Reducing Television Viewing To Prevent Obesity in Hispanic Preschool Children

Obesity has been linked to the development of multiple cancers, and to poorer prognoses and
higher mortality rates for certain pediatric and adult cancers. Preventing obesity is
therefore a major strategy to prevent new cases of cancer and to decrease cancer related
morbidity and mortality. In the US, childhood obesity is on the rise. Since childhood
obesity strongly tracks into adulthood this epidemic among children greatly increases the
risk of obesity and presumably cancer in adulthood. As a result, preventing childhood
obesity has been selected as a major public health goal to reduce the risk and sequelae of
obesity and cancer in the US.

Moreover, television (TV) viewing has been identified as a major risk factor for childhood
obesity and US children spent more time watching TV than any other activity except sleep.
TV viewing contributes to excess weight gain by decreasing physical activity and increasing
caloric intake. The American Academy of Pediatrics (AAP) has issued national guidelines for
parents to limit their children's total entertainment media time to no more than 1 to 2
hours of quality programming per day for children greater than 2 years of age. Low-income
and minority children were at greater risk for exceeding this recommendation.

Few published interventions have been successful in decreasing TV viewing in children and
only one was successful among preschool children. This intervention, "Fit 5 Kids" (i.e. fit
by age 5 years), was a preschool curriculum designed to decrease TV viewing via
age-appropriate lessons taught to the children by research staff. The curriculum also
included a take-home component consisting of a newsletter with ideas for parent (for this
grant, defined as the adult most responsible for the child's care, usually the mother) and
child activities that complemented the school lesson plans. Although most behavioral
interventions for preschoolers target parents rather than children, this curriculum was one
of the few successful interventions targeted directly at children. However, Fit 5 Kids was
not designed for or evaluated among Hispanic preschool children, the subpopulation of
preschool children most severely affected by obesity. Moreover, no published intervention
has successfully reduced both TV viewing and excess weight gain in any preschool population.
In order to fill this gap, the investigators propose to evaluate a culturally adapted Fit 5
Kids TV reduction curriculum among Hispanic preschool children enrolled in the Head Start
Program.

Fit 5 Kids is the TV reduction component of the Brocodile the Crocodile health promotion
program. The overall goal of Fit 5 Kids is to teach the preschoolers to decrease their TV
watching and encourage alternative activities such as family meals and active playtime. The
primary goal of this research plan will be to conduct a pilot group randomized controlled
trial evaluating the effectiveness of the adapted curriculum to reduce TV viewing and excess
weight gain in low income, Hispanic preschool children

To achieve the project goals, the investigators Specific Aim includes:

1. To successfully recruit forty-eight 3-5 year old Hispanic children from 4 Head Start
centers each year for 3 years and conduct a group randomized controlled study of the adapted
Fit 5 Kids curriculum to evaluate its effectiveness in reducing TV viewing and excess weight
gain in Hispanic preschool children.

The Primary Hypothesis to be tested includes:

H1. The culturally adapted Fit 5 Kids curriculum will reduce TV viewing and excess weight
gain among Hispanic preschool children.