Happy Family, Healthy Kids Program

Study Overview
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Brief Summary
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Happy Family, Healthy Kids program, funded by the Michigan Health Endowment Fund, is a 14-week healthy eating program aimed to foster Happy Family & Healthy Kids. The program will target parental emotional eating through a life stress management component, and parents will be coached on making happy and healthy eating behavioral changes at home that will support their children to establish lifelong healthy eating habits. At the end of this project, the investigators expect to have an effective, comprehensive, and sustainable healthy eating program ready to expand to any Head Start center in an urban or rural setting.

Detailed Description
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In Project Year 1, the program will be evaluated with about 100 Head Start children, aged 3 to 5 years, and their parents (one parent per family) in four urban and four rural Head Start centers. The investigators will compare the program outcomes between urban and rural settings. All involved Head Start centers will support MSU staff to conduct data collection activities (e.g., online survey completed by parents; height, weight, and blood pressure measures; hair samples collected from both children and parents). MSU staff, along with Head Start staff, will implement the 14-week healthy eating program activities including four components: A 14-week parent Facebook-based program focusing on stress management and healthy eating to reduce emotional eating and increase parents' capacity to initiate healthy eating practices at home Three parent face-to-face or virtual meetings at Head Start centers to connect parents with each other in person, offer healthy cooking tools/classes, and discuss behavioral change strategies and challenges 14-week child Eat My ABCs program at Head Start centers to provide an age-appropriate, healthy eating program to children Weekly child letter to parents to connect child learning at the Head Start center with parental practices at home In Project Year 2, the investigators will finalize the program based on the evaluation outcomes in Project Year 1, and work closely with the participating Head Start organizations to disseminate the healthy eating program to all the participating Head Start centers and classes.

Official Title
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Happy Family, Healthy Kids: An Intergenerational Program to Promote Healthy Eating Habits

Conditions
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Healthy Diet, Stress, Pediatric Obesity, Intergenerational Relations

Intervention / Treatment
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* Behavioral: Happy Family, Healthy Kids Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: There are ten inclusion criteria (five for preschoolers and five for caregivers). Preschoolers must: Have parental consent. Have child assent if the child is 5 years old. Be 3-5 years of age. Be able to understand and speak English. The intervention will be delivered in English. Be enrolled in the full-day or part-day Head Start program. Caregivers must: Provide consent. Be the primary adult caregiver (≥ 18 years old) for the preschooler. Primary caregiver refers to the one person most responsible for providing care to the preschooler on a daily basis. Be able to read, understand, and speak English. The intervention will be delivered in English. Have at least weekly Internet access using a smartphone, tablet, or a computer. Each caregiver needs to have Internet access to access the study's Facebook group for participating in the Facebook-based program. Be willing to use Facebook. Since the caregiver intervention component will be delivered via Facebook, caregivers need to be willing to use Facebook in the study. Exclusion Criteria: There are three exclusion criteria for both caregivers and preschoolers. Preschoolers or caregivers who have medical conditions precluding participating in dietary changes. Preschoolers or caregivers who have diagnosed health conditions known to impact weight (e.g., Prader-Willi Syndrome) or are taking weight-affecting medications (e.g., stimulants). Preschoolers who have diagnosed developmental disabilities (e.g., autism), or caregivers who have diagnosed psychiatric or mental health problems.

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 5 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Intervention Model: Single Group Assignment
Interventional Model Description: The program will be evaluated with about 100 Head Start children, aged 3 to 5 years, and their parents (one parent per family) in four urban and three rural Head Start centers to compare the program outcomes between urban and rural settings.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Program<br>The 14-week healthy eating program activities including four components: A 14-week parent Facebook-based program focusing on stress management and healthy eating to reduce emotional eating and increase parents' capacity to initiate healthy eating practices at home Three parent face-to-face or virtual meetings at Head Start centers to connect parents with each other in person, offer healthy cooking tools/classes, and discuss behavioral change strategies and challenges 14-week child Eat My ABCs program at Head Start centers to provide an age-appropriate, healthy eating program to children Weekly child letter to parents to connect child learning at the Head Start center with parental practices at home | Behavioral: Happy Family, Healthy Kids Program<br>* The 14-week healthy eating program activities including four components: A 14-week parent Facebook-based program focusing on stress management and healthy eating to reduce emotional eating and increase parents' capacity to initiate healthy eating practices at home Three parent face-to-face or virtual meetings at Head Start centers to connect parents with each other in person, offer healthy cooking tools/classes, and discuss behavioral change strategies and challenges 14-week child Eat My ABCs program at Head Start centers to provide an age-appropriate, healthy eating program to children Weekly child letter to parents to connect child learning at the Head Start center with parental practices at home<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Child dietary intake | Child dietary intake will be assessed by the 41-item Block Kids Food Screener. The Block Kids Food Screener is a food frequency questionnaire used to assess dietary intake of fruits, vegetables, dairy, whole grains, protein sources, saturated fat, and added sugars in youth aged 2-17 years old. It has been shown to have significant relationships (r=0.53-0.88) with Nutrition Data System for Research 24-h food recall data. The Block Kids Food Screener has acceptable Cronbach's alphas of 0.76-0.77 for the survey items assessing fruit and vegetable intake among Head Start preschoolers. The completed surveys will be processed and analyzed by NutritionQuest, and the number of cups of fruit and vegetable consumed per day will be used to describe children's fruit and vegetable intake, with a higher number indicating a healthier eating behavior. | Change from baseline child dietary intake at 15 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Child eating style | Child eating style will be assessed by the 35-item Child Eating Behavior Questionnaire. It has five response choices ranging from 1=never to 5=always. The Child Eating Behavior Questionnaire has eight factors including food responsiveness, emotional overeating, enjoyment of food, desire to drink, satiety responsiveness, slowness in eating, emotional undereating, and food fussiness with good reliability and validity among preschoolers. A mean score (min-max: 1-5) for each factor will be calculated, with a higher mean factor score indicating a higher level of food responsiveness, emotional overeating, enjoyment of food, desire to drink, satiety responsiveness, slowness in eating, emotional undereating, and food fussiness, respectively. | Change from baseline child eating style at 15 weeks | 
| Child proportion of overweight and obesity and body mass index z-score | Height and weight will be measured to the nearest 0.1 cm with a ShorrBoard stadiometer and to the nearest 0.1 kg with a Seca model 874 portable electronic weight scale, respectively. All measurements will occur in a private room with participants removing their shoes, jackets, or heavy clothes. BMI percentile and BMI z-score for age and sex will be determined via SAS program for CDC Growth Charts. | Change from baseline proportion of overweight and obesity and body mass index z-score at 15 weeks | 
| Systolic and diastolic blood pressure | Both systolic and diastolic blood pressure will be measured using the Omron HEM-705-CP digital blood pressure monitor in the right arm of each relaxed (rest at least 15 minutes) and seated participant. The Omron HEM-705-CP can provide accurate estimation of blood pressure in both children and adults with a sensitivity of 82% and specificity of 98%. | Change from baseline blood pressure at 15 weeks | 
| Hair cortisol concentration | Hair cortisol concentration in pg/mg will be obtained from hair samples using the enzyme immunoassay approach analyzed by the Hormone Assay Core Laboratory at the University of Massachusetts Amherst. | Baseline only | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intergenerational, Healthy eating, Obesity prevention, Life stress management, Early childhood