Promoting Heart Health in Preschool Children
Condition: Cardiovascular Health
Study type: Interventional
Phase: Phase 3

Summary: 
      As part of the Colombian Hearty Health Initiative program led by Mount Sinai Cardiovascular
      Institute, a multidisciplinary team design and implemented a pedagogic and communication
      strategies for the promotion of healthy heart habits (PPHH) in preschoolers. This included
      educational materials, pedagogical activities and the use of Sesame Workshop healthy habits
      for life materials. For Colombia, the latter were largely developed in collaboration with the
      Colombian Society of Pediatrics, Colombian Society of Cardiology and Cardiovascular Surgery,
      Colsubsidio and Fundación Cardioinfantil-Instituto de Cardiología.
    

Detailed description: 
      Background Increased levels of risk factors during childhood create an important life-long
      burden that favors the development of cardiovascular (CVD) disease in adulthood.
      Epidemiologic studies have demonstrated that cardiovascular disease risk factors are
      identifiable in childhood and persist through to adulthood. It is unknown whether
      interventions targeting preschoolers may change knowledge, attitudes and habits (KAH) towards
      healthy lifestyles and, eventually, reduce the burden of CVD.

      The goal of the proposed study is to assess over a five month intervention period, the impact
      of an educational intervention on preschooler's knowledge of, habits and attitudes towards
      healthy eating and living an active lifestyle. The impact of the intervention will be also
      assessed in parents and teachers.

      Methods The investigators will conduct a cluster, randomized controlled trial in 1216
      pre-school children 3 to 5 years of age, 928 parents, and 120 teachers from 14 preschool
      facilities in Bogotá, Colombia in a low socioeconomic and underprivileged community.
      Randomization will occur at the facility level. The intervention will include classroom
      activities and use of printed material (books, posters, teachers' guides, games) and videos.
      Meanwhile, children in the control facilities will continue with their usual curriculum. A
      structured survey will be used at baseline and end of study to evaluate changes in KAH and
      the authors a priori give differential weights (70-20-10, respectively) to the scores to
      compose a standardized weighted total score (WTS). The primary outcome will be the change in
      children's WTS and the secondary outcomes will be the changes in parents' and teachers´ WTS.

      Potential Impact of the Trial If found to be effective in improving the short-term changes in
      knowledge, attitudes and habits, the educational intervention may have the potential to
      influence the children's' diet and physical activity patterns throughout their lifetimes by
      early interventions when attitudes and habits are formed. The program also targets parents
      and teachers who contribute to shape children's attitudes and habits and who are often at
      high risk for health problems associated with unhealthy diet and limited physical activity
      themselves. The program aims to empower local partners in the health, education, media and
      government sectors to build up the capacities to ensure sustainability. If proven efficacious
      in the short term, further evaluative studies should test the hypothesis that this program
      will serve as an effective and sustainable model to improve children's health worldwide.
    

Intervention name(s): Children-Multicomponent intervention
Intervention type(s): Behavioral
Intervention description(s): The intervened children were provided classroom educational and playful activities during 5 months, which included Sesame Workshop Healthy Habits storybooks, posters, videos, games, and songs (1 hour daily); a "Healthy family day" workshop (1 hour); and weekly health notes. Parents participated in 3 workshops and weekly notes containing positive health messages about nutrition and active lifestyles to share with their children. Teachers also participated in 3 centralized training sessions, plus personalized working sessions with a research supervisor (2 hours every 15 days), and received a teacher's guide.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Keywords: behavioral modification; health communication; prevention