Healthy apple program to support child care centers to alter nutrition and physical activity practices and improve child weight: a cluster randomized trial
Autor: | Susan Arthur, Tito Arana, Jodi D. Stookey, Lisa Tao-Lew, Jane C. Evans, Curtis Chan |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
Pediatric Obesity medicine.medical_specialty Physical activity Nutritional Status Pilot Projects Disease cluster law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial stomatognathic system law medicine Cluster Analysis Humans Mass Screening 030212 general & internal medicine Cluster randomised controlled trial Exercise Child care center Child care 030505 public health business.industry Public health lcsh:Public aspects of medicine Weight change Public Health Environmental and Occupational Health Public health nursing lcsh:RA1-1270 Child Day Care Centers Child obesity Child Preschool Malus Public Health Nursing Female San Francisco Diet Healthy 0305 other medical science business Body mass index Research Article Program Evaluation Demography |
Zdroj: | BMC Public Health, Vol 17, Iss 1, Pp 1-16 (2017) BMC Public Health |
ISSN: | 1471-2458 |
Popis: | Background North Carolina Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) resources improve child body mass index (BMI) when the resources are introduced by nurses to child care providers, and offered with workshops and incentives. In San Francisco, public health and child care agencies partnered to adapt NAP SACC resources into an annual “Healthy Apple” quality improvement program (HAP). Methods This cluster randomized controlled trial pilot-tested integration of the HAP with bi-annual public health screenings by nurses. All child care centers that participated in Child Care Health Program (CCHP) screenings in San Francisco in 2011–2012 were offered routine services plus HAP in 2012–2013 (CCHP + HAP, n = 19) or routine services with delayed HAP in 2014–2015 (CCHP + HAP Delayed, n = 24). Intention-to-treat analyses (robust SE or mixed models) used 4 years of screening data from 12 to 17 CCHP + HAP and 17 to 20 CCHP + HAP Delayed centers, regarding 791 to 945 children ages 2 to 5y, annually. Year-specific, child level models tested if children in CCHP + HAP centers had greater relative odds of exposure to 3 index best practices and smaller Autumn-to-Spring changes in BMI percentile and z-score than children in CCHP + HAP Delayed centers, controlling for age, sex, and Autumn status. Multi-year, child care center level models tested if HAP support modified year-to-year changes (2013–2014 and 2014–2015 vs 2011–2012) in child care center annual mean Autumn-to-Spring BMI changes. Results In 2011–2012, the CCHP + HAP and CCHP + HAP Delayed centers had similar index practices ( |
Databáze: | OpenAIRE |
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