Family-centered Obesity Prevention: Communities for Healthy Living (CHL)

This evaluation will test the effectiveness of a family-focused intervention, Communities for
Healthy Living (CHL), implemented through Head Start. Over 20% of preschool-aged children in
the US experience overweight or obese. Because obesity prevention depends heavily on the
adoption of healthy lifestyle behaviors early in life, preventive efforts offer a higher
promise for success if they are family-centered. Effective family-centered interventions for
obesity prevention in preschool-aged children, however, remain elusive. While a number of
interventions have shown positive effects on child Body Mass Index (BMI), results are
inconsistent and short term effects are not maintained. What is more, because families at
greatest risk of childhood obesity - including low-income, single-parent, and ethnic minority
families - are the most difficult to recruit and retain, results are often limited in their
applicability to high risk populations.

In response, the researchers have partnered with Head Start to develop and test a new
approach to family-centered childhood obesity prevention that addresses family engagement
upfront. The CHL program will be refined and rigorously tested for efficacy in collaboration
with Head Start programs in the greater Boston area, which collectively serve over 2000
low-income children each year. Building on a previous pilot study, the investigators will
broaden the parent-centered Community Based Participatory Research approach and include Head
Start staff in the decision making and implementation process, refine intervention
components, and expand technical assistance protocols to support Head Start ownership of CHL
while ensuring implementation fidelity. In addition, consistent with the overarching
theoretical framework (Family Ecological Model), neighborhood-level socioeconomic, food and
physical activity environments around family homes and examine their impact on intervention
outcomes will be measured to inform future scale up efforts.

Primary Outcome Measures

Inclusion:

- Enrolled in Head Start

- Age 3 to 5 years

Exclusion:

- Those not meeting inclusion criteria

Secondary Outcome Measures

Inclusion:

- Parents/legal guardian/ primary caregiver

- Lives with the child at least 2 days a week

- Has child age 3 to 5 years enrolled at participating Head Start site

Exclusion:

- Those not meeting inclusion criteria