scholarly journals Evaluating a child care-based social marketing approach for improving children’s diet and physical activity: results from the Healthy Me, Healthy We cluster-randomized controlled trial

2020 ◽  
Author(s):  
Amber E Vaughn ◽  
Heidi Hennink-Kaminski ◽  
Renee Moore ◽  
Regan Burney ◽  
Jesse L Chittams ◽  
...  
Keyword(s):  
Physical Activity ◽  
Child Care ◽  
Outcome Measures ◽  
Social Marketing ◽  
Healthy Eating ◽  
Diet Quality ◽  
Post Intervention ◽  
Cluster Randomized ◽  
The Impact ◽  
Childcare Providers

Abstract Child care-based interventions offer an opportunity to reach children at a young and impressionable age to support healthy eating and physical activity behaviors. Ideally, these interventions engage caregivers, including both childcare providers and parents, in united effort. This study evaluated the impact of the Healthy Me, Healthy We intervention on children’s diet quality and physical activity. A sample of 853 three- to four-year-old children from 92 childcare centers were enrolled in this cluster-randomized control trial. Healthy Me, Healthy We was an 8-month, social marketing intervention delivered through childcare that encouraged caregivers (childcare providers and parents) to use practices that supported children’s healthy eating and physical activity behaviors. Outcome measures, collected at baseline and post-intervention, assessed children’s diet quality, physical activity, and BMI as well as caregivers’ feeding and physical activity practices. Generalized Linear Mixed Models were used to assess change from baseline to post-intervention between intervention and control arms. No significant changes were noted in any of the outcome measures except for small improvements in children’s sodium intake and select parent practices. Despite the negative findings, this study offers many lessons about the importance and challenges of effective parent engagement which is critical for meaningful changes in children’s health behaviors.

scholarly journals Self-Efficacy for Healthy Eating Moderates the Impact of Stress on Diet Quality Among Family Child Care Home Providers

2021 ◽  
Vol 53 (4) ◽  
pp. 309-315
Author(s):  
Phillip Dobson ◽  
Regan Burney ◽  
Derek Hales ◽  
Amber Vaughn ◽  
Alison Tovar ◽  
...  
Keyword(s):  
Child Care ◽  
Healthy Eating ◽  
Diet Quality ◽  
Self Efficacy ◽  
Care Home ◽  
Family Child Care ◽  
The Impact

scholarly journals Two Approaches to Increase Physical Activity for Preschool Children in Child Care Centers: A Matched-Pair Cluster-Randomized Trial

2019 ◽  
Vol 16 (20) ◽  
pp. 4020 ◽  
Author(s):  
Pooja S. Tandon ◽  
Katherine L. Downing ◽  
Brian E. Saelens ◽  
Dimitri A. Christakis
Keyword(s):  
Physical Activity ◽  
Child Care ◽  
Randomized Study ◽  
Free Play ◽  
Outdoor Play ◽  
Matched Pair ◽  
Child Care Centers ◽  
Post Intervention ◽  
Active Play ◽  
Cluster Randomized

Early childhood education settings are critical for promoting physical activity (PA) but intervention effects are often small. The aim of this study was to develop, test, and compare two approaches to increasing physical activity among preschoolers at child care centers: one focused on a teacher-led PA curriculum (Active Play!) and the other on increasing outdoor child-initiated free play time (Outdoor Play!). We conducted a matched-pair cluster-randomized study in 10 centers in and around Seattle, WA, USA (n = 97 children, mean age 4.6). Pre- and post-intervention data were collected from observations and accelerometers. At pre-intervention, 19% of Active Play! and 25% of Outdoor Play! children achieved >120 min/day of PA during child care. The total opportunity for PA increased in both interventions (Active Play! = 11 min/day; Outdoor Play! = 14 min/day), with the largest increase in outdoor child-initiated free playtime (Active Play! = 19 min/day; Outdoor Play! = 24 min/day). No changes in sedentary time, light or moderate- to vigorous-intensity PA (MVPA) were observed in either intervention and there was no difference between interventions in the percentage of children attaining more than 120 min/day of PA. A small (<3 min/day) relative increase in teacher-led outdoor activity was observed in the Active Play! intervention. Both intervention strategies led to an increase in active play opportunities, predominantly outdoors, but neither was able to substantially increase the intensity and/or duration of children’s PA. Future studies are needed to better understand and inform sustainable approaches to increase PA in early learning settings.

Promoting Cooking, Nutrition, and Physical Activity in Afterschool Settings

2019 ◽  
Vol 43 (6) ◽  
pp. 1050-1063 ◽  
Author(s):  
Henna Muzaffar ◽  
Cassandra J. Nikolaus ◽  
Brian G. Ogolsky ◽  
Amanda Lane ◽  
Carli Liguori ◽  
...  
Keyword(s):  
Physical Activity ◽  
Stages Of Change ◽  
Healthy Eating ◽  
Social Cognitive ◽  
Cognitive Theory ◽  
Caloric Intake ◽  
Adult Educators ◽  
Post Intervention ◽  
Cooking Skills ◽  
Cluster Randomized

Objective: In this study, we evaluated the afterschool PAWS (Peer-education About Weight Steadiness) Club program delivered by peer or adult educators to improve food choices, physical activity, and psychosocial variables related to healthy eating. Methods: We had 109 adolescents (53 in adult-led group; 56 in peer-led group) participate in a cluster randomized controlled intervention. The 12-session curriculum framed within Social Cognitive Theory (SCT) and Stages of Change addressed mediators of behavior change related to cooking skills, food intake, and physical activity. Anthropometric, dietary intake, physical activity, and SCT mediators were assessed at baseline, post-intervention, and 6-months post-intervention. Results: Adolescents in the peer-led group significantly improved whole grain intake at post-intervention (p = .017) and 6-months post-intervention (p = .014). Both peer-led and adult-led groups had significant reductions in caloric intake at 6-months post-intervention (p = .047). Only the adult-led group improved self-efficacy (SE) and social/family support (SS) for healthy eating at post-intervention [p = .019 (SE); p = .048 (SS)] and 6-months post-intervention [p = .036 (SE); p = .022 (SS)]. Conclusions: The PAWS Club program promoted lower caloric intake by adolescents. Peer educators were effective at increasing whole grains in adolescents, and adult educators contributed to positive changes in SE and SS related to healthy eating.

Cluster Randomized Trial of the Impact of an Obesity Prevention Intervention on Child Care Center Nutrition and Physical Activity Environment Over Two Years

2021 ◽  
pp. 1-25
Author(s):  
Ruby Natale ◽  
Folefac D. Atem ◽  
Cynthia Lebron ◽  
M. Sunil Mathew ◽  
Sitara M. Weerakoon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Child Care ◽  
Randomized Trial ◽  
Obesity Prevention ◽  
Mixed Models ◽  
Care Center ◽  
Cluster Randomized Trial ◽  
Physical Activity Environment ◽  
Cluster Randomized ◽  
The Impact

Abstract Objective: The prevalence of obesity among preschool-aged children in the United States remains unacceptably high. Here we examine the impact of Healthy Caregivers-Healthy Children (HC2) Phase 2, a child care center (CCC)-based obesity prevention intervention on changes in the CCC nutrition and physical activity environment over two school years. Design: This was a cluster randomized trial with 12 CCC receiving the HC2 intervention arm and 12 in the control arm. The primary outcome was change in the Environment and Policy Assessment and Observation (EPAO) tool over two school years (Fall-2015, Spring-2016 and Spring-2017). Changes in EPAO physical activity and nutrition score were analyzed via a (1) random effects mixed models and (2) mixed models to determine the effect of HC2 versus control. Setting: The study was conducted in 24 CCCs serving low-income, ethnically diverse families in Miami-Dade County. Participants: Intervention CCCs received (1) teachers/parents/children curriculum; (2) snack, beverage, physical activity, and screen time policies; and (3) menu modifications. Results: Two-year EPAO nutrition score changes in intervention CCCs were almost twice that of control CCCs. The EPAO physical activity environment scores only slightly improved in intervention CCCs versus control CCCs. Intervention CCCs showed higher combined EPAO physical activity and nutrition scores compared to control CCCs over the 2-year study period (β=0.09, P=0.05). Conclusions: Obesity prevention programs can have a positive impact on the CCC nutrition environment and can promote healthy weight in early childhood. CCCs may need consistent support to improve the physical activity environment to ensure the policies remain intact.

scholarly journals The Impact of Shorter, More Frequent Outdoor Play Periods on Preschoolers’ Physical Activity during Childcare: A Cluster Randomized Controlled Trial

2019 ◽  
Vol 16 (21) ◽  
pp. 4126 ◽  
Author(s):  
Molly Driediger ◽  
Stephanie Truelove ◽  
Andrew M. Johnson ◽  
Leigh M. Vanderloo ◽  
Brian W. Timmons ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Outdoor Play ◽  
Cluster Randomized Controlled Trial ◽  
Control Group ◽  
Post Intervention ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
The Impact

Children’s physical activity levels are higher at the start of outdoor playtime, which suggests that shorter, more frequent play periods might result in greater amounts of daily physical activity. In this extension of the Supporting Physical Activity in the Childcare Environment (SPACE) cluster randomized controlled trial, we explored the impact of four 30-min daily outdoor unstructured play periods on preschoolers’ moderate-to-vigorous-intensity physical activity (MVPA). Experimental childcare centres (n = 6) implemented four 30-min daily outdoor playtimes for 8 weeks, while control centres (n = 6) maintained their two 60-min outdoor sessions. Actical™ accelerometers were used to measure preschoolers’ physical activity pre- and post-intervention for 5 days during childcare hours. Linear mixed effects models were used to determine the impact of the intervention on preschoolers’ MVPA. Of the 185 preschoolers enrolled (54.20% female; mean age = 39.90 months, SD = 7.24), 127 (65 experimental and 62 control) were included in the analysis (30% and 9% loss to follow-up for experimental and control group preschoolers, respectively). No significant differences in MVPA were observed between groups over time (p = 0.36). Preschoolers’ MVPA did not improve after the introduction of shorter outdoor play periods. The loss of data due to wear time noncompliance and participant attrition may have influenced these findings. Trial registration: ISRCTN70604107 (October 8, 2014).

scholarly journals The impact of basic vs. enhanced Go NAPSACC on child care centers’ healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Amber E. Vaughn ◽  
Christina R. Studts ◽  
Byron J. Powell ◽  
Alice S. Ammerman ◽  
Justin G. Trogdon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Child Care ◽  
Implementation Strategies ◽  
Cluster Randomized Trial ◽  
Evidence Based ◽  
Child Care Centers ◽  
Post Intervention ◽  
Implementation Approach ◽  
Cluster Randomized ◽  
Type 3

Abstract Background To prevent childhood obesity and promote healthy development, health authorities recommend that child care programs use the evidence-based practices that foster healthy eating and physical habits in children. Go NAPSACC is an intervention shown to improve use of these recommended practices, but it is known to encounter barriers that limit its impact and widespread use. Methods This study will use a type 3 hybrid effectiveness-implementation cluster-randomized trial to compare effectiveness and implementation outcomes achieved from Go NAPSACC delivered with a basic or enhanced implementation approach. Participants will include approximately 25 coaches from Child Care Aware of Kentucky (serving four geographic regions), 97 child care centers with a director and teacher from each and two cross-sectional samples of 485 3–4-year-old children (one recruitment at baseline, another at follow-up). Coaches will be randomly assigned to deliver Go NAPSACC using either the basic or enhanced implementation approach. “Basic Go NAPSACC” represents the traditional way of delivering Go NAPSACC. “Enhanced Go NAPSACC” incorporates preparatory and support activities before and during their Go NAPSACC work, which are guided by the Quality Implementation Framework and the Consolidated Framework for Implementation Research. Data will be collected primarily at baseline and post-intervention, with select measures continuing through 6, 12, and 24 months post-intervention. Guided largely by RE-AIM, outcomes will assess change in centers’ use of evidence-based nutrition and physical activity practices (primary, measured via observation); centers’ adoption, implementation, and maintenance of the Go NAPSACC program (assessed via website use); center directors’, teachers’, and coaches’ perceptions of contextual factors (assessed via self-report surveys); children’s eating and physical activity behaviors at child care (measured via observation and accelerometers); and cost-effectiveness (assessed via logs and expense tracking). The hypotheses anticipate that “Enhanced Go NAPSACC” will have greater effects than “Basic Go NAPSACC.” Discussion This study incorporates many lessons gleaned from the growing implementation science field, but also offers opportunities to address the field’s research priorities, including applying a systematic method to tailor implementation strategies, examining the processes and mechanisms through which implementation strategies produce their effects, and conducting an economic evaluation of implementation strategies. Trial Registration ClinicalTrials.gov, NCT03938103, Registered April 8, 2019

scholarly journals Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – An umbrella review

2020 ◽  
Author(s):  
Janis Fiedler ◽  
Tobias Eckert ◽  
Kathrin Wunsch ◽  
Alexander Woll
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Sedentary Behavior ◽  
Healthy Eating ◽  
Social Contexts ◽  
Just In Time ◽  
Umbrella Review ◽  
Behavior Change Techniques ◽  
Adaptive Interventions ◽  
The Impact

Abstract Background: Electronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology.Methods: PubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects (i.e. subjects without physical or physiological morbidities which would influence the realization of behaviors targeted by the respective interventions) were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized.Results: The systematic search reveled eleven systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions.Conclusion: Findings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions.Trial registration: The protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.

scholarly journals An Evaluation of the University of Illinois Extension Get Up & Move! Program

2009 ◽  
Vol 4 (1) ◽  
pp. 126-131
Author(s):  
Mary Ann Halpin ◽  
Susan M. Farner ◽  
Stephen J. Notaro ◽  
Sheri Seibold ◽  
Pat McGlaughlin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Childhood Obesity ◽  
Physical Fitness ◽  
Healthy Eating ◽  
Healthy Lifestyles ◽  
University Of Illinois ◽  
Youth Leaders ◽  
The University ◽  
The Impact

Get Up & Move! is a program created by University of Illinois Extension to address childhood obesity. It provides ready-to-use materials for youth leaders to promote healthy lifestyles through physical fitness and healthy eating. The impact of the program on participants’ physical activity was evaluated to see whether involvement produces an increase in physical activity to the USDA recommended 60 minutes per day. It was found that a significant increase in minutes of physical activity occurred in participants from an average of 51.88 minutes per day to an average of 58.84 minutes per day.

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