, Management & Behavior, University at Albany School of Public Health, 1 University Place, Rensselaer, NY 12144, United States. Electronic address: jjurkowski@albany.edu. 5. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Action for Boston Community Development, 178 Tremont Street, Boston, MA 02111, United States. Electronic address: kindra.lansburg@bostonabcd.org. 6. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Community Action Agency of Somerville, 66 Union Square, Somerville, MA 02143, United States. 7. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: adam_gavarkovs@g.harvard.edu. 8. Community Action Agency of Somerville, 66 Union Square, Somerville, MA 02143, United States. Electronic address: avigilante@caasomerville.org. 9. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: rfigueroa@hsph.harvard.edu. 10. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: rachel.klabunde@mail.harvard.edu. 11. Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: shaneuse@hsph.harvard.edu. 12. Department of Pediatrics, Massachusetts General Hospital for Children, 125 Nashua St, Suite 860, Boston, MA 02114, United States. Electronic address: elsie.taveras@mgh.harvard.edu. 13. Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States. Electronic address: kdavison@hsph.harvard.edu.
Abstract
BACKGROUND: Childhood obesity is highly prevalent and carries substantial health consequences. Childhood obesity interventions have had mixed results, which may be partially explained by the absence of theory that incorporates broader family context and methods that address implementation challenges in low-resource settings. Communities for Healthy Living (CHL) is an obesity prevention program for Head Start preschools designed with careful focus on theory and implementation. This protocol paper outlines the design, content, implementation, and evaluation of CHL. METHODS/ DESIGN:CHL integrates a parenting program co-led by Head Start staff and parents, enhanced nutrition support, and a media campaign. CHL content and implementation are informed by the Family Ecological Model, Psychological Empowerment Theory, and Organizational Empowerment Theory. The intervention is directed by community-based participatory research and implementation science principles, such as co‑leadership with parents and staff, and implementation in a real world context. CHL is evaluated in a three-year pragmatic cluster-randomized trial with a stepped wedge design. The primary outcome is change in child Body Mass Index z-score. Secondary outcomes include children's weight-related behaviors (i.e., diet, physical activity, screen use, and sleep), parenting practices targeted at these behaviors (e.g., food parenting), and parent empowerment. The evaluation capitalizes on routine health data collected by Head Start (e.g., child height and weight, diet) coupled with parent surveys completed by subsamples of families. DISCUSSION: CHL is an innovative childhood obesity prevention program grounded in theory and implementation science principles. If successful, CHL is positioned for sustained implementation and nationwide Head Start scale-up.
RCT Entities:
BACKGROUND: Childhood obesity is highly prevalent and carries substantial health consequences. Childhood obesity interventions have had mixed results, which may be partially explained by the absence of theory that incorporates broader family context and methods that address implementation challenges in low-resource settings. Communities for Healthy Living (CHL) is an obesity prevention program for Head Start preschools designed with careful focus on theory and implementation. This protocol paper outlines the design, content, implementation, and evaluation of CHL. METHODS/ DESIGN:CHL integrates a parenting program co-led by Head Start staff and parents, enhanced nutrition support, and a media campaign. CHL content and implementation are informed by the Family Ecological Model, Psychological Empowerment Theory, and Organizational Empowerment Theory. The intervention is directed by community-based participatory research and implementation science principles, such as co‑leadership with parents and staff, and implementation in a real world context. CHL is evaluated in a three-year pragmatic cluster-randomized trial with a stepped wedge design. The primary outcome is change in child Body Mass Index z-score. Secondary outcomes include children's weight-related behaviors (i.e., diet, physical activity, screen use, and sleep), parenting practices targeted at these behaviors (e.g., food parenting), and parent empowerment. The evaluation capitalizes on routine health data collected by Head Start (e.g., child height and weight, diet) coupled with parent surveys completed by subsamples of families. DISCUSSION: CHL is an innovative childhood obesity prevention program grounded in theory and implementation science principles. If successful, CHL is positioned for sustained implementation and nationwide Head Start scale-up.
Authors: Derek M Griffith; Julie Ober Allen; E Hill DeLoney; Kevin Robinson; E Yvonne Lewis; Bettina Campbell; Susan Morrel-Samuels; Arlene Sparks; Marc A Zimmerman; Thomas Reischl Journal: J Prim Prev Date: 2010-04
Authors: Cristina M Gago; Janine Jurkowski; Jacob P Beckerman-Hsu; Alyssa Aftosmes-Tobio; Roger Figueroa; Carly Oddleifson; Josiemer Mattei; Erica L Kenney; Sebastien Haneuse; Kirsten K Davison Journal: Soc Sci Med Date: 2022-01-31 Impact factor: 4.634
Authors: Roger Figueroa; Cristina M Gago; Jacob Beckerman-Hsu; Alyssa Aftosmes-Tobio; Xinting Yu; Kirsten K Davison; Janine J Jurkowski Journal: Int J Environ Res Public Health Date: 2020-11-20 Impact factor: 3.390
Authors: Jacob P Beckerman-Hsu; Cristina Gago; Alyssa Aftosmes-Tobio; Janine M Jurkowski; Kindra Lansburg; Jessie Leonard; Merieka Torrico; Sebastien Haneuse; S V Subramanian; Erica L Kenney; Kirsten K Davison Journal: BMC Public Health Date: 2021-01-22 Impact factor: 3.295