The Colorado LEAP study: rationale and design of a study to assess the short term longitudinal effectiveness of a preschool nutrition and physical activity program

Abstract

Background: The preschool years are a critical window for obesity prevention efforts; representing a time when children establish healthy eating habits and physical activity patterns. Understanding the context in which these behaviors develop is critical to formulating a model to address childhood obesity. The Colorado LEAP Study, an intervention study designed to prevent early childhood obesity, utilizes a social ecological approach to explore individual, family and environmental factors and their relationship to child weight status over a 3 year timeframe.

Methods: The study is located in 5 rural Colorado preschool centers and elementary schools (2 treatment and 3 control). Treatment sites receive The Food Friends nutrition (12 weeks) and physical activity (18 weeks) interventions during preschool. Observational measures assess 3 layers of the social ecological model including individual, family and organizational inputs. Children's food preferences, food intake, gross motor skills, physical activity (pedometers/accelerometers), cognitive, physical and social self-competence and height/weight are collected. Parents provide information on feeding and activity practices, child's diet, oral sensory characteristics, food neophobia, home food and activity environment, height/weight and physical activity (pedometers). School personnel complete a school environment and policy assessment. Measurements are conducted with 3 cohorts at 4 time points - baseline, post-intervention, 1- and 2-year follow-up.

Discussion: The design of this study allows for longitudinal exploration of relationships among eating habits, physical activity patterns, and weight status within and across spheres of the social ecological model. These methods advance traditional study designs by allowing not only for interaction among spheres but predictively across time. Further, the recruitment strategy includes both boys and girls from ethnic minority populations in rural areas and will provide insights into obesity prevention effects on these at risk populations.

Trial registration: ClinicalTrials.gov: NCT01937481.

Figure 1

Colorado Longitudinal Eating And Physical activity (LEAP) study design.

Figure 2

Conceptual model for the Colorado LEAP study. This model illustrates a multidimensional approach to addressing healthy growth in young children. The bottom of the figure depicts the intervention’s impact on Eating and Physical activity-related behaviors which then may influence Diet, Physical Activity, and Growth. These behaviors occur in multiple environments (micro-, meso-, & macrosystems; colored boxes) that are influenced by roles and social norms. Individual and environmental characteristics (black font) may interact with behaviors, practices, and/or policies (white font) to influence healthy growth. The items listed in the white font in the Child characteristics and Home environment boxes are the outcome measures used in this study.