Communities for healthy living (CHL) - A family-centered childhood obesity prevention program integrated into Head Start services: Study protocol for a pragmatic cluster randomized trial
Communities for healthy living (CHL) - A family-centered childhood obesity prevention program integrated into Head Start services: Study protocol for a pragmatic cluster randomized trial
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DOI：
10.1016/j.cct.2019.01.002
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发表时间：
2019-03-01
影响因子：
2.2
通讯作者：
Hsu, Yu-Tien
中科院分区：
文献类型：
--
作者：
Beckerman, Jacob P.;Aftosmes-Tobio, Alyssa;Hsu, Yu-Tien
背景：儿童肥胖症非常普遍，并带来严重的健康后果。儿童肥胖干预措施取得了喜忧参半的结果，这可能部分是由于缺乏纳入更广泛的家庭背景和解决低资源环境中实施挑战的方法的理论。健康生活社区（CHL）是一个针对学前教育的肥胖预防计划，其设计注重理论和实施。该协议文件概述了CHL.Methods/Design的设计，内容，实施和评价：CHL集成了一个育儿计划共同领导的开端工作人员和家长，加强营养支持，和媒体宣传活动。CHL的内容和实施是由家庭生态模型，心理授权理论和组织授权理论。干预措施的指导是基于社区的参与性研究和实施科学原则，如与家长和工作人员共同领导，并在真实的世界背景下实施。CHL是在一项为期三年的实用性随机分组试验中采用阶梯楔形设计进行评估的。主要结局是儿童体重指数z评分的变化。次要结果包括儿童的体重相关行为（即，饮食、身体活动、屏幕使用和睡眠），针对这些行为的育儿实践（例如，食物养育）和父母赋权。评估利用了由Head Start收集的常规健康数据（例如，讨论：CHL是一个创新的儿童肥胖预防计划，以理论和实施科学原则为基础。如果成功，CHL将持续实施和在全国范围内扩大领先优势。
Background: Childhood obesity is highly prevalent and carries substantial health consequences. Childhood obesity interventions have had mixed results, which may be partially explained by the absence of theory that incorporates broader family context and methods that address implementation challenges in low-resource settings. Communities for Healthy Living (CHL) is an obesity prevention program for Head Start preschools designed with careful focus on theory and implementation. This protocol paper outlines the design, content, implementation, and evaluation of CHL.Methods/design: CHL integrates a parenting program co-led by Head Start staff and parents, enhanced nutrition support, and a media campaign. CHL content and implementation are informed by the Family Ecological Model, Psychological Empowerment Theory, and Organizational Empowerment Theory. The intervention is directed by community-based participatory research and implementation science principles, such as co-leadership with parents and staff, and implementation in a real world context. CHL is evaluated in a three-year pragmatic cluster randomized trial with a stepped wedge design. The primary outcome is change in child Body Mass Index z-score. Secondary outcomes include children's weight-related behaviors (i.e., diet, physical activity, screen use, and sleep), parenting practices targeted at these behaviors (e.g., food parenting), and parent empowerment. The evaluation capitalizes on routine health data collected by Head Start (e.g., child height and weight, diet) coupled with parent surveys completed by subsamples of families.Discussion: CHL is an innovative childhood obesity prevention program grounded in theory and implementation science principles. If successful, CHL is positioned for sustained implementation and nationwide Head Start scale-up.