Early Head Start & UCR Grow Well/Crecer Bien

Addressing early childhood obesity in low-income families

Karla Carrillo & Stephanie Estrada

February 13, 2021

Principal investigators are **Ann Cheney**, PhD from Social Medicine, Population, and Public Health, and **Tanya Nieri**, PhD from Sociology. Co-investigator **Alison Tovar** PhD, University of Rhode Island

Project Office: Grow Well/Crecer Bien, Watkins 1214, Riverside, CA 92521, (951) 827-4979

"The Grow Well/ Crecer Bien project, which runs from 2019-2024, is funded by an R01 as part of a U54 center grant from the National Institutes of Health, National Institute on Minority Health and Healthy Disparities. It is administered by the UCR School of Medicine.

We will engage EHS-enrolled mothers and other caregivers and EHS staff to develop and refine an enhanced program that will include new components on infant feeding styles and practices and the role of other caregivers in infant feeding. We will pilot test the enhanced program to produce information on its feasibility, acceptability and preliminary efficacy in promoting healthy feeding.

Community Partners

San Bernardino County Preschool Services Division

Riverside County Early Head Start

Orange County Head Start, Inc

Imperial County Early Head Start

FOR MORE INFORMATION VISIT: https://healthdisparities.ucr.edu/grow-well

Ann Marie Cheney

Principle Investigator

Faculty in the Department of Social Medicine Population and Public Health at the University of California, Riverside School of Medicine. She is a medical anthropologist with research expertise in health services research and community based participatory research. She has conducted research with disadvantaged populations in rural communities, including African Americans, Latino immigrants, and indigenous Mexicans. Her work addresses structural inequality in health and she uses community based participatory methods to empower grassroots leaders to use research as a vehicle to activate communities and change narratives of health and wellbeing. Dr. Cheney’s current work focuses on the impact of structure in health with a focus on Latino immigrant farmworkers in rural southern California. She is the director of HABLAMoS (Hispanic and Bilingual Longitudinal Ambulatory Medical Studies), a 4-year program for medical students that focuses on Spanish language acquisition and studies in cultural and structural competence. Dr. Cheney is faculty supervisor of the Global Health at Home group and oversees the Coachella Valley Free Clinics.

Tanya Nieri

Co-Principle Investigator

Faculty at the Department of Sociology. Tanya’s research interests include social determinants of health, such as immigration policy and institutional and academic cultures; culturally grounded health interventions, such as those promoting ethnic-racial socialization in families to reduce impacts of discrimination and training parents in infant feeding to promote healthy growth; and substance use prevention and recovery promotion. She works primarily with families in and organizations serving Latinx communities.

At University of California Riverside, Tanya is affiliated with the Center for Health Disparities Research, UCR School of Medicine.

Alison Tovar

Co- Investigator

Alison Tovar is an Assistant Professor in the Department of Nutrition and Food Sciences at the University of Rhode Island. Originally from Bogota, Colombia, she received her B.S. in Psychology from Northeastern University in 2001, a Masters in Public Health from Tufts University School of Medicine in 2005, and her Ph.D. from the Friedman School of Nutrition Science and Policy in 2009. She has established a research group that works toward preventing childhood obesity early in life. As a way to prevent childhood obesity, Dr. Tovar is interested in further understanding the influence of feeding practices of multiple caregivers including parents and child-care providers on a child’s dietary intake and weight in order to inform interventions among minority populations. Although some of her work is dedicated to understanding possible risk factors for obesity early in life, she is also involved with interventions that address these risk factors.

EHS Partnership w/ Grow Well

Childhood obesity is a major risk factor for cardiovascular disease, diabetes, and cancer. Obesity prevalence has doubled from the 1970s to the 21st century. Critical period is between 0 to 24 months for optimal nutrition and child development.

EHS Asociación con Crecer Bien

La obesidad infantil es un factor de riesgo importante de enfermedad cardiovascular, diabetes y cáncer. La prevalencia de la obesidad se ha duplicado desde la década de 1970 hasta los 2000. El período crítico es de 0 a 24 meses para una nutrición y un desarrollo infantil óptimos.

Our aims stem from our preliminary research on infant feeding practices and perceptions of childhood obesity risk among mothers in low-income Latino families enrolled in Early Head Start (EHS) which provides parenting and nutrition education to low-income mothers of children aged 0-3 years

Nuestros objetivos se derivan de nuestra investigación preliminar sobre las prácticas de alimentación infantil y las percepciones del riesgo de obesidad infantil entre las madres de familias latinas de bajos ingresos inscritas en Early Head Start (EHS), que brinda educación para padres y nutrición a madres de bajos ingresos con niños de 0 a 3 años.

01 / 06

UCR Grow Well focuses on the relation of infant feeding styles and practices to infant growth and obesity. Existing interventions do not account for feeding styles and practices into nutrition education, and do not account for the involvement of multiple caregivers in infant feeding. The goal is to develop a successful intervention to prevent childhood obesity.

UCR Crecer Bien se centra en la relación de los estilos y prácticas de alimentación infantil con el crecimiento infantil y la obesidad. Las intervenciones existentes no tienen en cuenta los estilos y las prácticas de alimentación en la educación nutricional y no tienen en cuenta la participación de múltiples cuidadores en la alimentación infantil. El objetivo es desarrollar una intervención exitosa para prevenir la obesidad infantil.

LONG TERM GOAL is to test an enhanced nutrition education program that promotes not only health nutrition, but also healthy feeding and prevents obesity in early life for children of low-income families.

OBJETIVO LARGO es probar un programa de educación nutricional mejorado que promueva no solo una nutrición saludable, sino también una alimentación saludable y previene la obesidad en la vida temprana de los niños de familias de bajos ingresos

SHORT TERM GOAL better understand the relation of feeding styles and practices to infant growth and obesity and the role of multiple caregivers in infant feeding, and to translate this understanding to intervention components that promote healthy feeding.

OBJETIVO CORTO comprender mejor la relación de los estilos y prácticas de alimentación con el crecimiento infantil y la obesidad y el papel de los múltiples cuidadores en la alimentación infantil, y traducir este conocimiento en componentes de intervención que promuevan una alimentación saludable.

Partnership Background

The EHS program effectively addresses nutrition, but does not contain content addressing obesity. Multiple caregivers can expose children to non-recommended feeding practices. Family, culture and values, low income is also a contributor.

WHAT WILL BE EVALUATED

-Feeding as a social and biological activity

-Acknowledge other caregivers’ role in infant feeding

-Integration of nutrition and obesity

Historia de Asociación

El programa EHS aborda de manera efectiva la nutrición, pero no incluye contenido que aborde la obesidad. Varios cuidadores pueden exponer a los niños a prácticas de alimentación no recomendadas. Familia, cultura y valores, bajos ingresos también son contribuidores.

QUE SERA EVALUADO

-La alimentación como actividad social y biológica

-Reconocer el papel de otros cuidadores en la alimentación infantil.

-Integración de nutrición y obesidad

Grow Well will study four southern California counties with pockets of high poverty and ethnic minority population. This will include San Bernardino, Riverside, Orange, and Imperial County.

Crecer Bien estudiará cuatro condados del sur de California con atención de alta pobreza y población de minorías étnicas. Esto incluirá los condados de San Bernardino, Riverside, Orange e Imperial.

County Boundaries

WHY EHS?

EHS helps researchers capitalize on existing resources. Researchers would then develop intervention components that can be added to already existing interventions to further improve infant obesity prevention

Por Qué EHS?

EHS ayuda a los investigadores a capitalizar los recursos existentes. Luego, los investigadores desarrollarían componentes de intervención que se pueden agregar a las intervenciones ya existentes para mejorar aún más la prevención de la obesidad infantil.

EHS nutrition education can influence child health by shaping infants eating and potentially caregivers’ feeding. Incorporating multiple caregiver feeding into the intervention we can understand and address diversity of US families in terms of their caregiving practices.

EHS collaborators are part of state and national networks, the enhanced intervention can have an impact on childhood obesity.

EHS currently measures its success in preventing obesity by examining obesity rates starting at age 3. Instead of developing a new intervention researchers plan on modifying existing intervention to efficiently translate to practice new knowledge about feeding.

La educación nutricional sobre medio ambiente, salud y seguridad puede influir en la salud infantil al moldear la alimentación de los bebés y la alimentación de sus cuidadores. Al incorporar la alimentación de múltiples cuidadores en la intervención, podemos comprender y abordar la diversidad de las familias estadounidenses en términos de sus prácticas de cuidado.

Los colaboradores de EHS son parte de redes estatales y nacionales, la intervención mejorada puede tener un impacto en la obesidad infantil.

En la actualidad, EHS mide su éxito en la prevención de la obesidad examinando las tasas de obesidad a partir de los 3 años. En lugar de desarrollar una nueva intervención, los investigadores planean modificar la intervención existente para traducir eficientemente en la práctica los nuevos conocimientos sobre alimentación.

Significance of EHS

EHS is federally funded & supports healthy development through home-or-site education and support services, classes, opportunity to meet with nutritionists, and referrals to community nutrition resources. However, the education does not include content on responsive feeding or the role of other caregivers, which is the main goal of this study.

Importancia de EHS

EHS recibe fondos federales y apoya el desarrollo saludable a través de servicios educativos y de apoyo en el hogar o en el lugar, clases, oportunidad de reunirse con nutricionistas y referencias a recursos de nutrición comunitarios. Sin embargo, la educación no incluye contenido sobre alimentación receptiva o el papel de otros cuidadores, que es el objetivo principal de este estudio.

Collaborator

Center for Health Disparities (HDR @ UCR)