Building Blocks for Healthy Preschoolers: Child Care and Family Models

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PROJECT SUMMARY/ABSTRACT Pediatric obesity, a defining health problem of the century, leads to long-term health disparities. This application evaluates strategies to prevent health disparities early in life by developing environmental wellness-related interventions focused on child-care center staff and families. Child-care centers provide an excellent opportunity to build healthy dietary and physical activity lifestyle habits and avoid the rapid weight gain that leads to health disparities. Building on a statewide survey among child-care centers and a pilot evaluation of an environmental intervention, this 3-cell randomized trial evaluates the impact of a staff-focused environmental wellness intervention and a staff and family-focused intervention, against a control condition. The trial will be conducted in 48 child-care centers throughout Maryland, enrolling 1080 children age 30-54 months from low-income families, 1080 parents, and 450 staff members. The aims are: 1) to examine the impact of the wellness intervention individually and combined with the family intervention versus control on child-care center staff wellness-related attitudes and behaviors; parent wellness-related attitudes and behaviors; and child dietary intake, food preferences, physical activity, and growth; 2) to examine the sustainability of the interventions; and 3) to examine whether changes in outcomes measures for children’s food preferences, growth, and feeding behavior are mediated by changes in the child-care staff wellness-related attitudes and behaviors and/or parent wellness-related attitudes and behaviors. Findings from the trial will inform programs and policies in child-care centers to prevent obesity and reduce disparities, and will be disseminated locally, regionally, and nationally through conferences, information briefs, social media, and peer-reviewed journal articles. The overall objective through our university/state agency/non-profit partnership (University of Maryland School of Medicine; Maryland State Department of Education and Department of Health and Mental Hygiene; and Maryland Family Network) is to promote statewide environmental strategies that reduce pediatric obesity and the long-term health disparities.