Obesity has become epidemic among U.S. children and results in serious negative health consequence over the lifespan. Thus, identifying effective interventions for prevention of obesity in children is paramount The purpose of the proposed study is to design, implement, and evaluate a culturally appropriate, multi-leve trans-community prevention intervention for decreasing obesity risk (measured by BMI percentile) in 3 to 5 year-old rural Hispanic and American Indian children. The primary intervention site will be Head Star centers, where enrolled low-income preschool children spend the majority of their days. The intervention Child Health Initiative for Lifelong Eating and Exercise (CHILE), will include policy changes to addres environmental determinants of healthful eating and physical activity, as well as individual and interpersona level strategies to promote increased moderate to vigorous physical activity;increased consumption of fruits vegetables, and whole grains;decreased consumption of sweetened beverages and high-fat foods;an decreased television viewing/screen time. The intervention includes six components: a classroom curriculu for Head Start classrooms;an in-service training program for Head Start teachers and aides;training fo Head Start food service staff;a home- and Head Start-based program for families;use of local health car providers as community change agents, advisors, and role models;and a community grocery store progra to increase availability and promotion of healthy food options. The study will employ a nested cohort desig in which 16 Head Start centers will be randomly assigned to intervention or control conditions. Two cohort of 3-year-old children within each Head Start center will be followed for two years post-randomization Participants will be assessed using a measurement and interview protocol across four time points. Data wil be analyzed using multi-level modeling to partition variance into individual- and Head Start- or intervention level components, and to explore individuals'change over time and potential mediating effects.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Special Emphasis Panel (ZRG1-HOP-S (50))
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Kuczmarski, Robert J
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University of New Mexico
Schools of Medicine
United States
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Davis, Sally M; Myers, Orrin B; Cruz, Theresa H et al. (2016) CHILE: Outcomes of a group randomized controlled trial of an intervention to prevent obesity in preschool Hispanic and American Indian children. Prev Med 89:162-8
Cruz, Theresa H; Davis, Sally M; Myers, Orrin B et al. (2016) Effects of an Obesity Prevention Intervention on Physical Activity Among Preschool Children: The CHILE Study. Health Promot Pract 17:693-701
Morshed, Alexandra B; Davis, Sally M; Keane, Patricia C et al. (2016) The Impact of the CHILE Intervention on the Food Served in Head Start Centers in Rural New Mexico. J Sch Health 86:414-23
Trappmann, Jessica L; Jimenez, Elizabeth Yakes; Keane, Patricia C et al. (2015) Cross-Sectional Relationships Between Household Food Insecurity and Child BMI, Feeding Behaviors, and Public Assistance Utilization Among Head Start Children From Predominantly Hispanic and American Indian Communities in the CHILE Study. J Hunger Environ Nutr 10:439-455
Morshed, Alexandra B; Davis, Sally M; Greig, Elizabeth A et al. (2015) Effect of WIC Food Package Changes on Dietary Intake of Preschool Children in New Mexico. Health Behav Policy Rev 2:3-12
Cruz, Theresa H; Davis, Sally M; FitzGerald, Courtney A et al. (2014) Engagement, recruitment, and retention in a trans-community, randomized controlled trial for the prevention of obesity in rural American Indian and Hispanic children. J Prim Prev 35:135-49
Davis, Sally M; Sanders, Sarah G; FitzGerald, Courtney A et al. (2013) CHILE: an evidence-based preschool intervention for obesity prevention in Head Start. J Sch Health 83:223-9
Sussman, Andrew L; Davis, Sally (2010) Integrating formative assessment and participatory research: Building healthier communities in the CHILE Project. Am J Health Educ 41:244-249