Communities for Healthy Living (CHL)

Project Summary

Communities for Healthy Living (CHL) is an obesity prevention program for Head Start preschools that integrates a parenting program co-led by Head Start staff and parents, enhanced nutrition support, and a media campaign. CHL content and implementation are informed by the Family Ecological Model, Psychological Empowerment Theory, and Organizational Empowerment Theory. The intervention is directed by community-based participatory research and implementation science principles and implemented in a real world context. Key outcomes include children’s Body Mass Index z-score, child health behaviors, parenting practices and parent empowerment. A three-year pragmatic cluster randomized trial with a stepped wedge design and routine health data collected by Head Start coupled with parent surveys completed by subsamples of families will be used to evaluate the program.

Approach

The intervention was designed by Head Start parents and staff using participatory methods and targets factors that are important to them while leveraging resources available through Head Start. Additionally, the key component of the intervention (a 10 session parenting program) is co-led by Head Start parent-staff cofacilitation teams who received comprehensive training .

Measurement & Metrics

Sixteen Internalizing and 12 externalizing elements from the Oxford Measure of Psychosocial Adjustment were used. Additionally, a sub-scale measuring prosocial attitudes/behaviors was used as a key outcome measure. Capacity for emotional regulation was assessed using 23 items from the Difficulties in Emotion Regulation Scale. The World Health Organization Disability Adjustment Scale, Inventory of Socially Supportive Behaviors, Classroom Performance Scale, and University of California, Los Angeles Post-Traumatic Stress Disorder Reaction Index were also utilized.

Key Findings

YRI participants reported significantly greater improvements in emotion regulation and prosocial attitudes/behaviors compared to controls.
YRI participants also reported significantly greater reductions infunctional impairment and greater improvements in social support.
At 6-month follow-up, the difference in symptom improvement between conditions was no longer greatly significant, as both treatment and control groups showed similar improvement relative to the elevated levels of symptoms on the initial screening.
YRI participants also had better school attendance and classroom behavior compared to controls.