Family-centered Obesity Prevention: Communities for Healthy Living (CHL)

Boston College4,999 enrolled

Overview

The Communities for Healthy Living (CHL) program is a family-focused intervention to promote healthy lifestyle behaviors including diet and physical activity among children (age 3-to 5-years) and their families, enrolled in Head Start.

This evaluation will test the effectiveness of a family-focused intervention, Communities for Healthy Living (CHL), implemented through Head Start. Over 20% of preschool-aged children in the US experience overweight or obese. Because obesity prevention depends heavily on the adoption of healthy lifestyle behaviors early in life, preventive efforts offer a higher promise for success if they are family-centered. Effective family-centered interventions for obesity prevention in preschool-aged children, however, remain elusive. While a number of interventions have shown positive effects on child Body Mass Index (BMI), results are inconsistent and short term effects are not maintained. What is more, because families at greatest risk of childhood obesity - including low-income, single-parent, and ethnic minority families - are the most difficult to recruit and retain, results are often limited in their applicability to high risk populations. In response, the researchers have partnered with Head Start to develop and test a new approach to family-centered childhood obesity prevention that addresses family engagement upfront. The CHL program will be refined and rigorously tested for efficacy in collaboration with Head Start programs in the greater Boston area, which collectively serve over 2000 low-income children each year. Building on a previous pilot study, the investigators will broaden the parent-centered Community Based Participatory Research approach and include Head Start staff in the decision making and implementation process, refine intervention components, and expand technical assistance protocols to support Head Start ownership of CHL while ensuring implementation fidelity. In addition, consistent with the overarching theoretical framework (Family Ecological Model), neighborhood-level socioeconomic, food and physical activity environments around family homes and examine their impact on intervention outcomes will be measured to inform future scale up efforts.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

4,999

Conditions

Pediatric Obesity Obesity

Interventions

Parents Connect for Healthy Living (PConnect)BEHAVIORAL

Parents Connect for Healthy Living (PConnect) parent curriculum: This 10-week program (20 hours total) engages Head Start parents in a wide range of topics related to health and empowerment and is designed to foster a safe, open forum through which parents can connect with other parents and mobilize resources to support their family's health; NOTE: The PConnect program was not implemented in 2019-2020 due to the coronavirus pandemic. In 2020-2021, PConnect was implemented virtually; these are pilot data and not part of the main trial.

Enhanced Nutrition SupportBEHAVIORAL

Enhanced Nutrition Support: Existing nutrition resources within Head Start (e.g., Biannual child health letters) are expanded and improved to ensure parents are aware of their child's weight status and are linked with age-appropriate weight management services if their child has overweight or obesity. NOTE: Enhanced nutrition support was not implemented in spring 2020 due to the pandemic. In 2020-2021, it was moved to a virtual format in what will be a pilot virtual trial.

Eligibility

Sex: ALLMin age: 3 YearsHealthy volunteers:

Medical Language ↔ Plain English

Primary Outcome Measures Inclusion: * Enrolled in a participating Head Start program * Age 33 months to 5 years (i.e., meets Head Start age eligibility criteria) Exclusion: * Those not meeting inclusion criteria Secondary Outcome Measures Inclusion: * Enrolled in a participating Head Start program * Age 33 months to 5 years Exclusion: * Children not enrolled at a participating Head Start program * Children less than 29 months or older than 59 months by Sept 1

Locations (1)

Boston College

Chestnut Hill, Massachusetts, United States

Outcomes

Primary Outcomes

Change in Child BMI-z score

Change in child BMI-z score

Time frame: Collected at the beginning and end of each academic year (i.e., fall, spring) for 3 years (BL, Y1, Y2) rather than 4 years as planned

Modified change in BMI z-score

BMI of a child is expressed relative to the median BMI in units of ½ of the distance between 0 and +2 z- scores. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703793/

Time frame: Collected at the beginning and end of each academic year (i.e., fall, spring) for 3 years (BL, Y1, Y2)

Secondary Outcomes

Change in child fruit and vegetable intake

Change in child fruit and vegetable intake assessed by parent report of child weekly frequency of intake

Time frame: Collected at the beginning and end of each academic year (i.e., fall, spring) for 3 years (BL, Y1, Y2) rather than 4 years as planned

Change in child sugar-sweetened beverage intake

Change in child sugar-sweetened beverage consumption assessed by parent report of child weekly frequency of intake

Time frame: Collected at the beginning and end of each academic year (i.e., fall, spring) for 3 years (BL, Y1, Y2) rather than 4 years as planned

Change in child physical activity

Change in child physical activity assessed by parent report of average minutes per day child spent in structured free play and organized physical activities

Time frame: Collected at the beginning and end of each academic year (i.e., fall, spring) for 3 years (BL, Y1, Y2) rather than 4 years as planned

Change in child sleep duration

Change in child daily sleep duration assessed by parent report (calculated from average bedtime and wake time)

Data from ClinicalTrials.gov

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