Food preferences and activity habits set in early childhood can profoundly influence lifelong trajectories for Body l /lass Index (BMI) and health. Specifically, rapid BMI gain in early childhood has been established to affect adulthood mortality and morbidity. Unfortunately, the longer such unhealthy patterns are in place, the more difficult it can be to reverse them. Therefore, healthy lifestyle interventions targeted at children as early as preschool 'have enormous potential to affect lifelong health. Furthermore, nutrition and activity patterns are determined not only at the child level, but within the family and the community. Building on the success of an existing partnership between Vanderbilt Pediatrics and Metro Parks and Recreation in Nashville, TN, we will conduct and evaluate an intervention intended to prevent obesity in preschoolers in an approach that affects multiple levels of risk and is both family-based and community centered. Prior to launching a large randomized controlled trial (RCT), formative research (focus groups and pilot studies) will be conducted to refine the intervention components. In the RCT, 600 parent-preschool children dyads from low income neighborhoods will be randomly assigned to one of two conditions. In the intervention condition, groups of parent-child dyads will participate in an empirically tested, literacy-sensitive, skills building curriculum to improve: 1) caloric intake with appropriate macronutrients, and 2) routine physical activity for both parent and child. The intervention condition will occur in community centers and utilize tools including goal setting, self-monitoring, and problem solving. In the control condition parent-child dyad groups will receive a literacy promotion/school success curriculum. Both conditions will have 90-minute sessions in: 1) an initiation phase (weekly for 3 months);2) a maintenance phase (biweekly for 6 months);and 3) a sustainability phase (monthly for 27 months). The primary outcome of interest will be early childhood BMI trajectories measured at multiple time points over the three year RCT. Additional measures collected throughout the study from children and parents will include: bioelectrical impedance;waist circumference;actigraphy;3-day diet recalls;questionnaires;social network data;and saliva to assess a genetic risk score associated with obesity.

Public Health Relevance

Pediatric obesity prevention must occur in preschool given that 60% of oven/weight preschoolers will go on to become overweight adolescents. By conducting and testing trials in public community centers, exportable interventions could result allowing for a macro-level system change to address this expanding public health crisis.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZHL1-CSR-W (M1))
Program Officer
Pratt, Charlotte
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Vanderbilt University Medical Center
Schools of Medicine
United States
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Heerman, William J; Berge, Jerica M; Barkin, Shari L (2018) Mentoring of Early-Stage Investigators When Funding Is Tight: The Childhood Obesity Prevention and Treatment Research Experience. JAMA Pediatr 172:4-6
Heerman, William J; Lounds-Taylor, Julie; Mitchell, Stephanie et al. (2018) Validity of the toddler feeding questionnaire for measuring parent authoritative and indulgent feeding practices which are associated with stress and health literacy among Latino parents of preschool children. Nutr Res 49:107-112
Barkin, Shari L; Heerman, William J; Sommer, Evan C et al. (2018) Effect of a Behavioral Intervention for Underserved Preschool-Age Children on Change in Body Mass Index: A Randomized Clinical Trial. JAMA 320:450-460
Ruiz, Rachel M; Sommer, Evan C; Tracy, Dustin et al. (2018) Novel patterns of physical activity in a large sample of preschool-aged children. BMC Public Health 18:242
French, Simone A; Sherwood, Nancy E; Veblen-Mortenson, Sara et al. (2018) Multicomponent Obesity Prevention Intervention in Low-Income Preschoolers: Primary and Subgroup Analyses of the NET-Works Randomized Clinical Trial, 2012-2017. Am J Public Health 108:1695-1706
Oelsner, Kathryn Tully; Guo, Yan; To, Sophie Bao-Chieu et al. (2017) Maternal BMI as a predictor of methylation of obesity-related genes in saliva samples from preschool-age Hispanic children at-risk for obesity. BMC Genomics 18:57
Berge, Jerica M; Truesdale, Kimberly P; Sherwood, Nancy E et al. (2017) Beyond the dinner table: who's having breakfast, lunch and dinner family meals and which meals are associated with better diet quality and BMI in pre-school children? Public Health Nutr 20:3275-3284
Heerman, William J; Taylor, Julie Lounds; Wallston, Kenneth A et al. (2017) Parenting Self-Efficacy, Parent Depression, and Healthy Childhood Behaviors in a Low-Income Minority Population: A Cross-Sectional Analysis. Matern Child Health J 21:1156-1165
French, Simone A; Sherwood, Nancy E; Mitchell, Nathan R et al. (2017) Park use is associated with less sedentary time among low-income parents and their preschool child: The NET-Works study. Prev Med Rep 5:7-12
Stevens, June; Pratt, Charlotte; Boyington, Josephine et al. (2017) Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations. Am J Prev Med 52:115-124

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