Obesity Prevention Program in Childcare Centers: Two-Year Follow-Up

Ruby A. Natale, Sarah E. Messiah, Lila S. Asfour, Susan B. Uhlhorn, Nicole E. Englebert, Kristopher L. Arheart

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Purpose: To assess the impact of an early childhood obesity prevention intervention "Healthy Caregivers-Healthy Children" (HC2) on dietary patterns and body mass index percentile (PBMI) over 2 school years. Design: Randomized controlled trial. Setting: Childcare centers. Participants: Low-income families. Intervention: Intervention centers (N = 12) received HC2 which consisted of (1) menu modifications, (2) a healthy eating and physical activity curriculum for children, and (3) a parent curriculum for healthy meal preparation, reinforced through a role-modeling curriculum. Control centers (N = 16) received an injury prevention/safety intervention. Measures: Child PBMI and parent report of child's consumption of fruits/vegetables and unhealthy food. Analysis: Confirmatory factor analysis verified the psychometric properties of factor scores for children's consumption of fruits/vegetables and unhealthy food. Growth curve analysis assessed the impact of HC2 on change in consumption of fruits/vegetables and unhealthy food and PBMI over 2 school years. Results: Children in the intervention group (n = 754) had a negative slope (β = -'1.95, standard error [SE] = 0.97, P =.04), indicating less increase in PBMI versus control children (n = 457). Stratified analyses showed that obese children in the intervention arm had a significantly higher increase in fruit/vegetable consumption versus control group obese children (β = 0.24, SE = 0.08, P =.003). Conclusion: The HC2 intervention resulted in the maintenance of healthy PBMI over 2 preschool years among low-income multiethnic children. These findings support efforts to implement healthy weight programs in the childcare setting.

Original languageEnglish (US)
Pages (from-to)502-510
Number of pages9
JournalAmerican Journal of Health Promotion
Issue number6
StatePublished - Nov 1 2017


  • Body mass index
  • Nutrition
  • Obesity
  • Overweight
  • Prevention
  • Young children

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


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