Intervention
obesity, health-related behaviors
OBESITY, AIDS
CHL was a cluster randomized family-centered obesity prevention trial implemented in partnership with Head Start in Boston, MA, USA (2016-2019). A detailed description of CHL’s study protocol, including its theoretical background, participatory methods, intervention components and evaluation protocol, is presented elsewhere [Grounded in a Community-Based Participatory Research (CBPR) [The CHL intervention included enhanced nutrition support, a media campaign and an empowerment-focused parenting program. All activities focused on four health-related behaviors in children including diet, physical activity, sleep and media use along with a healthy body weight. While nutrition support services, the provision of health promotion information and programming for parents are part of standard practice at Head Start, CHL enhanced each of these activities. For each intervention component, relevant existing Head Start infrastructure and practices, novel CHL intervention innovations introduced, and the theoretical basis for component development are described in Table Overview of existing Head Start infrastructure, novel CHL intervention innovations introduced, and the theoretical basis for CHL intervention component development• Standardized procedures for height and weight measurements and nutritional counseling° Developed a technical manual for anthropometric measurement and questionnaire administration° Created visual aids to facilitate questionnaire administration.° Delivered ongoing staff training.• Redesigned and distributed brochures and flyers for all participating Head Start programs based on themes identified as important by the Community Advisory Board.• Shared community-specific information and resources through online platforms• Created a novel online neighborhood resource map, made publicly available and free to use• Empowerment Theory [• Family Ecological Model [• Developed and implemented a new health- and empowerment-focused program, as a complement to preexisting Head Start parenting programs• 10 two-hour sessions co-led by a Head Start staff member and parent• Online supplements distributed via Facebook• Empowerment Theory [• Family Ecological Model [Briefly, CHL enhanced nutrition support services were offered at Head Start to improve staff communication skills, increase parent knowledge of healthy living and link parents with resources valuable for child health promotion. Such enhancements included revised biannual health letters (reviewed and approved by a CAB in the study development stages) which communicated the results of child health screenings, continued training for Head Start nutritionists and standardized protocols and nutrition counseling resources [To promote health-related parental empowerment [