Reducing Television Viewing To Prevent Obesity in Hispanic Preschool Children
Condition: Obesity; Physical Activity; Sedentary Activity; Television Viewing
MeSH terms: Obesity
Study type: Interventional

Summary: 
      Obesity has been linked to the development of multiple cancers, and to poorer prognoses and
      higher mortality rates for certain pediatric and adult cancers. Preventing obesity is
      therefore a major strategy to prevent new cases of cancer and to decrease cancer related
      morbidity and mortality. In the US, childhood obesity is on the rise. Since childhood obesity
      strongly tracks into adulthood this epidemic among children greatly increases the risk of
      obesity and presumably cancer in adulthood. As a result, preventing childhood obesity has
      been selected as a major public health goal to reduce the risk and sequelae of obesity and
      cancer in the US.

      Moreover, television (TV) viewing has been identified as a major risk factor for childhood
      obesity and US children spent more time watching TV than any other activity except sleep. TV
      viewing contributes to excess weight gain by decreasing physical activity and increasing
      caloric intake. The American Academy of Pediatrics (AAP) has issued national guidelines for
      parents to limit their children's total entertainment media time to no more than 1 to 2 hours
      of quality programming per day for children greater than 2 years of age. Low-income and
      minority children were at greater risk for exceeding this recommendation.

      Few published interventions have been successful in decreasing TV viewing in children and
      only one was successful among preschool children. This intervention, "Fit 5 Kids" (i.e. fit
      by age 5 years), was a preschool curriculum designed to decrease TV viewing via
      age-appropriate lessons taught to the children by research staff. The curriculum also
      included a take-home component consisting of a newsletter with ideas for parent (for this
      grant, defined as the adult most responsible for the child's care, usually the mother) and
      child activities that complemented the school lesson plans. Although most behavioral
      interventions for preschoolers target parents rather than children, this curriculum was one
      of the few successful interventions targeted directly at children. However, Fit 5 Kids was
      not designed for or evaluated among Hispanic preschool children, the subpopulation of
      preschool children most severely affected by obesity. Moreover, no published intervention has
      successfully reduced both TV viewing and excess weight gain in any preschool population. In
      order to fill this gap, the investigators propose to evaluate a culturally adapted Fit 5 Kids
      TV reduction curriculum among Hispanic preschool children enrolled in the Head Start Program.

      Fit 5 Kids is the TV reduction component of the Brocodile the Crocodile health promotion
      program. The overall goal of Fit 5 Kids is to teach the preschoolers to decrease their TV
      watching and encourage alternative activities such as family meals and active playtime. The
      primary goal of this research plan will be to conduct a pilot group randomized controlled
      trial evaluating the effectiveness of the adapted curriculum to reduce TV viewing and excess
      weight gain in low income, Hispanic preschool children

      To achieve the project goals, the investigators Specific Aim includes:

      1. To successfully recruit forty-eight 3-5 year old Hispanic children from 4 Head Start
      centers each year for 3 years and conduct a group randomized controlled study of the adapted
      Fit 5 Kids curriculum to evaluate its effectiveness in reducing TV viewing and excess weight
      gain in Hispanic preschool children.

      The Primary Hypothesis to be tested includes:

      H1. The culturally adapted Fit 5 Kids curriculum will reduce TV viewing and excess weight
      gain among Hispanic preschool children.
    


Intervention name(s): Television reduction curriculum
Intervention type(s): Behavioral
Intervention description(s): Students are taught the television reduction curriculum during the school day (15-30 minutes/day) 3-5 days/week over 7 weeks. Parents are invited to attend brief after-school meetings every other week to discuss reducing their children's television viewing.
Other intervention name(s): Fit 5 Kids
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Obesity; Physical Activity; Sedentary Activity; Television viewing; Latino; Hispanic; Preschool; School; Head Start