Document text
Principal Investigator: Kim M. Gans
Organization: BROWN UNIVERSITY
Fiscal Year: 2024
Award: $306,687
Funding agency: National Institute of Diabetes and Digestive and Kidney Diseases
The preschool years are a critical time for shaping food preferences and eating behaviors
which, in turn, affect dietary behaviors in adults and life-long risks for obesity, diabetes,
cardiovascular disease and other chronic conditions. Unfortunately, many US children,
especially low-income and ethnic minorities, have dietary patterns associated with obesity and
increased morbidity. Thus, to improve child diet quality, it is essential to develop effective
targeted interventions in settings where children (especially higher risk children) spend time.
There is a national call for dietary interventions that span multiple settings including the
childcare and home environments. In response to PAS-20-160, we build upon our efficacious
Healthy Start intervention with family childcare home (FCCH) providers (FCCP) to pilot a novel,
8-month multilevel tailored intervention to reach families through FCCH. This would be the first
study to incorporate family-based intervention components into FCCH. FCCH are a promising
intervention setting as parents trust FCCPs as extended family members and FCCP feel
comfortable talking to parents about children’s diet, but want more training to do so effectively.
The 8-month intervention will include an adapted version of the Healthy Start intervention for
English and Spanish-speaking FCCP as well as FCCP training to deliver nutrition messages to
parents using an existing childcare App, complemented with FCCH environmental cues and
tailored print and videos for parents. Specific Aims are to: SA.1. Conduct formative research
with FCCP and parents to inform refinement of the multi-level intervention. SA.2. Conduct a pilot
trial with 40 FCCP and 80 parents with 18-54-month-old children to evaluate feasibility and
acceptability of intervention and study protocols, and preliminary efficacy of the nutrition
intervention compared to an attention-matched control on: a). children’s dietary quality at FCCH
and home, b). social/physical FCCH and home food environments, c). children’s dermal
carotenoid levels and z-BMI scores. SA3. Conduct post qualitative interviews with parents,
FCCP, coaches, staff & partners to assess the intervention’s acceptability and suggestions for
improvement. In sum, feasible and effective interventions to improve young children’s diets are
urgently needed. The FCCH is a novel and untapped setting to intervene with both FCCP and
parents simultaneously to affect children’s diets in both the childcare and home settings, which
has the potential to more fully impact the child’s overall diet and weight status. This pilot
feasibility research of a novel, multi-level intervention will inform a future full-scale cluster RCT,
which will fill important research gaps and move the frontier of nutrition research forward.
Terms: <0-11 years old><1-5 years old><21+ years old><Active Follow-up><Address><Adult><Adult Human><Affect><Android App><Android Application><Attention><BMI><BMI percentile><BMI z-score><Behavior><Beverages><Body mass index><Cardiometabolic Disease><Cardiometabolic Disorder><Cardiovascular Diseases><Caring><Carotenes and Carotenoids><Carotenoids><Cell Phone Application><Cell phone App><Cellular Phone App><Cellular Phone Application><Cessation of life><Child><Child Behavior><Child Care><Child Youth><Children (0-21)><Chronic><Clinical Trials><Cluster randomization trial><Cluster randomized trial><Consumption><Cues><Data><Death><Dermal><Diabetes Mellitus><Diet><Dietary Fiber><Dietary Intervention><Dietary Practices><Dietary intake><Disease><Disorder><Eating><Eating Behavior><Enrollment><Environment><Espanol><Extended Family><Family><Family member><Food><Food Intake><Food Preferences><Foundations><Fruit><Future><Health><Heart><Home><Home Care><Home environment><Intervention><Intervention Strategies><Interview><Latine><Latinx><Licensing><Low income><Mission><Morbidity><Morbidity - disease rate><NIDDK><National Institute of Diabetes and Digestive and Kidney Diseases><Nursery Schools><Nutrition Interventions><Nutrition Research><Nutritional Interventions><Nutritional Study><Obesity><Outcome><Parents><Physical activity><Preschool Child><Preventative intervention><Prevention><Printing><Protocol><Protocols documentation><Provider><Puericulture><Quetelet index><Randomized, Controlled Trials><Research><Risk Factors><Sedentary behavior><Sedentary life-style><Shapes><Smart Phone App><Smart Phone Application><Smartphone App><Spanish><Spanish/English><Suggestion><Time><Training><Trust><Vegetables><Weight><acceptability and feasibility><active followup><adiposity><adolescent minority><adulthood><cardiovascular disorder><care providers><carotenoid biosynthesis><cell phone based app><compare intervention><comparison intervention><corpulence><cost><diabetes><diet intervention><dietary><dietary fruit><dietary pattern><dietary vegetable><diets><effective intervention><efficacy testing><empowerment><enroll><ethnic diversity><ethnic minority><ethnic minority group><ethnic minority individual><ethnic minority people><ethnic minority population><ethnically diverse><feasibility research><feasibility testing><flexibility><flexible><follow up><follow-up><followed up><followup><food environment><frontier><high risk><homes><iOS app><iOS application><iPhone App><iPhone Application><improved><innovate><innovation><innovative><intervention for prevention><intervention refinement><interventional strategy><kids><minority children><minority youth><mobile phone app><multi-component intervention><multi-faceted intervention><multi-modal intervention><multicomponent intervention><multifaceted intervention><multimodal intervention><novel><nutrition><obesity prevention><obesity risk><parent><patient home care><patient homecare><pediatric minority><pilot test><pilot trial><pre-k><pre-kindergarten><preschool><preschool child (1-5)><prevent obesity><prevention intervention><preventional intervention strategy><preventive intervention><primary outcome><public health relevance><randomized control trial><response><risk for obesity><risk of obesity><secondary outcome><sedentary lifestyle><smartphone application><smartphone based app><smartphone based application><social><trend><weights><whole grain><young minority><youngster>