Ethics approval and consent to participate
The Communities for Healthy Living trial was initially approved by the Institutional Review Board at the Harvard TH Chan School of Public Health, and again by that of Boston College when the team subsequently relocated (June 19, 2019, Boston College IRB Protocol Number 20.005.01). Regarding consent procedure, families were informed when enrolling in Head Start, prior to data collection, of the potential for de-identified demographic and health measures collected by Head Start to be used for quality improvement or research purposes; families were given the opportunity to opt out of this arrangement prior to measurement. Parents of eligible children enrolled at participating Head Start programs were also invited to complete a survey; before completing the survey, all participants provided informed, written consent.