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Journal ArticleDOI

Barriers To Obesity Prevention In Head Start

01 Mar 2010-Health Affairs (Health Affairs)-Vol. 29, Iss: 3, pp 454-462
TL;DR: Head Start program directors face difficulty in implementing policies and practices to address obesity-and in a national survey, they identified the key barriers as lack of time, money, and knowledge.
Abstract: Head Start provides early childhood education to nearly one million low-income children, through federal grants to more than 2,000 local programs. About one-third of children who enter Head Start are overweight or obese. But program directors face difficulty in implementing policies and practices to address obesity—and in our national survey, they identified the key barriers as lack of time, money, and knowledge. Also, parents and staff sometimes shared cultural beliefs that were inconsistent with preventing obesity, such as the belief that heavier children are healthier. Minimizing those barriers will require federal resources to increase staff training and technical assistance, develop staff wellness programs, and provide healthy meals and snacks.
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Journal ArticleDOI
TL;DR: An updated summary of recently published data regarding pediatric obesity epidemiology is provided to provide insight into infants and toddler obesity and explore the impact of ethnicity, socioeconomic status, school setting and geographic variations.
Abstract: Purpose of reviewTo provide updated summary of recently published data regarding pediatric obesity epidemiology.Recent findingsThere is a burgeoning literature of pediatric obesity epidemiology, with type 2 diabetes trends serving as the harbinger for obesity related diseases in children. The Nation

98 citations

Journal ArticleDOI
TL;DR: This review concludes that early childhood is a formative period for many weight-related behaviors (diet and activity), but little obesity prevention research targeting this age group has been conducted.
Abstract: Background: Early childhood is a formative period for many weight-related behaviors (diet and activity), but little obesity prevention research targeting this age group has been conducted. Early care and education settings are a useful avenue for interventions targeting young children, but the limited research provides insufficient evidence upon which to base policy decisions, practice guidelines, or mobilized efforts to improve healthy eating and physical activity, and ultimately healthy weight development in these settings. Methods: In September of 2011, prominent researchers, young investigators, and leaders in early care and education came together to examine past research and to explore challenges and priorities for future research on healthy weight development in children aged 2–5 years. During this meeting, experts presented and attendees discussed key issues around measurement of diet and physical activity, policy and environment measurement, intervention approaches, policy research, and ...

94 citations

Journal ArticleDOI
TL;DR: Although no substantial associations were observed between caregiver behaviors and center policies, effect size estimates suggest differences that may be of clinical significance.

60 citations

Journal ArticleDOI
TL;DR: This intervention showed promising initial results, with potential effectiveness as an intervention to promote healthier behaviors among adults and children in Head Start settings.
Abstract: Purpose. Examine the effectiveness of the “Eat Healthy, Stay Active!” pilot program, a multisite, 6-month educational intervention to promote healthy nutrition and physical activity among Head Start staff, parents, and children. Design. Comparison of within-group preintervention and postintervention knowledge and behavior, along with anthropomorphic measurements. Setting. The study was conducted in a convenience sample of six large Head Start agencies in five states. Subjects. Participants included 496 staff, 438 parents, and 112 preschool children. Intervention. The 6-month intervention consisted of core trainings and reinforcing activities for staff and parents that aligned with children's curricula. Measures. Pre-post questionnaires and anthropometric measurements examined changes in body mass index (BMI), knowledge, and behaviors related to nutrition and physical activity. Analysis. Paired t-tests to compare preintervention and postintervention weights and BMI; multiple regression analyses to...

56 citations


Cites background from "Barriers To Obesity Prevention In H..."

  • ...Also, parents and staff sometimes shared cultural beliefs that were inconsistent with preventing obesity, such as the belief that heavier children are healthier.(22,23) Minimizing those barriers will require federal resources to increase staff training and technical assistance, develop staff wellness programs, and provide healthy meals and snacks....

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Journal ArticleDOI
TL;DR: There was clear evidence of a co-occurrence of obesogenic risk factors among adolescents, especially among those from lower socioeconomic backgrounds, indicating this group would benefit from targeted prevention strategies.

49 citations

References
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Journal ArticleDOI
TL;DR: Head Start, a federal preschool program serving some 900,000 low-income infants and children up to age five, is cited as a model for other child care programs as it has federal performance standards for nutrition.
Abstract: Summary Mary Story, Karen Kaphingst, and Simone French argue that researchers and policymakers focused on childhood obesity have paid insufficient attention to child care. Although child care settings can be a major force in shaping children’s dietary intake, physical activity, and energy balance—and thus in combating the childhood obesity epidemic—researchers know relatively little about either the nutrition or the physical activity environment in the nation’s child care facilities. What research exists suggests that the nutritional quality of meals and snacks may be poor and activity levels may be inadequate. Few uniform standards apply to nutrition or physical activity offerings in the nation’s child care centers. With the exception of the federal Head Start program, child care facilities are regulated by states, and state rules vary widely. The authors argue that weak state standards governing physical activity and nutrition represent a missed opportunity to combat obesity. A relatively simple measure, such as specifying how much time children in day care should spend being physically active, could help promote healthful habits among young children. The authors note that several federal programs provide for the needs of low-income children in child care. The Child and Adult Care Food Program, administered by the Department of Agriculture, provides funds for meals and snacks for almost 3 million children in child care each day. Providers who receive funds must serve meals and snacks that meet certain minimal standards, but the authors argue for toughening those regulations so that meals and snacks meet specific nutrient-based standards. The authors cite Head Start, a federal preschool program serving some 900,000 low-income infants and children up to age five, as a model for other child care programs as it has federal performance standards for nutrition.

397 citations

Journal ArticleDOI
TL;DR: Children's intakes of fruit, juice, and vegetables (FJV) do not meet the recommended minimum of five daily servings, placing them at increased risk for development of cancer and other diseases.
Abstract: Children's intakes of fruit, juice, and vegetables (FJV) do not meet the recommended minimum of five daily servings, placing them at increased risk for development of cancer and other diseases. Because children's food preferences and practices are initiated early in life (e.g., 2–5 years of age), early dietary intervention programs may have immediate nutritional benefit, as well as reduce chronic disease risk when learned healthful habits and preferences are carried into adulthood. Families and child-care settings are important social environments within which food-related behaviors among young children are developed. FJV preferences, the primary predictor of FJV consumption in children, are influenced by availability, variety and repeated exposure. Caregivers (parents and child-care providers) can influence children's eating practices by controlling a vailability and accessibility of foods, meal structure, food modeling, food socialization practices, and food-related parenting style. Much remains to be learned about how these influences and practices affect the development of FJV preferences and consumption early in life.

391 citations

Journal ArticleDOI
TL;DR: Identifying aspects of the childcare environment that relate to the physical activity behavior of children should be considered when identifying determinants of physical activity and designing interventions is extended.

389 citations

Journal ArticleDOI
TL;DR: US preschool-aged children exposed to the 3 household routines of regularly eating the evening meal as a family, obtaining adequate nighttime sleep, and having limited screen-viewing time had an ∼40% lower prevalence of obesity than those exposed to none of these routines.
Abstract: To determine the association between the prevalence of obesity in preschool-aged children and exposure to 3 household rou- tines: regularly eating the evening meal as a family, obtaining adequate sleep, and limiting screen-viewing time. METHODS: We conducted a cross-sectional analysis of a nationally rep- resentative sample of 8550 four-year-old US children who were as- sessed in 2005 in the Early Childhood Longitudinal Study, Birth Cohort. Height and weight were measured. We assessed the association of childhood obesity (BMI 95th percentile) with 3 household routines: regularly eating the evening meal as a family (5 nights per week); obtaining adequate nighttime sleep on weekdays (10.5 hours per night); and having limited screen-viewing (television, video, digital video disk) time on weekdays (2 hours/day). Analyses were adjusted for the child's race/ethnicity, maternal obesity, maternal education, household income, and living in a single-parent household. RESULTS: Eighteen percent of children were obese, 14.5% were ex- posed to all 3 routines, and 12.4% were exposed to none of the routines. The prevalence of obesity was 14.3% (95% confidence interval (CI): 11.3%-17.2%) among children exposed to all 3 routines and 24.5% (95% CI: 20.1%-28.9%) among those exposed to none of the routines. After adjusting for covariates, the odds of obesity associated with ex- posure to all 3, any 2, or only 1 routine (compared with none) were 0.63 (95% CI: 0.46 - 0.87), 0.64 (95% CI: 0.47- 0.85), and 0.84 (95% CI: 0.63- 1.12), respectively. CONCLUSIONS: US preschool-aged children exposed to the 3 house- hold routines of regularly eating the evening meal as a family, obtain- ing adequate nighttime sleep, and having limited screen-viewing time had an 40% lower prevalence of obesity than those exposed to none of these routines. These household routines may be promising targets for obesity-prevention efforts in early childhood. Pediatrics 2010;125: 420-428

373 citations

Journal ArticleDOI
TL;DR: Racial/ethnic disparities in obesity are apparent in 4-year-old US children, with the highest prevalence in American Indian/Native Alaskan children, in whom obesity is twice as common as in non-Hispanic white or Asian children.
Abstract: Objective To estimate the prevalence of obesity in 5 major racial/ethnic groups in 4-year-old US children. Design Cross-sectional secondary data analysis. Setting Nationally representative sample of US children born in 2001. Participants Height and weight were measured in 2005 in approximately 8550 children who participated in the Early Childhood Longitudinal Study, Birth Cohort. Main Exposure Racial/ethnic group. Outcome Measure Prevalence of obesity, defined as body mass index at or above the 95th percentile for age of the sex-specific Centers for Disease Control and Prevention growth charts. Results Obesity prevalence among 4-year-old US children (mean age, 52.3 months) was 18.4% (95% confidence interval [CI], 17.1%-19.8%). Obesity prevalence differed by racial/ethnic group (P < .001): American Indian/Native Alaskan, 31.2% (95% CI, 24.6%-37.8%); Hispanic, 22.0% (95% CI, 19.5%-24.5%); non-Hispanic black, 20.8% (95% CI, 17.8%-23.7%); non-Hispanic white, 15.9% (95% CI, 14.3%-17.5%); and Asian, 12.8% (95% CI, 10.0%-15.6%). All pairwise differences in obesity prevalence between racial/ethnic groups were statistically significant after a Bonferroni adjustment (P < .005) except for those between Hispanic and non-Hispanic black children and between non-Hispanic white and Asian children. Conclusions Racial/ethnic disparities in obesity are apparent in 4-year-old US children. The highest prevalence is in American Indian/Native Alaskan children, in whom obesity is twice as common as in non-Hispanic white or Asian children.

336 citations