The Business of Childcare Homes & Child Health: Innovations for Nurturing Growth

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DESCRIPTION (provided by applicant): Childhood obesity is a major public health problem and an important predictor of obesity later in life. Although early childhood is a formative period for dietary and activity habits, little research targeting this young age group has been conducted. Child care facilities are a prime setting for interventions targeting young children, given the number of families using some form of out-of-home care. Family child care homes (FCCH) are a particular type of child care facility in which the provider cares for children out of his/her own residence. FCCHs are less regulated than child care centers, and there have been no published obesity prevention interventions in FCCHs to date. Interventions targeting FCCH providers could help promote healthy child weight by creating child care environments that provide and support active play opportunities and healthy food choices, while helping providers become role models for healthy lifestyles (physical activity and diet). However, the child care industry is facd with many challenges including limited profitability. By incorporating strategies for overcoming some of these economic challenges, interventions may be able to more easily address barriers to implementing and sustaining the changes needed to promote regular physical activity and healthy dietary intakes in children. This project will use a cluster-randomized controlled trial (RCT) to test the efficacy of the 9- month intervention H3: Healthy You, Healthy Home, Healthy Business, which targets FCCHs and is designed to promote (1) providers as healthy role models, (2) physical activity- and nutrition-supportive environments at the FCCH, and (3) healthy business practices. By combining these components, the ultimate objective is to create healthy and stable FCCHs that promote healthy physical activity and eating behaviors in children. This intervention will be delivered through group workshops, onsite visits, tailored coaching phone contacts, and educational toolkits. Increased child physical activity and improved quality of child diet while at the FCCH will be the primary outcomes used to assess the impact of this innovative, theory-driven intervention. Secondary outcomes and mediators include child body mass index, provider weight-related behaviors, provider motivation and self-efficacy, communication between providers and parents, and obesogenic environmental characteristics of the FCCH.