title: Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.
abstract: Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes.
  
  
  
  This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention.
  
  
  
  The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention.
authors.affiliation: University of Alabama at Birmingham, Division of Preventive Medicine, Birmingham, AL, USA.
authors.forename: S-J
authors.initials: SJ
authors.lastname: Salvy
authors.affiliation: University of Southern California, Department of Preventive Medicine, Los Angeles, CA, USA.
authors.forename: K
authors.initials: K
authors.lastname: de la Haye
authors.affiliation: University of Southern California, Center for Economic and Social Research, Los Angeles, CA, USA.
authors.forename: T
authors.initials: T
authors.lastname: Galama
authors.affiliation: University of Southern California, Department of Preventive Medicine, Los Angeles, CA, USA.
authors.forename: M I
authors.initials: MI
authors.lastname: Goran
mesh_terms: D002675:Child, Preschool; D015444:Exercise; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006792:House Calls; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D039382:Maternal Nutritional Physiological Phenomena; D050177:Overweight / Q000517:prevention & control; D063766:Pediatric Obesity / Q000453:epidemiology* / Q000517:prevention & control*; D011203:Poverty; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Early childhood; home visiting programs; infancy; obesity prevention