TY - JOUR
T1 - Keys to healthy family child care homes
T2 - Results from a cluster randomized trial
AU - Ward, Dianne S.
AU - Vaughn, Amber E.
AU - Burney, Regan V.
AU - Hales, Derek
AU - Benjamin-Neelon, Sara E.
AU - Tovar, Alison
AU - Østbye, Truls
N1 - Funding Information:
This work was supported by the National Heart, Lung, and Blood Institute ( HL108390 ), the Centers for Disease Control and Prevention ( U48-DP005017 ), and the National Institute of Diabetes and Digestive and Kidney Diseases ( DK056350 ). Content is solely the responsibility of the authors and does not represent the official views of any funders.
Funding Information:
Drs. Ward, Burney, Hales, Benjamin-Neelon, Tovar, Østbye, and Mrs. Vaughn have been funded by the National Heart, Lung, and Blood Institute (HL108390).
Funding Information:
We thank Tom Copeland, Red Leaf Press, for his assistance developing the Healthy Business content. We also thank the FCCH providers, parents, and children who participated. This work was supported by the National Heart, Lung, and Blood Institute (HL108390), the Centers for Disease Control and Prevention (U48-DP005017), and the National Institute of Diabetes and Digestive and Kidney Diseases (DK056350). Content is solely the responsibility of the authors and does not represent the official views of any funders. Deidentified data will be shared following publication provided the investigator seeking the data has approval from an Institutional Review Board, Independent Ethics Committee, or Research Ethics Board, and executes a data use/sharing agreement with UNC. Drs. Ward, Burney, Hales, Benjamin-Neelon, Tovar, ?stbye, and Mrs. Vaughn have been funded by the National Heart, Lung, and Blood Institute (HL108390).
Publisher Copyright:
© 2019
PY - 2020/3
Y1 - 2020/3
N2 - Early care and education settings, such as family child care homes (FCCHs), are important venues for children's health promotion. Keys to Healthy Family Child Care Homes evaluated a FCCH-based intervention's impact on children's diet and physical activity. This study enrolled 496 children aged 1.5–4 years and 166 FCCH providers into a cluster-randomized control trial (intervention = 242 children/83 FCCHs, control = 254 children/83 FCCHs) conducted during 2013–2016. The 9-month intervention addressed provider health, health of the FCCH environment, and business practices, and was delivered through three workshops, three home visits, and nine phone calls. The attention control arm received a business-focused intervention. Primary outcomes were children's diet quality (2 days of observed intakes summarized into Healthy Eating Index scores) and moderate to vigorous physical activity (3 days of accelerometry) at the FCCH. Secondary outcomes were child body mass index (BMI), FCCH provider health behaviors, and FCCH nutrition and physical activity environments and business practices. Repeated measures analysis, using an intent-to-treat approach, accounting for clustering of children within FCCHs and adjusting for child age, sex, and BMI, was used to evaluate change (completed in 2018). Compared to controls, intervention children significantly improved their diet quality (5.39, p = .0002, CI = 2.53, 8.26) but not MVPA (0.31, p = .195, CI = −0.16, 0.79). Intervention FCCH providers significantly improved their diet quality and several components of their FCCH environment (i.e., time provided for physical activity, use of supportive physical activity practices, and engagement in nutrition and physical activity education/professional development). FCCHs are malleable settings for health promotion, especially diet quality. Trial registration: This study is registered at www.clinicaltrials.gov NCT01814215.
AB - Early care and education settings, such as family child care homes (FCCHs), are important venues for children's health promotion. Keys to Healthy Family Child Care Homes evaluated a FCCH-based intervention's impact on children's diet and physical activity. This study enrolled 496 children aged 1.5–4 years and 166 FCCH providers into a cluster-randomized control trial (intervention = 242 children/83 FCCHs, control = 254 children/83 FCCHs) conducted during 2013–2016. The 9-month intervention addressed provider health, health of the FCCH environment, and business practices, and was delivered through three workshops, three home visits, and nine phone calls. The attention control arm received a business-focused intervention. Primary outcomes were children's diet quality (2 days of observed intakes summarized into Healthy Eating Index scores) and moderate to vigorous physical activity (3 days of accelerometry) at the FCCH. Secondary outcomes were child body mass index (BMI), FCCH provider health behaviors, and FCCH nutrition and physical activity environments and business practices. Repeated measures analysis, using an intent-to-treat approach, accounting for clustering of children within FCCHs and adjusting for child age, sex, and BMI, was used to evaluate change (completed in 2018). Compared to controls, intervention children significantly improved their diet quality (5.39, p = .0002, CI = 2.53, 8.26) but not MVPA (0.31, p = .195, CI = −0.16, 0.79). Intervention FCCH providers significantly improved their diet quality and several components of their FCCH environment (i.e., time provided for physical activity, use of supportive physical activity practices, and engagement in nutrition and physical activity education/professional development). FCCHs are malleable settings for health promotion, especially diet quality. Trial registration: This study is registered at www.clinicaltrials.gov NCT01814215.
KW - Child care
KW - Intervention
KW - Nutrition
KW - Obesity prevention
KW - Physical activity
UR - http://www.scopus.com/inward/record.url?scp=85077743567&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85077743567&partnerID=8YFLogxK
U2 - 10.1016/j.ypmed.2019.105974
DO - 10.1016/j.ypmed.2019.105974
M3 - Article
C2 - 31899253
AN - SCOPUS:85077743567
VL - 132
JO - Preventive Medicine
JF - Preventive Medicine
SN - 0091-7435
M1 - 105974
ER -