Restricted accessResearch articleFirst published online 2013-3
Early childhood development and obesity risk-factors in a multi-ethnic,low-income community: Feasibility of the ‘Five Hundred under Five’ social determinants of health pilot study
First, to describe a community–academic partnership that piloted a parent and home-based programme focused on the intersection of health and education from a social determinants foundation and determine the feasibility and acceptability of such work. Second, to examine trends and co-occurrence of social and environmental context, including obesity-related and school-readiness risk factors.
Design:
Cross-sectional component of pilot intervention.
Setting:
Family-based programme based in a low-income, multi-ethnic neighbourhood in Minneapolis, Minnesota, 2007–2009.
Methods:
English/Spanish/Somali-speaking families with preschool-aged children were recruited for the pilot intervention. Interviews were conducted with study staff to assess feasibility and acceptability. The intervention included an outreach worker and a parent education programme, home visits, school readiness activities and coordination and referral to social, health and school readiness resources through a trained family support advocate. Developmental assessments and a health and sociodemographic survey were conducted.
Results:
Complete data were available for 60/136 enrolled families. Recruiting and measuring families was feasible and acceptable under certain circumstances. The programme was well accepted by participants. Descriptive analyses suggest a relationship between school readiness, social conditions and obesity-related risk factors.
Conclusions:
This type of intervention has challenges but offers promising community-based strategies to address the interconnectedness of social conditions, weight-related health and education.
AndersonSEWhitakerRC. Prevalence of obesity among US preschool children in different racial and ethnic groups. Arch Pediatr Adolesc Med, 2009: 163(4): 344–8.
2.
Morbidity and Mortality Weekly Review (MMWR). Obesity prevalence among low-income, preschool-aged children – United States, 1998–2008. Morbidity and Mortality Weekly Review, 2009: 58(28): 769–73.
SunSSGraveGDSiervogelRMPickoffAAArslanianSSDanielsSR. Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life. Pediatrics, 2007: 119(2): 237–46.
5.
GuoSSHuangCMaynardLMDemerathETowneBChumleaWC. Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: The Fels longitudinal study. Int J Obes Relat Metab Disord, 2000: 24(12): 1628–35.
6.
SanigorskiAMBellACKremerPJCuttlerRSwinburnBA. Reducing unhealthy weight gain in children through community capacity-building: Results of a quasi-experimental intervention program, be active eat well. Int J Obes (Lond), 2008: 32(7): 1060–7.
7.
FitzgibbonMLStolleyMRSchifferLVan HornLKauferChristoffelKDyerA. Two-year follow-up results for hip-hop to health Jr.: A randomized controlled trial for overweight prevention in preschool minority children. J Pediatr, 2005: 146(5): 618–25.
8.
FitzgibbonMLStolleyMRDyerARVanHornLKauferChristoffelK. A community-based obesity prevention program for minority children: Rationale and study design for hip-hop to health Jr. Preventive Medicine, 2002: 34(2): 289–97.
9.
AnandSSDavisADAhmedRJacobsRXieCHillA. A family-based intervention to promote healthy lifestyles in an aboriginal community in Canada. Can J Public Health, 2007: 98(6): 447–52.
10.
Haire-JoshuDElliottMBCaitoNMHesslerKNanneyMSHaleN. High 5 for kids: The impact of a home visiting program on fruit and vegetable intake of parents and their preschool children. Prev Med, 2008: 47(1): 77–82.
11.
WhitakerRCGoozeRAHughesCCFinkelsteinDM. A national survey of obesity prevention practices in Head Start. Arch Pediatr Adolesc Med, 2009: 163(12): 1144–50.
12.
LytleLHearstM. Examining the state of the science of prevention of childhood obesity. Current Nutrition & Food Science, 2009: 5: 134–48.
13.
FlynnMAMcNeilDAMaloffBMutasingwaDWuMFordC. Reducing obesity and related chronic disease risk in children and youth: A synthesis of evidence with ‘best practice’ recommendations. Obes Rev, 2006: 7(Suppl 1): 7–66.
14.
LarsonNIStoryMTNelsonMC. Neighborhood environments: Disparities in access to healthy foods in the US. Am J Prev Med, 2009: 36(1): 74–81.
15.
DingDSallisJFKerrJLeeSRosenbergDE. Neighborhood environment and physical activity among youth: A review. Am J Prev Med, 2011: 41(4): 442–55.
16.
Acevedo-GarciaDOsypukTLMcArdleNWilliamsDR. Toward a policy-relevant analysis of geographic and racial/ethnic disparities in child health. Health Aff (Millwood), 2008: 27(2): 321–33.
17.
LowMLowBBaumlerEHuynhP. Can education policy be health policy? Implications of research on the social determinants of health. Journal of Health Polit Policy Law, 2005: 30(6): 1132–62.
18.
FriendlyMBrowneG (eds). Early Childhood Education and Care as a Determinant of Health. Paper presented at the The Social Determinants of Health across the Life-Span Conference. Toronto, 2002.
19.
WilliamsDRCostaMVOdunlamiAOMohammedSA. Moving upstream: How interventions that address the social determinants of health can improve health and reduce disparities. J Public Health Manag Pract, 2008: 14(Suppl): S8–17.
20.
GormleyW. Early childhood care and education: Lessons and puzzles. Journal of Policy Analysis and Management, 2007: 26(3): 633–71.
21.
GalobardesBLynchJWDavey SmithG. Childhood socioeconomic circumstances and cause-specific mortality in adulthood: Systematic review and interpretation. Epidemiol Rev, 2004: 26: 7–21.
22.
D’OniseKLynchJWSawyerMGMcDermottRA. Can preschool improve child health outcomes? A systematic review. Soc Sci Med, 2010: 70(9): 1423–40.
23.
ZhaiF (ed.). Effects of Head Start on the Outcomes of Participants. Paper presented at the Graduate School of Arts and Sciences Conference, Columbia University, 2008.
24.
FrisvoldD. Head Start Participation and Childhood Obesity. Michigan: Early Childhood Research Collaborative, 2007.
25.
ReynoldsAJTempleJASuh-RuuO. School-based early intervention and child well-being in the Chicago longitudinal study. Child Welfare, 2003: 82(5): 633–56.
26.
CampbellFARameyCTPungelloESparlingJMiller-JohnsonS. Early Childhood education: young adult outcomes from the abecedarian project. Applied Developmental Science, 2002: 6(1): 42–57.
27.
KuhDHardyRLangenbergCRichardsMWadsworthME. Mortality in adults aged 26–54 years related to socioeconomic conditions in childhood and adulthood: Post war birth cohort study. BMJ, 2002: 325(7372): 1076–80.
28.
Ben-ShlomoYKuhD. A life course approach to chronic disease epidemiology: Conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol, 2002: 31(2): 285–93.
29.
MuennigPSchweinhartLMontieJNeidellM. Effects of a prekindergarten educational intervention on adult health: 37-Year follow-up results of a randomized controlled trial. American Journal of Public Health, 2009: 99(8): 1431–7.
AndersonSWhitakerR. Household routines and obesity in US preschool-aged children. Pediatrics, 2010: 125(3): 420–8.
34.
ZimmermanFJChristakisDA. Children’s television viewing and cognitive outcomes: A longitudinal analysis of national data. Arch Pediatr Adolesc Med, 2005: 159(7): 619–25.
35.
NelsonMCNeumark-StzainerDHannanPJSirardJRStoryM. Longitudinal and secular trends in physical activity and sedentary behavior during adolescence. Pediatrics, 2006: 118(6): e1627–34.
36.
GortmakerSLPetersonKWiechaJSobolAMDixitSFoxMK. Reducing obesity via a school-based interdisciplinary intervention among youth: Planet health. Arch Pediatr Adolesc Med, 1999: 153(4): 409–18.
37.
CohenSKamarckTMermelsteinR. A global measure of perceived stress. J Health Soc Behav, 1983: 24(4): 385–96.
38.
SquiresJBrickerDHeoKTwomblyE. Identification of social-emotional problems in young children using a parent-completed screening measure. Early Childhood Research Quarterly, 2001: 16: 405–19.
39.
ShawELevittCWongSKaczorowskiJ. Systematic review of the literature on postpartum care: Effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health. Birth, 2006: 33(3): 210–20.
40.
WaldfogelJ. Prevention and the child protection system. Future Child, 2009: 19(2): 195–210.
41.
OldsDLKitzmanHColeRRobinsonJSidoraKLuckeyDW. Effects of nurse home-visiting on maternal life course and child development: Age 6 follow-up results of a randomized trial. Pediatrics, 2004: 114: 1550–9.
42.
Council on Community Pediatrics. The role of preschool home-visiting programs in improving children’s developmental and health outcomes. Pediatrics, 2009: 123(2): 598–603.
43.
LutfiyyaMNGarciaRDankwaCMYoungTLipskyMS. Overweight and obese prevalence rates in African American and Hispanic children: An analysis of data from the 2003–2004 national survey of children’s health. J Am Board Fam Med, 2008: 21(3): 191–9.
MorlandKWingSDiez RouxA. The contextual effect of the local food environment on residents’ diets: The atherosclerosis risk in communities study. Am J Public Health, 2002: 92(11): 1761–7.
46.
MorlandKWingSDiez RouxAPooleC. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med, 2002: 22(1): 23–9.
47.
MorlandKDiez RouxAVWingS. Supermarkets, other food stores, and obesity: The atherosclerosis risk in communities study. Am J Prev Med, 2006: 30(4): 333–9.
48.
MorlandKFilomenaS. Disparities in the availability of fruits and vegetables between racially segregated urban neighbourhoods. Public Health Nutr, 2007: 10(12): 1481–9.
49.
ZenkSNSchulzAJIsraelBAJamesSABaoSWilsonML. Fruit and vegetable access differs by community racial composition and socioeconomic position in Detroit, Michigan. Ethn Dis, 2006: 16(1): 275–80.
50.
HorowitzCRColsonKAHebertPLLancasterK. Barriers to buying healthy foods for people with diabetes: Evidence of environmental disparities. Am J Public Health, 2004: 94(9): 1549–54.
51.
Rose-JacobsRBlackMCaseyPCookJCuttsDChiltonM. Household food insecurity: Associations with at-risk infant and toddler development. Pediatrics, 2008: 121(1): 65–72.
52.
BhargavaAJolliffeDHowardL. Socio-economic, behavioural and environmental factors predicted body weights and household food insecurity scores in the early childhood longitudinal study – kindergarten. Br J Nutr., 2008: 100(2): 438–44. Epub 200814February.
53.
GableSChangYKrullJ. Television watching and frequency of family meals are predictive of overweight onset and persistence in a national sample of school-aged children. J Am Diet Assoc., 2007: 107(1): 53–61.
54.
FulkersonJRydellSKubikMLytleLBoutelleKStoryM. Healthy home offerings via the mealtime environment (HOME): Feasibility, acceptability, and outcomes of a pilot study. Obesity, 2010: 18(Suppl 1): S69–74.
55.
FieseBSchwartzRH. Reclaiming the family table: Mealtimes and child health and wellbeing. Social Policy Reports, 2008: 22(4): 3–19.
