Healthy caregivers-healthy children (HC2) phase 2: Integrating culturally sensitive childhood obesity prevention strategies into childcare center policies

Sarah Messiah, Cynthia Lebron, Rhoda Moises, M. Sunil Mathew, Krystal Sardinas, Catherina Chang, Joanne Palenzuela, Jennifer Walsh, Karla P. Shelnutt, Rachel Spector, Fiorella Altare, Ruby A Natale

Research output: Contribution to journalArticle

8 Scopus citations


Objective Despite the high prevalence of obesity among preschool-aged children, most states lack childcare center (CCC) nutrition and physical activity policies. The Healthy Caregivers, Healthy Children (HC) Phase 2 project is examining the relationship between the CCC nutrition and physical activity environment and child dietary intake/physical activity patterns and body mass index (BMI). Participants A total of 24 “Quality Counts” (Miami Dade County, Florida's Quality Rating Improvement System [QRIS)]) CCCs serving low resource families with ≥ 50 2-to-5 year olds attending have been randomized to either intervention (n = 12) or control (n = 12). Intervention The HC2 intervention arm CCCs receive implementation of a daily curricula for (1) teachers/parents; (2) children; (3) snack, beverage, physical activity, and screen time policies; and (4) technical assistance with menu modifications. Control arm schools receive an attention control safety curriculum. HC2 is delivered once a month in year 1, quarterly in year 2 and will be disseminated throughout the Quality Counts network in year 3. Main outcome measures Primary outcome measures include the Environment and Policy Assessment and Observation tool (EPAO), standardized dietary intake and physical activity patterns surveys, and child BMI. The ‘Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)’ framework will guide the interpretation of outcome measures. Conclusions CCCs are in need of evidence-based standardized nutrition and physical activity policies. The intersection of RE-AIM and early childhood obesity prevention in the childcare setting could generate robust and new information to the field about potential barriers, facilitators, adoption, and sustainability in this setting.

Original languageEnglish (US)
Pages (from-to)60-67
Number of pages8
JournalContemporary Clinical Trials
StatePublished - Feb 1 2017



  • Body mass index
  • Child care
  • Early childhood
  • Environment
  • Healthy
  • Policy
  • Prevention
  • Weight

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)

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