Healthy Children, Healthy Communities: Helping rural family childcare homes improve preschoolers' diets
Cluster Randomized Controlled Trial of a Multilevel Rural Community Engagement Model for Improving Children's Dietary Intake in Family Child Care Homes
This program will see if online training, one-on-one coaching, and mealtime feedback for rural family childcare providers helps 3–5-year-old children eat more fruits and vegetables and supports healthier mealtime practices.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 360 (estimated) |
| Ages | 3 Years and up |
| Sex | All |
| Sponsor | University of Nebraska Lincoln Academic / other |
| Locations | 1 site (Lincoln, Nebraska) |
| Trial ID | NCT07160530 on ClinicalTrials.gov |
What this trial studies
This cluster randomized controlled trial enrolls about 120 licensed family childcare homes in nonmetropolitan counties, with roughly 240 preschool-aged children nested within those homes. Participating providers are randomly assigned to an intervention that includes seven online training modules over 16 weeks, seven individual Zoom coaching sessions, and short recorded mealtime videos for personalized feedback, versus a comparison approach (Better Kid Care). Primary outcomes include children's dietary intake and provider feeding practices, with secondary measures of child BMI z-scores, skin carotenoid levels as a biomarker of fruit and vegetable intake, and the mealtime emotional climate. The unit of randomization is the family childcare home, and data collection occurs at the provider and child levels.
Who should consider this trial
Good fit: Ideal candidates are children aged 3–5 who attend licensed family childcare homes in nonmetropolitan counties that participate in the Child and Adult Care Food Program (CACFP), along with providers willing to complete online training and coaching and record mealtimes.
Not a fit: Children with feeding disorders, significant dietary restrictions, developmental delays that affect eating, or those not in the 3–5 age range—or childcare homes not enrolled in CACFP or outside the eligible rural areas—are unlikely to benefit from this program.
Why it matters
Potential benefit: If successful, the program could increase children's fruit and vegetable intake, improve providers' mealtime practices, and support healthier growth and eating habits in rural preschoolers.
How similar studies have performed: Previous provider-training and coaching programs have shown modest improvements in feeding practices and child vegetable intake, but multilevel rural community engagement models like this are less well tested.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: FCCH Settings: * Licensed family child care home-based early child care and education settings * Located in Nebraska (with potential expansion to Iowa, Kansas, South Dakota, Oklahoma, Illinois, and/or Northwest Missouri if needed) * Participate in the Child and Adult Care Food Program (CACFP) * Care for at least 2 preschool-aged non-sibling children (3-5 years old) without feeding disorders or developmental delays * Provide meals and snacks to attending children * Located in a county designated as nonmetropolitan based on the 2023 Rural-Urban Continuum Codes (RUCC) FCCH Providers: * Currently caring for at least two 3-5 year old non-sibling children who do not have dietary restrictions or feeding disorders that impact how they eat * Present with children during meals and snacks * Over the age of 19 years * Have not participated in this study before Children: * Between 3 to 5 years old * No dietary restrictions or feeding disorder that impact how they eat (lactose intolerance, egg/nut allergies, or vegetarian diet are acceptable) * Typically developing children (no diagnosis of developmental delays as identified by childcare providers) * Have a parent or guardian 19 years of age or older to consent for them Exclusion Criteria: FCCH Providers: * FCCH provider closes the business * FCCH provider stops serving meals to children * FCCH provider discontinues participation in CACFP and no longer adheres to CACFP meal pattern requirements * FCCH provider loses all eligible study children due to children leaving care, developing developmental delays or feeding disorders, or other reasons making them ineligible Children: * Diagnosis of dietary restrictions or feeding disorder that impact how they eat (soft diet requirements or difficulty swallowing that impacts how they eat) * Diagnosis of developmental delays * A sibling of a participating child (only one 3-5 year old child per family eligible)
Where this trial is running
Lincoln, Nebraska
- University of Nebraska Lincoln — Lincoln, Nebraska, United States (Recruiting)
Study contacts
- Principal investigator: Dipti Dev, PhD — University of Nebraska Lincoln
- Study coordinator: Dipti Dev, PhD
- Email: unlhealthychildren@unl.edu
- Phone: 402-472-2605
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.