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Abstract Background Nearly one in five 4-year-old children in the United States are obese, with low-income children almost twice as likely to be obese as their middle/upper-income peers. Few obesity prevention programs for low-income preschoolers and their parents have been rigorously tested, and effects are modest. We are testing a novel obesity prevention program for low-income preschoolers built on the premise that children who are better able to self-regulate in the face of psychosocial stressors may be less likely to eat impulsively in response to stress. Enhancing behavioral self-regulation skills in low-income children may be a unique and important intervention approach to prevent childhood obesity. Methods/design The Growing Healthy study is a randomized controlled trial evaluating two obesity prevention interventions in 600 low-income preschoolers attending Head Start, a federally-funded preschool program for low-income children. Interventions are delivered by community-based, nutrition-education staff partnering with Head Start. The first intervention (n = 200), Preschool Obesity Prevention Series (POPS), addresses evidence-based obesity prevention behaviors for preschool-aged children and their parents. The second intervention (n = 200) comprises POPS in combination with the Incredible Years Series (IYS), an evidence-based approach to improving self-regulation among preschool-aged children. The comparison condition (n = 200) is Usual Head Start Exposure. We hypothesize that POPS will yield positive effects compared to Usual Head Start, and that the combined intervention (POPS + IYS) addressing behaviors well-known to be associated with obesity risk, as well as self-regulatory capacity, will be most effective in preventing excessive increases in child adiposity indices (body mass index, skinfold thickness). We will evaluate additional child outcomes using parent and teacher reports and direct assessments of food-related self-regulation. We will also gather process data on intervention implementation, including fidelity, attendance, engagement, and satisfaction. Discussion The Growing Healthy study will shed light on associations between self-regulation skills and obesity risk in low-income preschoolers. If the project is effective in preventing obesity, results can also provide critical insights into how best to deliver obesity prevention programming to parents and children in a community-based setting like Head Start in order to promote better health among at-risk children. Trial registration number Clinicaltrials.gov Identifier: NCT01398358

Objective: We aim to share practical insight acquired while implementing the Chronic Disease Self‐Management Program (CDSMP), offering strategies to reach and support diverse individuals with chronic diseases. Background: In light of a global rise in chronic diseases, existing health disparities, and increasingly limited health care access, exacerbated by COVID‐19, empowering individuals through self‐management becomes important to alleviate burdens for families, individuals, and healthcare systems. Methods: Uptake and effectiveness of CDSMP were quantified via enrollment data and evaluation instruments. Qualitative exploration of instructor feedback provided lessons learned. Results: Participation in CDSMP courses increased during the pandemic with participants reporting greater confidence and frequency of engagement in self‐management activities. Strategic efforts including partnership‐building, targeted marketing, and innovative delivery methods played a pivotal role in recruitment success. Inclusivity measures, such as use of electronic platforms and varied engagement options, broadened program accessibility. Addressing social isolation emerged as a key factor, both as an end in itself and as a motivator for course engagement and retention. Conclusion: Reducing barriers related to program accessibility, inclusivity, and social isolation are important factors influencing program enrollment both in total number and in diversity of participants, course engagement and retention, and program effectiveness. Implications: Lessons learned can inform future implementation as family educators seek to uplift and improve the well‐being and health of diverse families coping with chronic diseases. [ABSTRACT FROM AUTHOR]

Entities that seek to provide quality community-based health education need sustainable funding to maintain their efforts. With dwindling funding sources, it has become important to have diverse financial support for program stability. A promising new practice for expanding funding involves partnering with third-party payers. Michigan State University Extension created a multistep approach to prepare organizations to receive third-party payments. This approach includes (a) assessing readiness, need, and capacity; (b) conducting organizational preparation; (c) conducting staff preparation; and (d) formalizing partnerships. The result is the creation of an infrastructure that allows for partnering with varied funding sources for sustainable community-based health education programming.

Community-delivered sleep education interventions have been demonstrated to be effective in improving sleep outcomes, but whether these benefits persist once the program ends is not well characterized. This study sought to determine whether the previously reported positive effects attributed to the SLeep Education for Elders Program (SLEEP) were maintained six months after program completion. Nineteen participants were surveyed three times: at baseline, program completion (six weeks), and the six-month post-program timepoint. Sleep outcomes for quality, duration, insomnia symptoms, sleep hygiene behaviors, and excessive daytime sleepiness were assessed using validated surveys, including the Pittsburgh Sleep Quality Index (from which duration was also extracted), the Insomnia Severity Index, the Sleep Hygiene Index, and the Epworth Sleepiness Scale. Longitudinal models adjusted for baseline sleep problems revealed the benefits achieved immediately after the program were retained at six months for sleep quality (estimate: −2.0 (95%CI: −2.7, −1.3)), sleep duration (estimate: 0.9 (95%CI: 0.6, 1.2)), insomnia symptoms (estimate: −3.5 95%CI: (−4.6, −2.3)), and sleep hygiene behaviors (estimate: −2.6 (−4.3, −0.9)). These results suggest that a community-delivered sleep education intervention can produce sustained benefits for participants and should be considered as a tool to address uncomplicated sleep issues. [ABSTRACT FROM AUTHOR]

This study compared rural vs urban eating and physical activity (PA) behaviors and perceived barriers. Analyses revealed rural adults cooked more at home, ate out less at restaurants (5.59 vs 4.91 days, P =.00;.71 days vs 1.08 days, P =.01, respectively), and snacked less than urban adults (1.69 vs 2.01 times per day, P =.03). Among rural adults, unaffordability was associated with not meeting fruit recommendations (P =.02) and safety and traffic concerns were negatively associated with daily PA (P =.03, P =.00, respectively). Among urban adults, inadequate selection (P =.03) was associated with not meeting fruit recommendations. Results revealed contextual issues for policymakers and practitioners. [ABSTRACT FROM AUTHOR]

Background With one in eight preschoolers classified as obese in the USA, childhood obesity remains a significant public health issue. This study examined rural–urban differences in low-income preschoolers' body mass index z-scores (BMIz), eating behaviors, dietary quality, physical activity (PA) and screen time. Methods Pre-intervention data from 572 preschooler-parent dyads participating in a randomized, controlled obesity prevention trial in the Midwest USA were analyzed. We examined the associations among living in rural versus urban areas, child BMIz and child obesity-related behaviors, including eating behaviors, dietary quality, PA and screen time. Results Rural children had higher BMIz, more emotional overeating behaviors and more time spent playing outdoors compared with urban children. We found no associations between children living in rural versus urban areas and dietary quality and screen time. Conclusions The study found that rural–urban differences in BMIz may start as early as 3–4 years of age, if not earlier. To reverse the weight-related health disparities between rural and urban low-income preschoolers, structural changes in rural locations and family supports around coping skills may be needed. [ABSTRACT FROM AUTHOR]