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Examine differences in dietary intake of children aged 2–5 years in early care and education (ECE) setting in the US Affiliated Pacific (USAP). Secondary analysis of cross-sectional data collected by the Children's Healthy Living program. Children (n = 1,423) with complete dietary records and information on the ECE setting. Dietary intake by ECE setting; Head Start (HS), other ECE (OE), and no ECE. Comparison of mean dietary intake across ECE settings and multivariate logistic regression to evaluate ECE setting and likelihood for meeting dietary reference intake (DRI). Children in HS and OE settings had a significantly higher intake of several food groups and nutrients, compared with no ECE; vegetables (0.4 cup-equivalents per thousand kcals [CETK] vs 0.3 CETK; P < 0.001), fruits (0.8 CETK vs 0.6 CETK; P = 0.001), milk (0.9 CETK for HS and 1.0 CETK for OE vs 0.8 CETK; P < 0.001). Sixty-five percent of the HS group met DRI and had greater odds of meeting calcium DRI (odds ratio, 1.8; 95% confidence interval, 1.2–2.7) compared with other groups. The OE group had the lowest proportion of children meeting recommended intakes for 19 out of 25 nutrients. Mean intakes of foods and nutrients for children across the USAP meet some, but not all, recommendations and intakes vary across children attending various ECE setting types. Additional research on the clinical importance of these differences and the impact of the complex food systems in the USAP may identify systematic strategies for improving diet among children. [ABSTRACT FROM AUTHOR]

To describe the quality of food and physical activity (PA) environments by World Bank Income level in jurisdictions from the Children's Healthy Living Program. Baseline cross-sectional community data were analyzed from 11 jurisdictions categorized by World Bank Income levels to describe exposure to different food and PA outlets. The Children's Healthy Living Program was a multilevel, multijurisdictional prevalence study and community intervention trial that reduced child obesity in the US-Affiliated Pacific region. US-Affiliated Pacific region. Food (n = 426) and PA (n = 552) Outlets. Physical activity and food scores that reflect the quality of the outlets that support being physically active and healthy eating options, respectively. Descriptive statistics are presented as means ± SD or percentages. High-income-income level jurisdictions had higher food and PA scores than middle-income level jurisdictions. The US-Affiliated Pacific region has limited quality food and PA outlets in underserved communities at risk for obesity. The findings in this paper can be used to develop tools and design interventions to improve the food and PA environment to increase a healthier, active lifestyle. [ABSTRACT FROM AUTHOR]

To serve as a Center of Excellence to further build capacity and new knowledge for collective impact on child health in the US Affiliated Pacific Region. CHL Center continues to strengthen capacity with the Child Health in the Pacific (CHAP) Summer Fellowship Program and the CHL Dietetics Scholarship Program (CHLD), the CHL Summer Institute. Ten fellows from CNMI, Guam and Hawai'i completed the CHAP Summer Fellowship program and the CHL Summer Institute had a total of 123 students completing online courses (nine offered) related to childhood obesity. To examine the CHL intervention's long-term impact, retraining and standardization workshops are being conducted; and data collection has begun. Eighteen community reports provide a comprehensive compilation of data already collected, and CHL data are available for continued analysis to fill the void in basic nutrition and health information of children in the region. A CHL network multistate project (W1194) has expanded CHL's reach, with members from Arizona and West Virginia. The published CHL intervention effect showed significant improvement in intervention communities compared with control in overweight and obesity prevalence (effect size [d] = −3.95%; 95% CI, −7.47% to −0.43%), waist circumference (d = −0.71 cm; 95% CI, −1.37 to −0.05 cm), and acanthosis nigricans prevalence (d = −2.28%; 95% CI, −2.77% to −1.57%). Greater differences existed among intervention communities in acanthosis nigricans prevalence in the group aged 2 to 5 years (−3.99%) vs the group aged 6 to 8 years (−3.40%), and the interaction was significant (d = 0.59%, P <.001). There was a smaller difference in the group aged 2 to 5 years (−0.10%) vs the group aged 6 to 8 years (−1.07%) in screen time (d = −0.97 hour per day, P =.01). Further analysis of intervention levels, activities and child behaviors that influenced the intervention effect continues to be investigated. Year one built on efforts established by the CHL program to build the CHL Center of Excellence. [ABSTRACT FROM AUTHOR]