The New York-Presbyterian Hospital, in collaboration with the Columbia University Medical Center, intends to operate a Healthy Tomorrows obesity prevention initiative that will reach 750 Northern Manhattan Latino and Black children age 3-5 over the five-year project period. National obesity rates have doubled in the last 30 years for 2-5 year olds and nearly tripled for 6- 11 year olds. Rates are even higher in Latino and Black children. In 2011, 26.5% of children in the Northern Manhattan community to be served were considered obese, compared with 20% of all New York City children. Prevention needs to start early as patterns of physical activity and dietary practices are formed early in the lifespan under the influence of family behavior.
The project goal is to decrease community rates of childhood obesity through development of an early childhood obesity prevention program that focuses on systemic, sustainable changes in preschool settings and targets underserved children and their families in Washington Heights/ Inwood, the northernmost part of Manhattan. Our objectives are to implement "CHALK Jr." in Washington Heights/Inwood early childhood centers to increase physical activity and decrease consumption of sugar-sweetened beverages for 750 low-income children aged 3-5.
We will build on our evidence-based, culturally tailored, scalable and sustainable Choosing Healthy & Active Lifestyles for Kids (CHALK) program that targets elementary-aged children and their families and is implemented in school, clinical practice and community settings. CHALK was recognized by Michelle Obama and replicated in more than 200 schools. In addition, we aim to increase nutrition knowledge and awareness in parents; increase early childhood center staff knowledge and awareness of nutrition and physical activity policies; provide physician training and family education at four community primary care centers; and assess and improve overall environmental wellness at each early childhood center.
We will be guided by a Community Advisory Board and steadily increase the number of participating early childhood centers over the five-year project period.
We will evaluate parent behaviors, attitudes and knowledge through pre- and post- questionnaires; measure improvement in rates of child physical activity; use an environmental scan instrument to measure impact on early childhood centers; and conduct an annual process and performance outcome review to refine the CHALK Jr. program model. Project products will include CHALK physical activity "Just Move" flash cards adapted to the younger population and a bilingual health literate "10 Healthy Habits" adapted from Healthy Children Healthy Futures. CHALK Jr. is designed to be a low-cost, sustainable intervention that will be disseminated through conference presentations, publications, and our participation in the American Academy of Pediatrics.