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GENERAL ARTICLE

CHILE: An Evidence-Based Preschool
Intervention for Obesity Prevention in Head
Start
SALLY M. DAVIS, PhDa SARAH G. SANDERS, RN, MSb COURTNEY A. FITZGERALD, MSSW, LMSWc PATRICIA C. KEANE, MS, RD, LDd GLENDA F. CANACA, MDe RENEE VOLKER-RECTOR, BAf

ABSTRACT
BACKGROUND: Obesity is a major concern among American Indians and Hispanics. The Child Health Initiative for Lifelong Eating and Exercise (CHILE) is an evidence-based intervention to prevent obesity in children enrolled in 16 Head Start (HS) Centers in rural communities. The design and implementation of CHILE are described. METHODS: CHILE uses a socioecological approach to improve dietary intake and increase physical activity. The intervention includes: a classroom curriculum; teacher and food service training; family engagement; grocery store participation; and health care provider support.

RESULTS: Lessons learned from CHILE include the need to consider availability of recommended foods; the necessity of multiple training sessions for teachers and food service; the need to tailor the family events to local needs; consideration of the profit needs of grocery stores; and sensitivity to the time constraints of health care providers. CONCLUSIONS: HS can play an important role in preventing obesity in children. CHILE is an example of a feasible intervention that addresses nutrition and physical activity for preschool children that can be incorporated into HS curricula and aligns with HS national performance standards.

Keywords: child and adolescent health; chronic diseases; nutrition and diet; physical fitness and sport; preschool. Citation: Davis SM, Sanders SG, FitzGerald CA, Keane PC, Canaca GF, Volker-Rector R. CHILE: an evidence-based preschool intervention for obesity prevention in Head Start. J Sch Health. 2013; 83: 223-229. Received on May 4, 2012

Accepted on September 1, 2012

O

besity is a serious public health concern for
individuals of all ages, including preschool-age
children.1,2 Children are disproportionately affected
by obesity if they are American Indian, Hispanic,
in rural areas, or in low-income families.3,4 Data
from New Mexico, a largely rural state, indicate
that 41% of American Indian and 32% of Hispanic
kindergarten students are overweight or obese.5

Rural communities, particularly American Indian and
Hispanic populations, are underrepresented in obesity
prevention research.4,6-10
Diet and physical activity are modifiable risk factors
that contribute to obesity. The majority of US children
neither consume diets that meet the recommendations
set forth in the Dietary Guidelines for Americans nor
achieve adequate levels of daily physical activity.11,12

a

Director, (SDavis@salud.unm.edu), Prevention Research Center, University of New Mexico, 1 University of New Mexico, MSC 11 6145, Albuquerque, NM 87131. Exercise Scientist, (SReinh@salud.unm.edu), Prevention Research Center, University of New Mexico, 1 University of New Mexico, MSC 11 6145, Albuquerque, NM 87131. c

Community Engagement Specialist, (CAFitzgerald@salud.unm.edu), PreventionResearchCenter, University of NewMexico, 1University of NewMexico, MSC116145, Albuquerque, NM 87131.
dAssociate Scientist II, (PKeane@salud.unm.edu), Prevention Research Center, University of New Mexico, 1 University of New Mexico, MSC 11 6145, Albuquerque, NM 87131. e Associate Scientist II, (GlCanaca@salud.unm.edu), Prevention Research Center, University of New Mexico, 1 University of New Mexico, MSC 11 6145, Albuquerque, NM 87131. f Community-Based Research Specialist, (nmweaver@msn.com), 8 Campo Road, Tijeras, NM 87059. b

Address correspondence to: Sally M. Davis, Director, (SDavis@salud.unm.edu), Prevention Research Center, University of New Mexico, 1 University of New Mexico, MSC 11, 6145, Albuquerque, NM 87131.
We express our deepest appreciation and sincere thanks to all the teachers, staff, and administration at the participating Head Start centers, as...
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