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An educational intervention to prevent overweight in pre-school years: a cluster randomised trial with a focus on
Alison Hodgkinson1, Janice Abbott2, Margaret A Hurley3
1School of Psychology, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK.
Insights
Early prevention programs in preschool settings can reduce childhood obesity. The Healthy Heroes intervention successfully deterred excess weight gain in young children from disadvantaged backgrounds.
Area of Science:
- Pediatric Obesity Prevention
- Public Health Interventions
- Early Childhood Education
Background:
- Childhood obesity is a growing public health concern.
- Early Years settings offer a prime opportunity for obesity prevention interventions.
- This study evaluated an educational intervention to prevent overweight and obesity in preschool children.
Purpose of the Study:
- To evaluate the effectiveness of the "Healthy Heroes" educational intervention in preventing overweight and obesity in preschool children.
- To assess the impact of the intervention on children's BMI z-scores and parent-reported outcomes.
- To determine the feasibility of implementing the intervention through Early Years' staff.
Main Methods:
- A pragmatic, cluster randomized trial with a matched-pair design.
- Intervention involved staff training using "Be Active, Eat Healthy" and delivery of the "Healthy Heroes Activity Pack" to families.
- Child and parent anthropometrics were measured over two years; primary outcome was change in child BMI z-score from ages 2 to 4.
Main Results:
- The intervention group showed a significant reduction in mean BMI z-score between ages 2 and 4 years (p=0.002).
- The control group exhibited an increasing BMI z-score over the same period.
- No significant differences were observed in parent-reported outcomes or parent BMI between groups.
Conclusions:
- The "Healthy Heroes" educational resource effectively deterred excess weight gain in preschool children from socioeconomically disadvantaged areas.
- Early Years' staff can be trained to successfully implement the "Healthy Heroes" program.
- Early intervention in preschool settings is a viable strategy for childhood obesity prevention.
Background:
Early prevention is a promising strategy for reducing obesity in childhood, and Early Years settings are ideal venues for interventions. This work evaluated an educational intervention with the primary aim of preventing overweight and obesity in pre-school children.
Methods:
A pragmatic, cluster randomised trial with a parallel, matched-pair design was undertaken. Interventions were targeted at both the cluster (Early Years' Centres, matched by geographical area) and individual participant level (families: mother and 2-year old child). At the cluster level, a staff training intervention used the educational resource Be Active, Eat Healthy. Policies and provision for healthy eating and physical activity were evaluated at baseline and 12-months. The intervention at participant level was the Healthy Heroes Activity Pack: delivered over 6 months by Centre staff to promote healthy eating and physical activity in a fun, interactive way. Child and parent height and weight were measured at four time-points over 2 years. The trial primary outcome was the change in BMI z-score of the child between ages 2 and 4 years. Secondary outcomes consisted of parent-reported measures administered at baseline and two-year follow-up.
Results:
Five pairs of Early Years' Centres were recruited. Four pairs were analysed as one Centre withdrew (47 intervention families; 34 control families). At the cluster level, improvement in Centre policies and practices was similar for both groups (p = 0.830). At the participant level, the intervention group reduced their mean BMI z-score between age 2 and 4 years (p = 0.002; change difference 0.49; 95% CI 0.17 to 0.80) whereas the control group showed increasing BMI z-score throughout. Changes in parent-reported outcomes and parent BMI (p = 0.582) were similar in both groups.
Conclusions:
The Healthy Heroes educational resource deterred excess weight gain in pre-school children from poor socioeconomic areas. With training, Early Years' staff can implement the Healthy Heroes programme.
Trial Registration:
ISRCTN22620137 Registered 21st December 2016.
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