References
Data flow diagram.Scores of general motor quotient (Treatment conditions.Offer 90 min free and structured physical activity to children every day.
Offer balanced healthy meals and snacks utilizing the USDA Child and Adult Care Food Program best practice recommendations.
Children provided with 15 min of teacher-led activities using ¡Míranos! Activity Cards during outdoor play and then given 15 min of free play.
Children participate in active-learning classroom activities during center time, transition, and breaks (30 min) each day. Children provided with outdoor play (structured activity 15 min and free play 15 min) each day. Screen time for entertainment at the center limited to 30 min a week. Children’s sitting time <15 min in any setting except nap and mealtime.Use health-education activities from Sesame Street’s Healthy Habits for Life daily lessons. Provide weekly health challenges. Offer food tastings.Staff wellness challenges to promote healthy lifestyle changes.Modify lunch and snacks offered to children to increase fresh fruit, vegetable, and whole-grain intake, reduce sugar intake, and increase exposure to healthy food.Review ¡Míranos! intervention plan and policies.Monthly wall-poster parent-education sessions on eight health topics (15 min), to change parental obesity-related beliefs and practices, and teach parents recommendations on preschool children’s body weight, PA, nutrition.Head Start staff conduct three home visits (30–45 min) with parents over the school year and help parents develop skills and strategies to promote PA, healthy eating, and sleep for their children at home.Promote physical activity and healthy eating. Keep active control centers engaged in study.Teach skills for parents to introduce basic literacy and nutrition concepts at home. Keep parents engaged in study.Demographics and characteristics of Head Start centers and study participants.CBI + HBI, Center- and home-based intervention; CBI, Center-based intervention. Descriptive statistics of outcomes of interest by study groups.CBI + HBI, Center- and home-based intervention; CBI, Center-based intervention; GMQ, General motor quotient; LS pctl, Locomotive skill percentile; BS pctl, Ball skill percentile; Change = post intervention− baseline; Entries are mean ± SD. * Adjusted change in outcomes of interest CBI + HBI, Center- and home-based intervention; CBI, Center-based intervention; GMQ, General motor quotient; LS pctl, Locomotive skill percentile; BS pctl, Ball skill percentile. ^ 