title: Obesity Prevention Program in Childcare Centers: Two-Year Follow-Up.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Childcare centers.
  
  
  METHODS
  Low-income families.
  
  
  METHODS
  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.
  
  
  METHODS
  Child PBMI and parent report of child's consumption of fruits/vegetables and unhealthy food.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Division of Clinical Psychology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Ruby A
authors.initials: RA
authors.lastname: Natale
authors.affiliation: 2 Department of Pediatrics, Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, FL, USA.|3 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Messiah
authors.affiliation: 3 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Lila S
authors.initials: LS
authors.lastname: Asfour
authors.affiliation: 1 Division of Clinical Psychology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Uhlhorn
authors.affiliation: 1 Division of Clinical Psychology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Nicole E
authors.initials: NE
authors.lastname: Englebert
authors.affiliation: 2 Department of Pediatrics, Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, FL, USA.|3 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Kristopher L
authors.initials: KL
authors.lastname: Arheart
mesh_terms: D015992:Body Mass Index; D002656:Child Day Care Centers; D002675:Child, Preschool; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000517:prevention & control*
keywords: body mass index; nutrition; obesity; overweight; prevention; young children