Míranos! Look at us, we are healthy! An environmental approach to early childhood obesity prevention.
BACKGROUND
Obesity prevention research is sparse in young children at risk for obesity. This study tested the effectiveness of a culturally tailored, multicomponent prevention intervention to promote healthy weight gain and gross motor development in low-income preschool age children.


METHODS
Study participants were predominantly Mexican-American children (n = 423; mean age = 4.1; 62% in normal weight range) enrolled in Head Start. The study was conducted using a quasi-experimental pretest/posttest design with two treatment groups and a comparison group. A center-based intervention included an age-appropriate gross motor program with structured outdoor play, supplemental classroom activities, and staff development. A combined center- and home-based intervention added peer-led parent education to create a broad supportive environment in the center and at home. Primary outcomes were weight-based z-scores and raw scores of gross motor skills of the Learning Achievement Profile Version 3.


RESULTS
Favorable changes occurred in z-scores for weight (one-tailed p < 0.04) for age and gender among children in the combined center- and home-based intervention compared to comparison children at posttest. Higher gains of gross motor skills were found in children in the combined center- and home-based (p < 0.001) and the center-based intervention (p < 0.01). Children in both intervention groups showed increases in outdoor physical activity and consumption of healthy food. Process evaluation data showed high levels of protocol implementation fidelity and program participation of children, Head Start staff, and parents.


CONCLUSIONS
The study demonstrated great promise in creating a health-conducive environment that positively impacts weight and gross motor skill development in children at risk for obesity. Program efficacy should be tested in a randomized trial.
Department of Health and Kinesiology, The University of Texas at San Antonio, USA. zenong.yin@utsa.edu
Zenong
Z
Yin
Deborah
D
Parra-Medina
Alberto
A
Cordova
Meizi
M
He
Virginia
V
Trummer
Erica
E
Sosa
Kipling J
KJ
Gallion
Amanda
A
Sintes-Yallen
Yaling
Y
Huang
Xuelian
X
Wu
Desiree
D
Acosta
Debra
D
Kibbe
Amelie
A
Ramirez
D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D054521:Cultural Competency; D005178:Faculty; D005247:Feeding Behavior; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000208:ethnology; D009043:Motor Activity / Q000502:physiology*; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D010290:Parents / Q000193:education; D011203:Poverty / Q000208:ethnology; D015397:Program Evaluation; D013781:Texas / Q000208:ethnology; D015431:Weight Loss