Healthy Weight: Linking Child Care Centers with the Home

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DESCRIPTION (provided by applicant): The prevalence of overweight among young children has risen more than 40% over the past decade. More specifically, in North Carolina 10% of children ages 2-5 years are considered overweight. Because a majority of preschool children spend much of their day and consume up to two-thirds of their daily calories" in child care centers, centers are in a unique position to encourage and role model healthy nutrition and physical activity behaviors for children. In addition, centers can share healthy lifestyle messages, emphasizing the importance of lifelong health, with parents. With children forming nutrition and physical activity lifestyles early in life, reciprocal reinforcement of a consistent message between the child care center and the home can greatly promote the formation of healthy behaviors and potentially prevent the development of childhood overweight. This proposal is for a child care-home intervention that uses a previously developed intervention (NAP SACC) designed to change the nutrition and physical activity environments at the child care center with a simultaneous home-based, family component (to be called NAP SACC Family) that includes parenting skills training, home visits, resource material, and telephone support to prevent overweight in children aged 3-5 years. The first half of this intervention, NAP SACC, or Nutrition and Physical Activity Self-Assessment for Child Care, was recently developed by this research team and results from pilot work are promising. We now propose to recruit 18 child care centers from one county in North Carolina and randomly assign them to three groups: six of the centers will receive NAP SACC intervention only, six will receive NAP SACC and Family intervention, and six will be used as a control group and receive no formal intervention. NAP SACC and NAP SACC Family interventions are based on Social Cognitive Theory and focus on reciprocal interaction among environment, policy, and interpersonal channels of influence within the child care centers and the home environments. The primary outcomes of this feasibility study are physical activity, as measured by accelerometry, and diet (fruit/vegetable, milk, and fat consumption), as measured by a validated food frequency measure obtained from parents (Block for Kids). BMI will be assessed pre and post intervention. Accomplishing the aims of this proposal will allow the expansion of this intervention into a full-scale trial that can be used in a wide range of child care and family settings.