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Preventing childhood obesity in early care and education settings: lessons from two intervention studies
S E Benjamin Neelon1, T Østbye2, D Hales3
1Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Insights
Obesity prevention interventions in child care settings are crucial for young children. Lessons learned emphasize behavior change theory, provider input, and flexible implementation for effective, evidence-based obesity prevention programs.
Area of Science:
- Public Health
- Pediatrics
- Behavioral Science
Background:
- Childhood obesity is a significant public health concern in the USA, affecting nearly 10% of children under five.
- Most young children attend out-of-home child care, presenting a key setting for interventions.
- Few interventions have specifically targeted the youngest children or less formal settings like family child care homes.
Purpose of the Study:
- To share practical lessons from two intervention studies on obesity prevention in early care and education settings.
- To guide researchers and public health professionals in implementing and evaluating similar interventions.
- To inform the development of effective obesity prevention strategies for diverse child care environments.
Main Methods:
- Examined two distinct intervention studies: one in child care centers (children 4-24 months) and another in family child care homes (children 18 months-4 years).
- Incorporated lessons learned from pilot studies and ongoing larger trials.
- Focused on practical aspects of intervention design and delivery in real-world settings.
Main Results:
- Interventions should be grounded in behavior change theory and involve an advisory group for material evaluation and delivery planning.
- Realistic recruitment strategies must account for the economic challenges faced by child care businesses.
- Flexible data collection and sample size calculations are necessary due to high child turnover rates.
- Simpler interventions are more likely to be adopted by a wider range of early care and education providers.
Conclusions:
- Early care and education settings offer a significant opportunity for large-scale obesity prevention in children.
- Understanding the unique aspects of both child care centers and family child care homes is vital for intervention success.
- Leveraging lessons learned from current studies is essential for developing effective, evidence-based obesity prevention interventions.
Background:
Obesity prevention in young children is a public health priority. In the USA, nearly 10% of children less than 5 years of age are obese, and most attend some form of out-of-home child care. While a number of interventions have been conducted in early care and education settings, few have targeted the youngest children in care or the less formal types of child care like family child care homes. Additionally, only two previous studies provided recommendations to help inform future interventions.
Methods:
This paper presents lessons learned from two distinct intervention studies in early care and education settings to help guide researchers and public health professionals interested in implementing and evaluating similar interventions. We highlight two studies: one targeting children ages 4 to 24 months in child care centres and the other intervening in children 18 months to 4 years in family child care homes. We include lessons from our pilot studies and the ongoing larger trials.
Results:
To date, our experiences suggest that an intervention should have a firm basis in behaviour change theory; an advisory group should help evaluate intervention materials and plan for delivery; and realistic recruitment goals should recognize economic challenges of the business of child care. A flexible data collection approach and realistic sample size calculations are needed because of high rates of child (and sometimes facility) turnover. An intervention that is relatively easy to implement is more likely to appeal to a wide variety of early care and education providers.
Conclusions:
Interventions to prevent obesity in early care and education have the potential to reach large numbers of children. It is important to consider the unique features and similarities of centres and family child care homes and take advantage of lessons learned from current studies in order to develop effective, evidence-based interventions.
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