Promoting Nutrition and Physical Activity in Family Child Care

Completed

• Conditions: Obesity, Childhood; Diet, Healthy; Physical Activity
• Interventions: Behavioral: Policy/program

• Registration Number: NCT04372823
• Lead Sponsor: University of South Carolina

Brief Summary

The CHEER study takes advantage of a natural experiment happening in South Carolina (SC). The South Carolina Department of Social Services implemented new healthy eating and physical activity standards through a state-wide policy for family child care homes that participate in the ABC Grow Healthy program. Thus, CHEER is a quasi-experimental, two-group, pre-test/post-test design study.

Detailed Description

The overall goal of the study is to evaluate new healthy eating and physical activity standards targeting family child care homes in South Carolina. To accomplish this goal, we are assessing the effects of the standards on the dietary intake and physical activity levels of racially diverse low-income children in family child care homes. The specific aims of the "CHEER" study are as follows:

Aim 1. Evaluate the extent to which the new regulatory standards impact children's dietary intake assessed via direct observation in homes and 24-hour recalls with parents, and physical activity and sedentary behavior assessed via accelerometry.

Aim 2. Evaluate the extent to which the new regulatory standards impact children's body mass index computed from researcher-measured height and weight.

Secondary Aim. Evaluate the extent to which family child care homes in the SC ABC Child Care Program comply with the new healthy eating and physical activity regulatory standards, compared to family child care homes not participating in the program.

We hypothesize that most homes will comply with the new standards, yielding improvements in children's healthy eating and physical activity levels. As an exploratory aim, we will examine the effects of the standards on children's weight status.

Study Timeline

• Study Start: 2017-10-01
• Study First Submitted: 2020-04-29
• Study First Submitted QC: 2020-04-29
• Study First Posted: 2020-05-04
• Primary Completion: 2023-05-31
• Study Completion: 2023-05-31
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-24
• Last Update Posted: 2025-03-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 300

Inclusion Criteria

• Having a child in care between the ages 2 and 4 years at recruitment
• The family is planning to stay in the same care arrangement for the next few years

Exclusion Criteria

• Family planning to leave the care arrangement in next few years

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Intervention	Policy/program	Intervention children within family child care homes exposed to policy/program

Primary Outcome Measures

Name	Time	Method
Diet	Approx 1 year	Healthy Eating Index score - The Healthy Eating Index is a calorie-adjusted comparison of individual or group-level dietary intake to current dietary guidelines. The Healthy Eating Index was last updated in 2015 and represents the sum of thirteen component scores. Higher scores are awarded for healthier intake within each component. Each component of the Healthy Eating Index has a standard for receiving the minimum or maximum points possible. The HEI components and maximum scores include: total fruit (5), whole fruit (5), total vegetables (5), greens and beans (5), whole grains (10), dairy (10), total proteins (5), seafood/plant (lean) proteins (5), fatty acids (10), refined grains (10), sodium (10), added sugars (10), and saturated fats (10).
Physical activity	Approx every year for 2 years	Accelerometer measured minutes of moderate to vigorous physical activity

Secondary Outcome Measures

Name	Time	Method
Body mass index	Approx every year for 2 years	Child body mass index z-score
Family child care home environment	Approx every year for 2 years	Environment and Policy Assessment and Observation

Trial Locations

Locations (2)

University of South Carolina; 🇺🇸 Columbia, South Carolina, United States

Johns Hopkins University; 🇺🇸 Baltimore, Maryland, United States