Childhood obesity is a major public health problem and an important predictor of obesity later in life. Although early childhood is a formative period for dietary and activity habits, little research targeting this young age group has been conducted. Child care facilities are a prime setting for interventions targeting young children, given the number of families using some form of out-of-home care. Family child care homes (FCCH) are a particular type of child care facility in which the provider cares for children out of his/her own residence. FCCHs are less regulated than child care centers, and there have been no published obesity prevention interventions in FCCHs to date. Interventions targeting FCCH providers could help promote healthy child weight by creating child care environments that provide and support active play opportunities and healthy food choices, while helping providers become role models for healthy lifestyles (physical activity and diet). However, the child care industry is facd with many challenges including limited profitability. By incorporating strategies for overcoming some of these economic challenges, interventions may be able to more easily address barriers to implementing and sustaining the changes needed to promote regular physical activity and healthy dietary intakes in children. This project will use a cluster-randomized controlled trial (RCT) to test the efficacy of the 9- month intervention H3: Healthy You, Healthy Home, Healthy Business, which targets FCCHs and is designed to promote (1) providers as healthy role models, (2) physical activity- and nutrition-supportive environments at the FCCH, and (3) healthy business practices. By combining these components, the ultimate objective is to create healthy and stable FCCHs that promote healthy physical activity and eating behaviors in children. This intervention will be delivered through group workshops, onsite visits, tailored coaching phone contacts, and educational toolkits. Increased child physical activity and improved quality of child diet while at the FCCH will be the primary outcomes used to assess the impact of this innovative, theory-driven intervention. Secondary outcomes and mediators include child body mass index, provider weight-related behaviors, provider motivation and self-efficacy, communication between providers and parents, and obesogenic environmental characteristics of the FCCH.

Public Health Relevance

Interventions targeting family child care home providers could help promote the development of healthy child weight by creating care environments that provide and support active play opportunities and healthy food choices by helping providers become role models of healthy lifestyles (physical activity and diet) and improve their home businesses.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL108390-04
Application #
8838232
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Boyington, Josephine
Project Start
2012-05-01
Project End
2017-04-30
Budget Start
2015-05-01
Budget End
2016-04-30
Support Year
4
Fiscal Year
2015
Total Cost
$733,780
Indirect Cost
$155,135
Name
University of North Carolina Chapel Hill
Department
Nutrition
Type
Schools of Public Health
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Neshteruk, C D; Mazzucca, S; Østbye, T et al. (2018) The physical environment in family childcare homes and children's physical activity. Child Care Health Dev 44:746-752
Benjamin-Neelon, Sara E; Vaughn, Amber E; Tovar, Alison et al. (2018) The family child care home environment and children's diet quality. Appetite 126:108-113
Tovar, Alison; Benjamin-Neelon, Sara E; Vaughn, Amber E et al. (2018) Nutritional Quality of Meals and Snacks Served and Consumed in Family Child Care. J Acad Nutr Diet 118:2280-2286
Vaughn, Amber E; Mazzucca, Stephanie; Burney, Regan et al. (2017) Assessment of nutrition and physical activity environments in family child care homes: modification and psychometric testing of the Environment and Policy Assessment and Observation. BMC Public Health 17:680
Tovar, Alison; Vaughn, Amber E; Grummon, Anna et al. (2017) Family child care home providers as role models for children: Cause for concern? Prev Med Rep 5:308-313
Benjamin Neelon, S E; Østbye, T; Hales, D et al. (2016) Preventing childhood obesity in early care and education settings: lessons from two intervention studies. Child Care Health Dev 42:351-8
Ward, Dianne S; Vaughn, Amber E; Burney, Regan V et al. (2016) Recruitment of Family Child Care Homes for an Obesity Prevention Intervention Study. Contemp Clin Trials Commun 3:131-138
Tovar, Alison; Vaughn, Amber E; Fallon, Megan et al. (2016) Providers' response to child eating behaviors: A direct observation study. Appetite 105:534-41
Mann, Courtney M; Ward, Dianne S; Vaughn, Amber et al. (2015) Application of the Intervention Mapping protocol to develop Keys, a family child care home intervention to prevent early childhood obesity. BMC Public Health 15:1227
Østbye, Truls; Mann, Courtney M; Vaughn, Amber E et al. (2015) The keys to healthy family child care homes intervention: study design and rationale. Contemp Clin Trials 40:81-9