Childhood Obesity Clinical Trial
Official title:
Healthy Caregivers/Healthy Children
Background: Many unhealthy dietary and physical activity habits that foster the development
of obesity are established by the age of five. Presently, approximately 70 percent of
children in the United States are currently enrolled in early childcare facilities, making
this an ideal setting to implement and evaluate childhood obesity prevention efforts. We
describe here the methods for conducting an obesity prevention intervention randomized trial
in the child care setting.
Methods/Design: A randomized, controlled obesity prevention trial in 28 low-income,
ethnically diverse child care centers located throughout Miami-Dade County, FL is currently
being conducted over two years (2010-present) to test the efficacy of an intervention that
poises teachers and parents as lifestyle change agents. The Healthy Caregivers-Healthy
Children (HC2) program includes a curriculum focusing specifically on healthy food choices,
increased exercise, and role modeling. The program targets food policy changes throughout
the school, and via the child, caregiver, and teacher. Major outcome measures include child
body mass index percentile and z score, fruit and vegetable and other nutritious food
intake, and amount of physical activity.
Discussion: Although few attempts have been made to prevent obesity during the first years
of life, this period may represent the best opportunity for obesity prevention. Findings
from this investigation should inform both the fields of childhood obesity prevention and
early childhood research about the effects of an obesity prevention program housed in the
childcare setting. (H1) A child care center-based obesity prevention intervention program
that includes a teacher and parent nutritional gatekeeper and role modeling program will be
more effective in maintaining BMI in 3-5 year olds compared to a control group.
(H2) Role modeling (teacher and parent) will be identified as a significant mediator in
preventing obesity among intervention children versus controls.
(H3) A child care center-based multi-level obesity prevention intervention program will
improve child nutrition (increased consumption of fruits and vegetables, decreased
consumption of sweetened beverages) and increase physical activity level compared to a
control group.
Over one third of preschoolers were either overweight (18.4%) or obese (16.5%). The majority
(92%) of caregivers of an overweight/obese child inaccurately perceived that their child was
in a normal BMI category. Foreign-born caregivers were significantly more likely to
inaccurately perceive their child's BMI percentile category, versus US-born caregivers
(OR=0.65, 95% CI, 0.48-0.88). Specifically, those born in South America [OR=0.59. 95% CI,
0.36-0.98), Central America/Mexico (OR=0.59, 95% CI,0.41-0.85), and Caribbean Hispanic
nations [OR=0.54, 95% CI 0.35-0.83) were significantly less likely to accurately perceive
their child's BMI category, versus US-born caregivers.
Conclusions: The results of this study suggest that foreign-born parents of preschool-age
overweight/obese children in particular do not accurately perceive their child's BMI status.
Pediatricians and other healthcare providers serving foreign-born caregivers may consider
additional healthy weight counseling for these families.
;
Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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