Please select the eligibility criteria that correspond to the clinical trial below.
Title: Children's Healthy Living Program for Remote Underserved Minority Populations in the Pacific Region
Brief Summary: The goal is to build social/cultural, political/economic, and physical/built environments that will promote active play and intake of healthy food to prevent young child obesity in the Pacific Region. Our methods will support local culture in order to achieve this goal in these remote, underserved native populations. CHL will engage the community, and focus on capacity building and sustainable environmental change.

The focus of the CHL community-based program is to promote healthy eating and to increase physical activity. In order to demonstrate effectiveness, the investigators will recruit and measure children in six communities selected in each of our jurisdictions in the Pacific. These represent intervention communities, comparison communities, and temporal communities.


Options:
A: Inclusion Criteria:

* Adult caregiver with a 2-5 year old child
* 2-5 year old child with a caregiver
* Caregiver has a working cell phone and is willing to receive regular text messages as part of study participation
* Caregiver lives within feasible travel distance of data collection site and willing to come for data collection visits at 0, 6 months, 12 months, 18 months and 24 months
* Willingness to be randomized to one of two groups with the understanding that all participants will receive all components of the intervention, randomization simply determines the order in which materials are received
* Valid mailing address where participant can receive mail and packages
* Basic English fluency and literacy sufficient for understanding the intervention materials and completing questionnaires

Exclusion Criteria:

* Adults with no children or whose only children are younger than 2 or older than 5
* Children younger than 2 or older than 5 years of age
* No cell phone or unwilling to receive regular text messages as part of study participation
* Lives beyond feasible travel distance of data collection sites AND/OR planning on moving out of the area within a two year period
* Child has major physical or behavioral disorder (e.g. failure to thrive, severe autism) that would seriously impact study participation
* No valid mailing address
* Unwillingness to accept random allocation to study arm
* Spouse/partner of another caregiver-child pair who is living in same home \& who has already enrolled (e.g. only one adult-child pair per household may be enrolled)
B: Inclusion Criteria:

- healthy mothers/caregivers of infants

Exclusion Criteria:

* Subjects with recent antibiotic use (within 3 months)
* Subjects on any medication that is immunosuppressive
* Subjects who self-report they have xerostomia due to medication use
C: Inclusion Criteria:

* Native American pregnant teens or young women ages 12-22 years old at the time of conception.
* Women ages 20-22 years at the time of conception must be pregnant for the first time.
* Partners of pregnant teens must be between the ages of 12-24.
* Pregnant \<28 weeks gestation and able to meet the requirements for completing the program in a timely way.
* An enrolled tribal member.
* Reside in the Reservation Service Unit Catchment Area and within 60 mile of the Indian Health Service Unit Headquarters.

Exclusion Criteria:

* Severe mental illness - schizophrenia, bipolar disorder, incapacitating depression, or Substance abuse/dependence in need of intensive and specific treatment
* Active legal problems - subjects will not be enrolled if they are incarcerated or if program participation has been made a condition of parole
* Ongoing social service involvement for abuse and neglect
D: Inclusion Criteria:

* Community criteria

Four (4) to six (6) communities in each of five (5) jurisdictions (Alaska, American Samoa, Commonwealth of Northern Mariana Islands, Guam \& Hawai'i) chosen for community randomized program based on:

* 2000 U.S. Census criteria

  * \>1000 people
  * \>25% Native population,
  * \>10% under 5y
* CHL Staff Community Evaluation

  * Sufficient Head Start/preschool, kindergarten
  * Children live \& go to school in area
  * Separation between communities to allow testing
  * Access for CHL
  * Sufficient community cohesiveness
  * Sufficient settings for program (community centers, parks, stores...)
* Child criteria • 2-10 years of age

Exclusion Criteria:

* Child criteria

  * Known orthopedic, psychological or neurologic impairments that prevent physical activity
  * Presence or history of any metabolic or chronic health problems known to affect intermediary metabolism (e.g. untreated thyroid disease, cancer, hepatic disease, renal disease, diabetes, cardiovascular disease, hypertension)
  * Irregular use of prescription or over-the-counter medications known to affect appetite, food intake or intermediary metabolism (e.g. appetite suppressants, lithium, antidepressants, etc.)

Answer: D