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

描述(申请人提供)：儿童肥胖是一个主要的公共卫生问题，也是日后肥胖的一个重要预测因素。尽管童年早期是一个形成期 在饮食和活动习惯方面，针对这一年轻群体的研究很少。 鉴于使用某种形式的家庭护理的家庭的数量，托儿设施是针对幼儿的干预措施的主要场所。家庭托儿所(FCCH)是一种特殊类型的托儿设施，提供者在其中照顾离开自己住所的儿童。与儿童护理中心相比，FCCH的监管较少，到目前为止，FCCH中还没有发表肥胖预防干预措施。针对FCCH提供者的干预措施可以通过创建提供和支持积极游戏机会和健康食物选择的儿童保育环境来帮助促进健康的儿童体重，同时帮助提供者成为健康生活方式(体力活动和饮食)的榜样。然而，托儿行业面临着许多挑战，包括盈利能力有限。通过纳入克服其中一些经济挑战的战略，干预措施可能能够更容易地解决实施和维持促进儿童定期体力活动和健康饮食摄入量所需变革的障碍。该项目将使用整群随机对照试验(RCT)来测试为期9个月的干预措施H3：健康你、健康家庭、健康商业的有效性，该干预针对FCCH，旨在促进(1)提供者作为健康榜样，(2)FCCH支持身体活动和营养的环境，以及(3)健康的商业实践。通过将这些组成部分结合在一起，最终目标是创建健康稳定的FCCH，促进儿童健康的身体活动和饮食行为。这种干预将通过小组研讨会、现场访问、量身定做的教练电话联系和教育工具包来提供。在FCCH期间，增加儿童体力活动和改善儿童饮食质量将是用于评估这一创新的、理论驱动的干预措施的影响的主要结果。次要结果和中介因素包括儿童体重指数、提供者体重相关行为、提供者动机和自我效能、提供者与父母之间的沟通以及FCCH的肥胖环境特征。

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.