Please select the eligibility criteria that correspond to the clinical trial below.
Title: Improving Nutrition and Physical Activity Environments in Home-based Child Care
Brief Summary: Drs. Patricia Risica (Brown University) and Kim Gans (University of Connecticut) are Dual Principal Investigators for this project. The research team will first conduct formative research using focus groups and key-informant interviews of Family Child Care Home (FCCH) providers. This formative work will inform our adaptation of components of previous evidence-based interventions to create a new innovative intervention in both English and Spanish to improve food and PA environments of Family Child Care Homes (FCCH). The intervention will integrate: a) support from peer counselors with child care experience who will serve as team leaders for groups of FCCPs; b) tailored print and video materials; and c) a set of portable active toys. A cluster-randomized trial with 132 FCCH will evaluate the effectiveness of the intervention with a Steering Committee and Community Advisory Board guiding all aspects. The Specific Aims of the study are to: 1) Conduct formative research to inform the development and adaptation of the FCCH intervention. 2) Conduct a cluster-randomized trial of the intervention's efficacy with 66 FCCH providers and a control intervention with 66 demographically-matched FCCH providers to evaluate its impact on: a) Children's overall dietary quality at FCCHs; b) Children's PA and sedentary behaviors at FCCHs; and c) the physical and social food and PA environments of FCCHs. Evaluation methods will include survey data collection of the FCCH Providers; observation of children's' dietary intake and physical activity in FCCHs; recruitment of children within the FCCH for physical and survey measurement with permission from their parents.


Options:
A: Inclusion Criteria:

* operator of a FCCH
* have at least 1 children in their care,
* provide at least 2 meals/snacks to the children
* ability to read and speak English or Spanish
* expect to be in operation in a year
* have a working phone
* have either a DVD player or internet access through computer or phone

Exclusion Criteria:

* under 18 years of age
* has no children in their care between the ages of 2 and 5 years old
* child care will be closed for more than 1 month at a time in the forthcoming year.
* does not prepare the food served by the children (children bring it from home).
B: Inclusion Criteria:

* 4-6 y
* BMI due to Cole criteria as overweight or obesity

Exclusion Criteria:

* Medical disorders
* Endocrine disorders
C: Inclusion Criteria. Centers must have met the following criteria to be included: (1) have \> 30 children ages 2-5 enrolled; (2) Serve low income families who are a part of the USDA food program and SNAP eligible; (3) Reflect the ethnic distribution of the Miami-Dade County Public School System (63 percent Hispanic, 19 percent African American, 18 percent white); and (4) Center directors agree to participate and sign a letter of commitment. Studies were excluded if they did not meet these criteria.
D: Specific Inclusion Criteria at the parent-child dyad level will include:

* Consent from a primary caregiver (i.e., parent or legal guardian)
* Caregiver's ability to speak English or Spanish
* Infant presenting for a 2 month well-child visit (child is 6 ≥ 12 weeks old)
* Caregiver agrees to participate in the study, and agrees to bring their child to all well-child care visits until their 2 year well-child care visit.

Specific Exclusion Criteria at the parent-child dyad level will include:

* Child born prior to 32 weeks' gestational age or with a birth weight \< 1500 grams
* Child with weight/length \< 3rd percentile at 2 months of age
* Child with a diagnosis of failure to thrive or with weight that has dropped ≥ 2 percentile curves since the previous well child visit
* Child with known medical problems that may affect their ability to thrive or requires a special diet (e.g. metabolic disease, uncorrected congenital heart disease, renal disease, lung disease)
* Caregiver with significant mental or neurologic illness likely to impair their ability to participate
* Caregiver age \< 18 years
* Caregiver with known plans to move out of the immediate area during the study period
* Caregiver with poor visual acuity (i.e. vision worse than 20/50 with Rosenbaum Pocket Screener as assessed at the time of recruitment)

Specific Inclusion Criteria at the Pediatric Resident level will include:

* Participation in the medical center's pediatric resident training program
* Providing regular care (\> 3 sessions per month) in the pediatric resident primary care clinic; AND
* Consent to participate in the study

Specific Exclusion Criteria at the Pediatric Resident level will include:

* Providing no regular care in the pediatric resident primary care clinic (e.g., transitional-year resident, Medicine/Pediatrics resident); OR
* Known plans to leave the training program during the ensuing 6 months

Answer: A