Mofleh Dania, Chuang Ru-Jye, Ranjit Nalini, Cox Jill N, Anthony Christine, Sharma Shreela V
Department of Epidemiology, Human Genetics and Environmental Sciences, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, 1200 Pressler St, Houston, TX 77030, USA.
Department of Epidemiology, Human Genetics and Environmental Sciences, Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston School of Public Health, 1616 Guadalupe St., Austin, TX, USA.
Prev Med Rep. 2022 Jun 27;28:101873. doi: 10.1016/j.pmedr.2022.101873. eCollection 2022 Aug.
Create Healthy Futures is a self-paced, web-based intervention on improving healthy eating behaviors among Early Care and Education (ECE) providers. We examined the impact of web-based Create Healthy Futures on diet quality measured by the Alternative Healthy Eating Index (AHEI) 2010, dietary behaviors, and related psychosocial and environmental factors among ECE providers. A cluster randomized controlled trial (CRCT) was implemented with baseline surveys administered from October 2019-January 2020, intervention implementation from April-May 2020, and post-intervention from May 2020-August 2020. Centered-based ECE programs under the Pennsylvania Head Start Association (n = 12) were recruited and randomized to intervention (n = 5) or comparison (n = 7) groups. A total of 186 ECE providers completed the post-intervention surveys (retention rate: 86.1%). At baseline, 31.5% of ECE providers were food insecure. Pre-to-post intervention demonstrated no significant within-or-between-group changes in the AHEI-2010 diet quality scores. ECE providers in the intervention group reported a significant decrease from baseline to post-intervention in the number of days eating out (aMD = -0.8, CI:-1.6, -0.1, = 0.03). Process evaluation showed that 89.9% of the intervention group completed all online module, and 82.9% attended all of wellness session groups. Although the Create Healthy Futures intervention did not improve ECE providers' diet quality and dietary behaviors, it confirmed critical needs to provide health support to ECE providers. Future studies should employ strategies that improve access to healthy foods and nutrition education, and address social determinants of health such as food insecurity to improve diet quality and health in ECE provider population.
“创造健康未来”是一项自主学习的在线干预项目，旨在改善早期护理和教育（ECE）提供者的健康饮食行为。我们研究了在线的“创造健康未来”项目对通过2010年替代健康饮食指数（AHEI）衡量的饮食质量、饮食行为以及ECE提供者相关的心理社会和环境因素的影响。实施了一项整群随机对照试验（CRCT），基线调查于2019年10月至2020年1月进行，干预实施于2020年4月至5月进行，干预后调查于2020年5月至8月进行。招募了宾夕法尼亚州学前教育协会下属的以中心为基础的ECE项目（n = 12），并将其随机分为干预组（n = 5）或对照组（n = 7）。共有186名ECE提供者完成了干预后调查（保留率：86.1%）。在基线时，31.5%的ECE提供者存在粮食不安全问题。干预前后，AHEI - 2010饮食质量得分在组内或组间均无显著变化。干预组的ECE提供者报告称，从基线到干预后外出就餐天数显著减少（调整后均值差 = -0.8，置信区间：-1.6，-0.1，P = 0.03）。过程评估显示，89.9%的干预组完成了所有在线模块，82.9%的人参加了所有健康课程组。尽管“创造健康未来”干预项目没有改善ECE提供者的饮食质量和饮食行为，但它证实了为ECE提供者提供健康支持的迫切需求。未来的研究应采用改善获取健康食品和营养教育的策略，并解决粮食不安全等健康的社会决定因素，以改善ECE提供者群体的饮食质量和健康状况。
