Please select the eligibility criteria that correspond to the clinical trial below.
Title: Promoting Healthy Eating and Active Playtime by Connecting Preschool Children to Nature
Brief Summary: Recent research suggests a majority of Hong Kong's toddlers (aged 2 to 4) are much less active than is recommended and are increasingly engaged in sedentary behaviour, which places them at risk of becoming overweight or obese. The proposed project will test whether connecting families to nature positively influences physical activity (that is, active playtime) and healthy eating routines in children aged 2 to 4. The investigators have recently conducted a pilot study Play \& Grow (P\&G), a programme based on the most successful international preschool interventions described in the literature. In addition to adopting healthy eating and physical activity intervention elements, the programme was enhanced by including a novel third element: connectedness to nature (CN). To test the effectiveness of this enhanced intervention, the plan is to run a family-based randomised controlled trial (RCT). The intervention will include 240 families with children aged 2 to 4, will take the form of one-hour activity sessions for parents and children held once a week for 10 weeks. The investigators will assess lifestyle-related habits before, immediately after the completion the intervention, at 6 months and one year after the intervention. Created for this purpose, a novel measuring tool for connectedness to nature, Nature Relatedness Scale (NRS), will be validated and tested for reliability prior to the RTC. The results of RCT are intended to be used to understand which components of the intervention were most effective. The objectives of this project will be achieved over a 36-month period, and it is expected to contribute to a close examination of key components of successful healthy lifestyle promotion programme during early childhood. The investigators predict that is that the new element CN will significantly improve the intervention. Finally, the overall aim is that connecting families to nature will result in sustainable lifestyle changes that remain with them for a lifetime.


Options:
A: * INCLUSION CRITERIA - MAIN TRIAL
* All participants in the main trial will be healthy adult parents 18 years and older
* Inclusion criteria include:

  1. being the parent of a biological child who is between 4 and 7 years old with no major allergies or dietary-related health conditions;
  2. having some responsibility for child s dietary intake ;
  3. having the ability to read, write, and converse in English;
  4. being able to come to the NIH Clinical Center for one visit.

EXCLUSION CRITERIA - MAIN TRIAL

* Exclusion criteria include:

  1. having received information about the study purpose;
  2. being an NHGRI employee;
  3. being from a family wherein another household member or co-parent of a biological child has already participated or is scheduled to participate.

     EXCLUSION CRITERIA - VIRTUAL REALITY
* Exclusion criteria related to use of the virtual reality environment include:

  1. having a medical susceptibility to dizziness, disorientation or nausea;
  2. having a seizure disorder or epilepsy;
  3. having a high propensity for motion sickness;
  4. lacking freedom of movement;
  5. known pregnancy;
  6. low, uncorrected vision and hearing.

INCLUSION CRITERIA - PILOT

* Participants in the Pilot test will be healthy adult parents 18 years and older.
* Inclusion criteria include:

  1. being the parent of a biological child who is between 3 and 7 years old with no major allergies or dietary-related health conditions, but only for the first 10 participants;
  2. having the ability to read, write, and converse in English;
  3. being able to come to the NIH Clinical Center for one visit.

EXCLUSION CRITERIA - PILOT

1. having received information about the study purpose;
2. being an NHGRI employee;
3. low, uncorrected vision and hearing.

INCLUSION CRITERIA - BUFFET SERVING EVALUATION

* Participants in the secondary Buffet Serving Evaluation will be healthy adult parents 18 years and older
* Inclusion criteria include:

  1. being the parent of a biological child who is between 3 and 7 years old with no major allergies or dietary-related health conditions;
  2. having some responsibility for child s dietary intake ;
  3. having the ability to read, write, and converse in English;
  4. being able to come to the NIH Clinical Center for one visit.

EXCLUSION CRITERIA - BUFFET SERVING EVALUATION (MAIN)

1. being an NHGRI employee;
2. being from a family wherein another household member or co-parent of a biological child has already participated or is scheduled to participate.

EXCLUSION CRITERIA - BUFFET SERVING EVALUATION (VIRTUAL REALITY)

* Exclusion criteria related to use of the virtual reality environment include:

  1. having a medical susceptibility to dizziness, disorientation or nausea;
  2. having a seizure disorder or epilepsy;
  3. having a high propensity for motion sickness;
  4. lacking freedom of movement;
  5. known pregnancy;
  6. low, uncorrected vision and hearing.

     INCLUSION CRITERIA- OLFACTORY AWARENESS TEST:
* Participants in the Olfactory Awareness Test will be healthy adults between the ages of 18 and 59

Inclusion criteria include:

1. Having the ability to read, write and converse in English
2. Able to come to the clinical center for on visit.

We may also include the following inclusion criteria:

1. Being the parent of a biological child who is between 3 and 7 years old with no major allergies or dietary-related health conditions
2. Having some responsibility for child s dietary intake; however, if we encounter recruitment difficulties, we may instead sample nonparent participants who are of the same general age range as parents who participated in our past studies using the virtual buffet. For the pilot test, we will sample non-parents in the age range of past parent participants

EXCLUSION CRITERIA-OLFACTORY AWRAENESS TEST:

1. Being an NHGRI employee;
2. Having participated in the Parents TAKE study conducted previously in this lab.

Exclusion criteria related to use of the virtual reality environment include:

1. Having a medical susceptibility to dizziness, disorientation or nausea;
2. Having a seizure disorder or epilepsy;
3. Having a high propensity for motion sickness;
4. Lacking freedom of movement;
5. Known pregnancy;
6. Weak, uncorrected vision, hearing, and/or smell. No adults older than age 59 will be able to participate in this study because older adults tend to experience a decline in olfactory function
B: Inclusion Criteria:

* 2-4 year old children
* With English-speaking parents

Exclusion Criteria:

* Children with chronic health conditions
* Families who have recently taken part in a healthy lifestyle promotion programme
C: Inclusion Criteria:

* parents having a four year old child and living in Östergötland; having the ability to have their child measured at baseline at 4.5 years ± 2 months of age
* at least one parent had to able to speak and read Swedish sufficiently well (i.e. be able to provide informed consent and understand the intervention content)

Exclusion Criteria:

* A child with a neurological or endocrine disease effecting weight
* A child with a parent suffering from a serious physical or psychological disease making the study too demanding for the family.
D: Inclusion Criteria:

* Healthy singleton term born infants of appropriate size for gestational age (AGA) according to the Centers for Disease Control growth charts based on weight at birth between the 5th and 95th percentiles for sex; and born to healthy breastfeeding women. This allows us to assess growth and bone mineral accretion without bias of intrauterine growth restriction.

Exclusion Criteria:

* Infants of mothers with history of gestational diabetes or hypertension in pregnancy; chronic alcohol use; malabsorption syndromes due to malabsorption of vitamin D (celiac disease, Crohn's etc.); and multiple births.
* Should any exclusion criteria be identified after recruitment, the infant will be excluded from the main analyzes, but followed in a separate arm as intent-to-treat.

Answer: B