# Healthy Start: An innovative, multi-level intervention with family child care providers and families to improve the dietary behaviors of preschool children

> **NIH NIH R01** · BROWN UNIVERSITY · 2024 · $306,687

## Abstract

The preschool years are a critical time for shaping food preferences and eating behaviors
which, in turn, affect dietary behaviors in adults and life-long risks for obesity, diabetes,
cardiovascular disease and other chronic conditions. Unfortunately, many US children,
especially low-income and ethnic minorities, have dietary patterns associated with obesity and
increased morbidity. Thus, to improve child diet quality, it is essential to develop effective
targeted interventions in settings where children (especially higher risk children) spend time.
There is a national call for dietary interventions that span multiple settings including the
childcare and home environments. In response to PAS-20-160, we build upon our efficacious
Healthy Start intervention with family childcare home (FCCH) providers (FCCP) to pilot a novel,
8-month multilevel tailored intervention to reach families through FCCH. This would be the first
study to incorporate family-based intervention components into FCCH. FCCH are a promising
intervention setting as parents trust FCCPs as extended family members and FCCP feel
comfortable talking to parents about children’s diet, but want more training to do so effectively.
The 8-month intervention will include an adapted version of the Healthy Start intervention for
English and Spanish-speaking FCCP as well as FCCP training to deliver nutrition messages to
parents using an existing childcare App, complemented with FCCH environmental cues and
tailored print and videos for parents. Specific Aims are to: SA.1. Conduct formative research
with FCCP and parents to inform refinement of the multi-level intervention. SA.2. Conduct a pilot
trial with 40 FCCP and 80 parents with 18-54-month-old children to evaluate feasibility and
acceptability of intervention and study protocols, and preliminary efficacy of the nutrition
intervention compared to an attention-matched control on: a). children’s dietary quality at FCCH
and home, b). social/physical FCCH and home food environments, c). children’s dermal
carotenoid levels and z-BMI scores. SA3. Conduct post qualitative interviews with parents,
FCCP, coaches, staff & partners to assess the intervention’s acceptability and suggestions for
improvement. In sum, feasible and effective interventions to improve young children’s diets are
urgently needed. The FCCH is a novel and untapped setting to intervene with both FCCP and
parents simultaneously to affect children’s diets in both the childcare and home settings, which
has the potential to more fully impact the child’s overall diet and weight status. This pilot
feasibility research of a novel, multi-level intervention will inform a future full-scale cluster RCT,
which will fill important research gaps and move the frontier of nutrition research forward.

## Key facts

- **NIH application ID:** 10873768
- **Project number:** 5R01DK131940-02
- **Recipient organization:** BROWN UNIVERSITY
- **Principal Investigator:** Kim M. Gans
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $306,687
- **Award type:** 5
- **Project period:** 2023-07-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10873768

## Citation

> US National Institutes of Health, RePORTER application 10873768, Healthy Start: An innovative, multi-level intervention with family child care providers and families to improve the dietary behaviors of preschool children (5R01DK131940-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10873768. Licensed CC0.

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