[R01] Efficacy of Center-based Childcare to Mitigate Unhealthy Weight Gain in Preschoolers from Low-income Households During the Summer
Ente: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Scadenza: 2030-06-30
Importo max: 627.740 EUR
Paese: US
Descrizione
Studies show that preschool-age children are especially vulnerable to accelerated weight gain during the
summer, with those from low-income households (≤185% poverty level or Medicaid eligible - the target population
for this study) exhibiting the greatest risk of unhealthy weight gain. Despite numerous interventions designed to
prevent OWOB, none target preschoolers during summer. For families from low-income households, attending
center-based childcare is associated with a lower risk of developing OWOB by 1st grade compared to attending
home-based care. We believe center-based childcare lowers the risk of OWOB through daily rules/routines that
promote healthy behaviors. For families from low-income households, publicly funded center-based childcares
(e.g., needs-based pre-K, Head Start) typically operate on an academic/school 9-month calendar (Aug-May).
During summer, fewer than 30% of preschoolers attend center-based childcare. For many preschoolers from
lower-income households, summer may serve as an extended period away from formal center-based childcare,
because the out-of-pocket expense may prohibit attendance. This may promote unhealthy behaviors and
excessive weight gain. In the majority of US states, publicly funded center-based childcare during the
academic/school year for families from underserved populations is free; however, center-based childcare during
the summer is an out-of-pocket expense for many of these families. Despite parents’ desire for childcare during
the summer, a major reason children from low-income households do not attend center-based care during
summer is cost. This creates unequal access to resources and likely exacerbates health disparities for families
from low-income households. Using a structural intervention approach, our study will test the impact of providing
free center-based childcare in the summer. For this R01, we will rigorously test the impact of providing free
center-based childcare during the summer on weight status (i.e., BMI z-score/BIA - primary outcome) and health
behaviors (physical activity, diet, sleep and screentime - secondary outcomes) of preschoolers from low-income
households (≤185% of poverty level or Medicaid eligible). We will also evaluate the impact of the intervention on
parental well-being and employment. Using a pragmatic randomized design, we will randomize 300 preschoolers
from low-income households to either free center-based childcare during the summer or a comparison/control
group. The Specific Aims are: Evaluate changes in A) preschoolers’ weight status (primary), B) preschoolers’
health behaviors (secondary) and C) parental well-being and paid employment (tertiary) between intervention
and control groups; Examine changes in A) preschoolers’ health behaviors and B) parental well-being as
potential mediators of changes in preschoolers’ weight status between the intervention and control groups; and
Evaluate the incremental cost effectiveness of the intervention in terms of a
Istituzione: UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
PI: MICHAEL W BEETS
Progetto: 5R01HD116435-02
Settori: Eunice Kennedy Shriver National Institute of Child Health and Human Development
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