Improving Self-Regulation for Obesity Prevention in Head Start: A Randomized Controlled Trial

Area of Science:

• Childhood obesity prevention
• Behavioral science
• Public health interventions

Background:

• Preschoolers are at a critical developmental stage for establishing lifelong health habits.
• Obesity prevention programs often target diet and physical activity, but behavioral factors like self-regulation are also crucial.
• Improving emotional and behavioral self-regulation may positively influence obesity-related behaviors.

Purpose of the Study:

• To evaluate the impact of a combined intervention (obesity prevention + self-regulation) on obesity prevalence and related behaviors in preschoolers.
• To assess the effect of the Incredible Years Series (IYS) and Preschool Obesity Prevention Series (POPS) on child self-regulation and obesity indicators.
• To determine if enhancing Head Start (HS) with POPS and IYS reduces obesity and improves related behaviors.

Main Methods:

• A cluster-randomized trial involving 697 preschoolers in Head Start classrooms over 4 academic years (2011-2015).
• Three intervention arms: HS + POPS + IYS, HS + POPS, and HS (control).
• Primary outcomes included obesity prevalence, BMI z-score, and teacher-reported self-regulation; secondary outcomes covered diet, physical activity, and parent factors.

Main Results:

• The HS + POPS + IYS intervention significantly improved teacher-reported emotional and behavioral self-regulation compared to control groups.
• No significant effect was observed on the prevalence of obesity, overweight/obesity, or BMI z-score across all intervention arms.
• A significant reduction in sugar-sweetened beverage intake was noted in the HS + POPS + IYS group compared to the HS-only group.

Conclusions:

• Integrating a self-regulation program with an obesity prevention curriculum in Head Start did not decrease obesity prevalence in preschoolers.
• While the combined intervention enhanced children's self-regulation, it did not significantly impact most obesity-related behaviors or overall obesity rates.
• Future research may explore tailored approaches to address the complex interplay between self-regulation and childhood obesity.