A Head Start Center-Based Preschool Obesity Prevention Program Improved Body Mass Index Percentiles and Raw Gross Motor Skill in Refugee Children from Asia and Africa




Juarez, Fernando, Jr.

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Immigrants that arrive to the USA as children and adolescents (age < 20 years) are more likely to become overweight/obese than immigrants that arrive as adults after years of resettlement (Roshania, Narayan, & Oza-Frank, 2008). Refugee children between the ages 0-5 years have shown to have an increase in BMI shift after living in the USA for 6-24 months (Hervey et al., 2009). While similarly aged children born in the USA have a decrease in BMI as they age. Research has shown that childhood obesity can result in a multitude of health issues including cardiovascular burden, insulin resistance, sleep apneas and asthma (Palmieri et al., 2001; Papoutsakis et al., 2013; Sinha et al., 2002). Although obesity prevention interventions in childcare settings have shown promise in reducing excessive weight in young children, research is sparse on the effectiveness of interventions on the refugee children. The present study assessed whether a preschool program will be effective in refugee children from Asia and Africa. ¡Miranos! Look at Us We Are Healthy (¡Miranos!) is a Latino tailored obesity prevention program for preschoolers. The main goals of ¡Miranos! was to increase physical activity, healthy eating, and gross motor development; while decreasing sedentary behaviors and excessive weight gain. ¡Miranos! used a quasi-experimental design and utilized a systems approach and social cognitive theory. The present study is a secondary data analysis using a subsample of refugee children enrolled in the ¡Miranos! study. The subsample consisted of refugee children from one Head Start center that had an enrollment of nearly 50% refugee children. The center received the ¡Miranos! center-based intervention which incorporated policy changes, curriculum content changes, and training to the Head Start staff. The purpose of the study was to examine the effects of this intervention on a subsample of the refugee children from Asia and Africa. Children's heights, weights, and gross motor skill scores were collected as the outcome measures at pretest and posttest. The results show that the participants had improvements in BMI z score and gross motor skills. Participation in the intervention was associated with increased number of preschool children in the normal weight category at the posttest. The intervention also significantly improved the gross motor skills of refugee children. The study findings suggest that ¡Miranos! may be applicable to a more diverse audience. This can be attributed to the study design and usage of policy changes. ¡Miranos! showed that refugee children can grow healthfully while not becoming obese. ¡Miranos! was able to meet the unique needs of the refugee children. Although ¡Miranos! was not tailored to the needs of refugee children, the intervention produced significant results to an underserved population. Future studies need to replicate the findings in the present study in a controlled trial.


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Childhood Obesity, Gross Motor Development, Healthy Weight Gain, Preschool Intervention, Refugee Health



Health and Kinesiology