Healthy Start/Comienzos Sanos

Multiple Principal Investigators
Patricia Markham Risica, DrPH
Kim M. Gans, PhD, MPH, LDN

National Institutes of Health (NIH)/ National Heart, Lung and Blood Institute (NHLBI)

Grant Number

Improving nutrition and physical activity environments in home-based child care 

Preschool years are critical times when dietary and PA behaviors are established and over 70% of U.S. children under the age of six attend out-of-home child care. Unhealthy food and physical activity (PA) behaviors contribute to the high prevalence rates of childhood obesity. Through this study, our research team has already conducted focus groups and individual interviews with Family Child Care Providers (FCCPs) to inform the development of the intervention and evaluation. Utilizing the findings from this formative research, we are creating an innovative intervention in both English and Spanish to improve the food and PA environments in their Family Child Care Homes (FCCHs).

The intervention will integrate:
a) support from peer counselors with child care experience who will serve as team leaders for groups of FCCPs;
b) tailored print and video materials; and
c) a set of portable active toys.

We are now planning for the main trial, through which we will evaluate whether the intervention is feasible and whether it is effective at:
a) improving the nutrition and PA environments in FCCHs; and
b) improving children’s dietary and physical activity behaviors with 132 total FCCHs (66 in the intervention group and 66 in a comparison group).

Evaluation for the main trial will include a survey of the FCCPs; physical measurements (height and weight) and physical activity measurements (using Actigraph accelerometers) of the children; and observation of the FCCH including the home food and physical activity environments (including food and beverages served and consumed, types of physical activity provided, etc.)