Healthy Caregivers-Healthy Children: A Train-the-Trainer (TTT) Implemented Childcare Center-Based Obesity Prevention Program

Abstract

The purpose of this project is to evaluate the effectiveness of the train-the-trainer (TTT)-implemented “Healthy Caregivers-Healthy Children” (HC2) obesity prevention toolkit on parent and teacher adoption of healthy lifestyle role modeling behaviors, and policy integration in childcare centers. A total of 24 Quality Rating and Improvement System (QRIS) childcare centers were randomized to HC2 or an attention control arm. Treatment centers (n=12) are currently receiving the HC2 program via a TTT model that includes menu modifications, a child-centered curriculum for healthy eating and physical activity, and a parent-and teacher-centered curriculum for healthy meal preparation, reinforced through an adult role-modeling curriculum. Control centers (N=12) are receiving an injury prevention (safety) intervention. Over a quarter of the sample (27%) is overweight/obese. Mean BMI percentile is 60.1% and z score is 0.33. Analysis of the Health Environment Rating Scale showed that at baseline only 59% have water available to drink throughout the day, 13% served vegetables 1xday (20% never), 40% always serve whole grain snacks, 38% spend at least 1.5 hours doing vigorous activity. Lower child BMI was significantly correlated with more daily vegetable servings (R=-.55, p=0.04). Health Environment Rating Scale baseline center-level analysis showed that most centers are not meeting HC2 policy standards (water as beverage choice, fruits/vegetables served daily, at least 120 minutes of physical activity/day, and < ½ hour of screen time per week). center level nutrition behavior, and serving more vegetables in particular, has a positive impact on child healthy weight. implementing standardized nutrition and physical activity policies in childcare centers can have a significant impact on child healthy growth and development.