• Angela Kong, Joanna Buscemi, Melinda R Stolley, Linda A Schiffer, Yoonsang Kim, Carol L Braunschweig, Sandra L Gomez-Perez, Lara B Blumstein, Linda Van Horn, Alan R Dyer, and Marian L Fitzgibbon.
• Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois; University of Illinois Cancer Center, Chicago, Illinois; Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois. Electronic address: akong@uic.edu.
• Am J Prev Med. 2016 Feb 1; 50 (2): 136144136-44.

IntroductionThe preschool years provide a unique window of opportunity to intervene on obesity-related lifestyle risk factors during the formative years of a child's life. The purpose of this study was to assess the impact of a preschool-based obesity prevention effectiveness trial at 1-year follow-up.DesignRCT.Settings/ParticipantsPrimarily African American children (aged 3-5 years, N=618) attending Head Start preschool programs administered by Chicago Public Schools.MethodsEighteen preschools were randomly assigned in 2007-2008 to receive either (1) a 14-week teacher-delivered intervention focused on healthy lifestyle behaviors or (2) a 14-week teacher-delivered general health curriculum (control group).Main Outcome MeasuresThe primary outcome, BMI, was measured at baseline, postintervention, and 1-year follow-up. Diet and screen time behaviors were also assessed at these time points. Multilevel mixed effects models were used to test for between-group differences. Data were analyzed in 2014.ResultsSignificant between-group differences were observed in diet, but not in BMI z-score or screen time at 1-year follow-up. Diet differences favored the intervention arm over controls in overall diet quality (p=0.02) and in subcomponents of diet quality, as measured by the Healthy Eating Index-2005, and in fruit intake (servings/day, excludes juice) (p=0.02). Diet quality worsened more among controls than the intervention group at 1-year follow-up.ConclusionsThe adaptation of Hip-Hop to Health Jr. produced modest benefits in diet quality but did not significantly impact weight gain trajectory. Not unlike other effectiveness trials, this real-world version delivered by Head Start teachers produced fewer benefits than the more rigorous efficacy trial. It is important to understand and build upon the lessons learned from these types of trials so that we can design, implement, and disseminate successful evidence-based programs more widely and effectively.Trial RegistrationThis study is registered at www.clinicaltrials.gov NCT00241878.Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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