Building Blocks for Healthy Preschoolers

Not Applicable

Terminated

Brief Summary: Pediatric obesity, a defining health problem of the century, leads to long-term health disparities. This application evaluates strategies to prevent health disparities early in life by developing environmental wellness-related interventions focused on child-care center staff and families.

Childcare centers provide an excellent opportunity to build healthy dietary and physical activity lifestyle habits and avoid the rapid weight gain that leads to health disparities. Building on a statewide survey among childcare centers and a pilot evaluation of an environmental intervention, this 3-cell randomized trial evaluates the impact of a staff-led wellness intervention and a staff-led and family-focused intervention, against a control condition.

Detailed Description: The intervention trial will be conducted in 48-55 childcare centers throughout Maryland, enrolling 864 children age 30-54 months from childcare centers serving low-income families. The aims are:

1. to examine the impact of the wellness intervention individually and combined with the family intervention versus control on BMI z-score, food preferences and knowledge, and physical activity among children

2. to examine the sustainability of the interventions

3. to examine whether changes in outcomes measures for children's BMI z-score, gross motor skills, food preferences and knowledge, and physical activity are mediated by changes in the childcare staff wellness-related attitudes and behaviors and/or parent wellness-related attitudes and behaviors (exploratory).

Findings from the trial will inform programs and policies in childcare centers to prevent obesity and reduce disparities, and will be disseminated locally, regionally, and nationally through conferences, information briefs, social media, and peer-reviewed journal articles. The overall objective is to promote statewide strategies that reduce pediatric obesity and the long-term health disparities.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Caregivers and staff who do not speak or read English
Childcare staff and preschoolers with health problems that would interfere with participation in physical activities

Arm && Interventions

Group	Intervention	Description
CHAMP+ group	CHAMP+	These childcare centers, also randomly assigned, will have the same intervention as the CHAMP group in addition to a parenting intervention that promotes wellness and healthy behaviors within families.
CHAMP+ group	CHAMP	These childcare centers, also randomly assigned, will have the same intervention as the CHAMP group in addition to a parenting intervention that promotes wellness and healthy behaviors within families.
CHAMP group	CHAMP	Childcare centers randomly assigned the CHAMP group will receive an intervention that promotes physical activity in the classroom by developing gross motor skills through movement and enhances the nutritional environment in the centers by exposing preschoolers to new foods.

Primary Outcome Measures

Name	Time	Method
Change of BMI Z-score for preschoolers	Baseline to 6 month (Midline) Follow-up or 1 year (Post Intervention) Follow-up	Measured weight and height for the preschoolers, calculated as age and gender-specific BMI Z-score

Secondary Outcome Measures

Name	Time	Method
Change of Physical Activity for preschoolers and childcare center staff	Baseline to 6 month (Midline) Follow-up or 1 year (Post Intervention) Follow-up	Moderate to Vigorous Physical Activity (MVPA) based on anthropometrics
Change in Preschoolers to try new foods	Baseline to 6 month (Post Intervention) Follow-up or 1 year (Delayed Intervention) Follow-up	Measured by Food Tasting Assessment
Change in Gross Motor Skills	Baseline to 6 month (Post Intervention) Follow-up or 1 year (Delayed Intervention) Follow-up	Measured by Test of Gross Motor Development-2

Locations (1): University of Maryland Growth and Nutrition Division
🇺🇸
Baltimore, Maryland, United States