Community Partnering to Encourage Healthy Beverage Intake through Child Care Inappropriate intake of whole milk, fruit juice, and sugar-sweetened beverages is associated with childhood obesity, obesity-related co morbidities, and dental caries, yet there are few proven interventions to promote child intake of healthy beverages consistent with national guidelines. Child care facilities provide a potential venue for influencing healthy beverage intake in children and families. Our overall objective is to use principles of community-based participatory research (CBPR;an approach in which researchers partner with community members to conduct research) to develop, pilot test, and examine the acceptability, feasibility, sustainability, and preliminary outcomes of a child care-based intervention to encourage child intake of age-appropriate, guideline-recommended beverages. Our central hypothesis is that a multi-level intervention consisting of educational strategies to encourage intake of guideline-recommended beverages;increased accessibility of lead-free, fluoridated, drinking water in child care and at home;and evidence-based child care and home beverage policies will lead to healthier beverage intake and reduced childhood obesity. In preparation for submitting an R01 grant application to test this hypothesis, we propose the following specific aims:
Aim 1 : Investigate beverage consumption patterns as well as barriers and facilitators to guideline-recommended beverage intake among 0-5 year olds;
Aim 2 : Design, pilot test, and evaluate the preliminary outcomes of a child care-based healthy beverage intervention;
and Aim 3 : Refine the intervention based on an evaluation of intervention feasibility, acceptability, and sustainability.
In Aim 1, we will conduct interviews with child care staff and parents and observe child care facilities to explore factors that influence children's beverage intake and barriers and facilitators to healthy beverage consumption.
In Aim 2, we will use community partner feedback and findings from Aim 1 to design, pilot test, and evaluate preliminary outcomes (e.g., child BMI, beverage intake, child care beverage policies) of a healthy beverage intervention in a licensed child care center and 2 child care homes in an ethnically and socioeconomically diverse California county. Comparison facilities will be matched on intervention facility characteristics.
In Aim 3, we will evaluate the feasibility, acceptability, and sustainability of the intervention - based on our observations of child care facilities, debriefing sessions, parent/staff surveys, and community feedback - in order to refine the intervention for a future larger randomized controlled trial, to be proposed in an R01 application before the end of this award. This career development award will allow Dr. Patel to strengthen her skills in dissemination and implementation sciences and to acquire new skills in policy and institututional strategies to translate evidence into practice, measurement development, longitudinal and hierarchical modeling, and cost-effectiveness analysis. At the end of this award, Dr. Patel will be well positioned to translate evidence into practice to prevent childhood obesity.

Public Health Relevance

The proposed research is relevant to public health because the development of effective interventions to encourage intake of age-appropriate beverages that are consistent with national guidelines will help prevent obesity, obesity-related comorbidities, and dental caries among children. The proposed research is relevant to the part of NIH's mission that pertains to the application of knowledge to extend healthy life and reduce the burdens of illness.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Pediatrics Subcommittee (CHHD)
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Esposito, Layla E
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University of California San Francisco
Schools of Medicine
San Francisco
United States
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