Objective: Describe Happy Healthy Homes, an interdisciplinary, community-based study in Oklahoma, to improve FCCH environments and children's health through the development and testing of two interventions: a nutrition intervention to increase quality of foods served and promote compliance with Child and Adult Care Food Program (CACFP) best-practices and a healthy environment intervention to reduce children's exposure to toxins.
Description: Early childhood is a critical developmental period that largely determines health throughout the life course. Over 60% of U.S. children spend time in weekly early care and education (ECE) environments away from home. The physical and social environments of ECEs influence children's health in multiple ways and, as such, ECEs are important settings for health promotion interventions. Family Child Care Homes (FCCH), ECE that provide care for children in the provider's own home, serve over one million children in the U.S. Matched attention intervention trials offer an opportunity to test nutrition interventions in FCCHs along with other intervention to promote children's health.
Evaluation: Cluster randomized controlled trial with matched attention design. Fifty-two FCCH providers in and around Oklahoma City were randomly assigned into either of the two interventions, where each serves as an attention control for the other. Interventions were based on existing evidence base for health promotion interventions in ECE, Public Health Ecological Model, Social Cognitive Theory, Social Support, Self-Determination Theory, and Adult Learning Practices. Both interventions were completed over three months and consists of two 90-minute home visits with interactive activities, reflection, and goal setting, and a three-hour small group class. The aims include determining the effectiveness, over a 12-month follow-up period, of a pilot community-based intervention to enhance meeting (CACFP) best practices. Multiple observed and self-reported measures were collected at baseline and at 3 and 12 months post-baseline.
Conclusions and Implications: Implementation of this intervention will enhance the quality of nutrition provided to young children in FCCH and can be used to scale to rural environments and other states.
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