USDA Healthy Caregivers/Healthy Children: A Childhood Obesity Prevention Program
Condition: Childhood Obesity
MeSH terms: Obesity; Pediatric Obesity
Study type: Interventional

Summary: 
      Background: Many unhealthy dietary and physical activity habits that foster the development
      of obesity are established by the age of five. Presently, approximately 70 percent of
      children in the United States are currently enrolled in early childcare facilities, making
      this an ideal setting to implement and evaluate childhood obesity prevention efforts. We
      describe here the methods for conducting an obesity prevention intervention randomized trial
      in the child care setting.

      Methods/Design: A randomized, controlled obesity prevention trial in 28 low-income,
      ethnically diverse child care centers located throughout Miami-Dade County, FL is currently
      being conducted over two years (2010-present) to test the efficacy of an intervention that
      poises teachers and parents as lifestyle change agents. The Healthy Caregivers-Healthy
      Children (HC2) program includes a curriculum focusing specifically on healthy food choices,
      increased exercise, and role modeling. The program targets food policy changes throughout the
      school, and via the child, caregiver, and teacher. Major outcome measures include child body
      mass index percentile and z score, fruit and vegetable and other nutritious food intake, and
      amount of physical activity.

      Discussion: Although few attempts have been made to prevent obesity during the first years of
      life, this period may represent the best opportunity for obesity prevention. Findings from
      this investigation should inform both the fields of childhood obesity prevention and early
      childhood research about the effects of an obesity prevention program housed in the childcare
      setting. (H1) A child care center-based obesity prevention intervention program that includes
      a teacher and parent nutritional gatekeeper and role modeling program will be more effective
      in maintaining BMI in 3-5 year olds compared to a control group.

      (H2) Role modeling (teacher and parent) will be identified as a significant mediator in
      preventing obesity among intervention children versus controls.

      (H3) A child care center-based multi-level obesity prevention intervention program will
      improve child nutrition (increased consumption of fruits and vegetables, decreased
      consumption of sweetened beverages) and increase physical activity level compared to a
      control group.
    

Detailed description: 
      Over one third of preschoolers were either overweight (18.4%) or obese (16.5%). The majority
      (92%) of caregivers of an overweight/obese child inaccurately perceived that their child was
      in a normal BMI category. Foreign-born caregivers were significantly more likely to
      inaccurately perceive their child's BMI percentile category, versus US-born caregivers
      (OR=0.65, 95% CI, 0.48-0.88). Specifically, those born in South America [OR=0.59. 95% CI,
      0.36-0.98), Central America/Mexico (OR=0.59, 95% CI,0.41-0.85), and Caribbean Hispanic
      nations [OR=0.54, 95% CI 0.35-0.83) were significantly less likely to accurately perceive
      their child's BMI category, versus US-born caregivers.

      Conclusions: The results of this study suggest that foreign-born parents of preschool-age
      overweight/obese children in particular do not accurately perceive their child's BMI status.
      Pediatricians and other healthcare providers serving foreign-born caregivers may consider
      additional healthy weight counseling for these families.
    

Intervention name(s): Childhood Obesity
Intervention type(s): Other
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: childhood obesity, early childhood, nutrition