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Healthy Bodies Project to Prevent Childhood Obesity

Not Applicable
Completed
Conditions
Obesity, Childhood
Interventions
Behavioral: Healthy Eating, Active Play, Self-Regulation
Behavioral: Healthy Eating Only
Behavioral: Healthy Eating, Active Play, Self-Regulation, Parent Education
Behavioral: Healthy Eating, Active Play, Parent Education
Behavioral: Healthy Eating + Active Play
Behavioral: Healthy Eating + Parent Education
Behavioral: Active Play + Self-Regulation
Behavioral: Active Play + Parent Education
Behavioral: Active Play Only
Behavioral: Self-Regulation + Parent Education
Behavioral: Food Literacy + Parent Education
Behavioral: Healthy Eating, Self-Regulation, Parent Education
Behavioral: Healthy Eating + Self-Regulation
Behavioral: Self-Regulation Only
Behavioral: Active Play, Self-Regulation, Parent Education
Behavioral: Food Literacy Only
Registration Number
NCT04552678
Lead Sponsor
Penn State University
Brief Summary

The goal of this study is to evaluate components of a preschool-based intervention designed to (1) increase children's nutrition knowledge, (2) increase physical activity in childcare settings, (3) increase emotional, behavioral and eating-related regulation, and (4) provide guidance to parents/caregivers about appropriate parenting and child-feeding strategies that promote healthy eating behaviors, dietary patterns and physical activity in preschool-aged children. The long-term goal is to help children develop healthy habits that reduce risk for obesity.

Detailed Description

Findings from intervention studies designed to prevent obesity among preschool children are mixed. One approach to stemming the development of obesity in childhood is to alter children's choices and environments in ways that promote food literacy, acceptance of healthy foods, physical activity and self-regulation. Research on factors that influence the development of obesity in children has identified factors in children's environments that are potential targets for prevention programs. The goal of this study is to evaluate the efficacy of components designed for a preschool-based approach to preventing obesity in children. Using an innovative approach to optimizing behavioral interventions, the multiphase optimization strategy (MOST), we will examine the effects of a 28-week, randomized set of experiments designed to (1) increase children's nutrition knowledge, (2) increase physical activity in childcare settings, (3) increase emotional, behavioral and eating-related regulation, and (4) provide guidance to parents/caregivers about appropriate parenting and child-feeding strategies that promote healthy eating behaviors, dietary patterns and physical activity in preschool-aged children. Participants will include over 1300 predominantly low-income preschool children ages 3 to 5 years attending center-based childcare settings in Pennsylvania (\~100 classrooms). The proposed study will provide information on the most efficacious components that produce measurable changes in children's nutrition knowledge and obesity-related behaviors. The results of this study will be used to inform the design of a randomized controlled trial to prevent obesity in children.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
2480
Inclusion Criteria
  • Children ages 3 to 5 years enrolled in full-day, center-based childcare programs
  • Caregiver ≥ 18 years of age
  • Caregiver responsible for providing meals for child at least half of the time
  • Fluent in English (caregiver and child)
Exclusion Criteria
  • Developmental delays or disorders that affect learning, mobility and eating

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
Healthy Eating, Active Play, Self-RegulationHealthy Eating, Active Play, Self-RegulationClassrooms receive all curricula (Food Literacy, Healthy Eating, Active Play, Self-Regulation Curriculum), but no Parent Education
Healthy Eating OnlyHealthy Eating OnlyClassrooms receive the core Food Literacy Curriculum, the Healthy Eating Curriculum, but no Parent Education
Healthy Eating, Active Play, Self-Regulation, Parent EducationHealthy Eating, Active Play, Self-Regulation, Parent EducationClassrooms receive all curricula (Food Literacy, Healthy Eating, Active Play, Self-Regulation Curriculum) and Parent Education
Healthy Eating, Active Play, Parent EducationHealthy Eating, Active Play, Parent EducationClassrooms receive the core Food Literacy Curriculum, the Healthy Eating Curriculum, the Active Play Curriculum, and Parent Education
Healthy Eating + Active PlayHealthy Eating + Active PlayClassrooms receive the core Food Literacy Curriculum, the Healthy Eating Curriculum, the Active Play Curriculum, but no Parent Education
Healthy Eating + Parent EducationHealthy Eating + Parent EducationClassrooms receive the core Food Literacy Curriculum, the Healthy Eating Curriculum, and Parent Education
Active Play + Self-RegulationActive Play + Self-RegulationClassrooms receive the core Food Literacy Curriculum, the Active Play Curriculum, the Self-Regulation Curriculum, but no Parent Education
Active Play + Parent EducationActive Play + Parent EducationClassrooms receive the core Food Literacy Curriculum, the Active Play Curriculum, and Parent Education
Active Play OnlyActive Play OnlyClassrooms receive the core Food Literacy Curriculum, the Active Play Curriculum, but no Parent Education
Self-Regulation + Parent EducationSelf-Regulation + Parent EducationClassrooms receive the core Food Literacy Curriculum, the Self-Regulation Curriculum, and Parent Education
Food Literacy + Parent EducationFood Literacy + Parent EducationClassrooms receive the core Food Literacy Curriculum, and parents are invited to complete web-based education modules.
Healthy Eating, Self-Regulation, Parent EducationHealthy Eating, Self-Regulation, Parent EducationClassrooms receive the core Food Literacy Curriculum, the Healthy Eating Curriculum, the Self-Regulation Curriculum, and Parent Education
Healthy Eating + Self-RegulationHealthy Eating + Self-RegulationClassrooms receive the core Food Literacy Curriculum, the Healthy Eating Curriculum, the Self-Regulation Curriculum, but no Parent Education
Self-Regulation OnlySelf-Regulation OnlyClassrooms receive the core Food Literacy Curriculum, the Self-Regulation Curriculum, but no Parent Education
Active Play, Self-Regulation, Parent EducationActive Play, Self-Regulation, Parent EducationClassrooms receive the core Food Literacy Curriculum, the Active Play Curriculum, the Self-Regulation Curriculum, and Parent Education
Food Literacy OnlyFood Literacy OnlyClassrooms only receive the core Food Literacy Curriculum, and no other intervention materials or parent education.
Primary Outcome Measures
NameTimeMethod
Child Body Mass Index (BMI)Change from baseline to post-assessment (5-6months) and follow-up (~9 months)

Absolute BMI, BMI z-score (BMIz), BMI percentile (BMIp) calculated from measured height and weight

Children's Behavioral Regulation - ObservedChange from baseline to post-assessment (5-6months) and follow-up (~9 months)

Behavioral tasks that measure child inhibitory control: Walk a Line Slowly, Peg/Pencil Tapping Procedure and Choosing Dinky Toys.

Assessor reports of children's emotions, attention, and behavior: Preschool Self-Regulation Assessor Report

Nutrition KnowledgeChange from baseline to post-assessment (5-6months) and follow-up (~9 months)

Ability to identify energy- vs. nutrient-dense foods using the Food Knowledge Procedure

Food ChoicesChange from baseline to post-assessment (5-6months) and follow-up (~9 months)

Children's choices between energy- vs. nutrient-dense foods for a hypothetical lunch using the Snack Selection Procedure

Physical and Sedentary ActivityChange from Baseline to Mid-Intervention (~3 months), Post-Intervention (5-6 months) and follow-up (~9 months)

Children's engagement in sedentary and moderate-vigorous physical activity during the school day objectively measured via accelerometry.

Children's Behavioral Regulation - Parent- and Teacher-ReportChange from baseline to post-assessment (5-6months)

Teacher reports of children's attentional focusing, impulsivity and inhibitory control: Child Behavior Questionnaire

Parent reports of children's impulsivity and inhibitory control: Child Behavior Questionnaire

Children's Emotion Regulation - Parent- and Teacher-ReportChange from baseline to post-assessment (5-6months)

Parent and Teacher reports of children's anger/frustration: Child Behavior Questionnaire

Children's Eating in the Absence of HungerChange from baseline to post-assessment (5-6months)

Parent reported measure of children's eating in the absence of hunger due to negative emotions, fatigue/boredom, or external food cues.

Secondary Outcome Measures
NameTimeMethod
Children's Food RequestsBaseline, Post-Intervention (5-6 months)

Parental reports of children's requests for fruits, vegetables, whole grains and dairy.

Children's Appetitive BehaviorsBaseline, Post-Intervention (5-6 months)

Parent report of children's appetitive trait-like behaviors (responsiveness to food, enjoyment of food, satiety responsiveness, slowness in eating, fussiness, emotional overeating, emotional undereating, and desire for drinks). Measured using the Children's Eating Behavior Questionnaire.

Parental reports of children's requests for fruits, vegetables, whole grains and dairyBaseline, Post-Intervention (5-6 months)

Parent reported measure of children's eating in the absence of hunger due to negative emotions, fatigue/boredom, or external food cues.

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