title: Hip-Hop to Health Jr. Randomized Effectiveness Trial: 1-Year Follow-up Results.
abstract: BACKGROUND
  The preschool years provide a unique window of opportunity to intervene on obesity-related lifestyle risk factors during the formative years of a child's life. The purpose of this study was to assess the impact of a preschool-based obesity prevention effectiveness trial at 1-year follow-up.
  
  
  METHODS
  RCT.
  
  
  METHODS
  Primarily African American children (aged 3-5 years, N=618) attending Head Start preschool programs administered by Chicago Public Schools.
  
  
  METHODS
  Eighteen preschools were randomly assigned in 2007-2008 to receive either (1) a 14-week teacher-delivered intervention focused on healthy lifestyle behaviors or (2) a 14-week teacher-delivered general health curriculum (control group).
  
  
  METHODS
  The primary outcome, BMI, was measured at baseline, postintervention, and 1-year follow-up. Diet and screen time behaviors were also assessed at these time points. Multilevel mixed effects models were used to test for between-group differences. Data were analyzed in 2014.
  
  
  RESULTS
  Significant between-group differences were observed in diet, but not in BMI z-score or screen time at 1-year follow-up. Diet differences favored the intervention arm over controls in overall diet quality (p=0.02) and in subcomponents of diet quality, as measured by the Healthy Eating Index-2005, and in fruit intake (servings/day, excludes juice) (p=0.02). Diet quality worsened more among controls than the intervention group at 1-year follow-up.
  
  
  CONCLUSIONS
  The adaptation of Hip-Hop to Health Jr. produced modest benefits in diet quality but did not significantly impact weight gain trajectory. Not unlike other effectiveness trials, this real-world version delivered by Head Start teachers produced fewer benefits than the more rigorous efficacy trial. It is important to understand and build upon the lessons learned from these types of trials so that we can design, implement, and disseminate successful evidence-based programs more widely and effectively.
  
  
  BACKGROUND
  This study is registered at www.clinicaltrials.gov NCT00241878.
authors.affiliation: Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; University of Illinois Cancer Center, Chicago, Illinois; Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois. Electronic address: akong@uic.edu.
authors.forename: Angela
authors.initials: A
authors.lastname: Kong
authors.affiliation: Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; Cancer Education and Career Development Program, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Joanna
authors.initials: J
authors.lastname: Buscemi
authors.affiliation: Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; University of Illinois Cancer Center, Chicago, Illinois; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Melinda R
authors.initials: MR
authors.lastname: Stolley
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Linda A
authors.initials: LA
authors.lastname: Schiffer
authors.affiliation: Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Yoonsang
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Braunschweig
authors.affiliation: Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois; Cancer Education and Career Development Program, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Gomez-Perez
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Lara B
authors.initials: LB
authors.lastname: Blumstein
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Linda
authors.initials: L
authors.lastname: Van Horn
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Alan R
authors.initials: AR
authors.lastname: Dyer
authors.affiliation: Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; University of Illinois Cancer Center, Chicago, Illinois; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; School of Public Health, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Marian L
authors.initials: ML
authors.lastname: Fitzgibbon
mesh_terms: D001741:Black or African American; D015992:Body Mass Index; D002641:Chicago; D002675:Child, Preschool; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D012572:School Health Services / Q000458:organization & administration*; D057185:Sedentary Behavior