{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:01:22Z","timestamp":1760144482142,"version":"build-2065373602"},"reference-count":51,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010001","name":"HRSA\/Maternal Child Health Bureau","doi-asserted-by":"publisher","award":["R40MC41747"],"award-info":[{"award-number":["R40MC41747"]}],"id":[{"id":"10.13039\/100010001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Children with disabilities have higher prevalence estimates of obesity than typically developing children. The Healthy Caregivers\u2013Healthy Children Phase 3 (HC3) project implemented an obesity prevention program adapted for children with special health care needs (CSHCN) that includes dietary intake and physical activity (PA) components. The primary outcome was a change in dietary intake, PA, and the body mass index (BMI) percentile. Ten childcare centers (CCCs) serving low-resource families with \u226530 2- to 5-year-olds attending were randomized to either the intervention (n = 5) or control (n = 5). The HC3 CCCs received (1) snack, beverage, PA, and screen time policies via weekly technical assistance; (2) adapted lesson plans for CSHCN; and (3) parent curricula. The control CCCs received a behavioral health attention curriculum. HC3 was delivered over three school years, with data collected at five different timepoints. It was delivered weekly for six months in year one. To ensure capacity building, the HC3 tasks were scaled back, with quarterly intervention delivery in year 2 and annually in year 3. Adaptations were made to the curriculum to ensure appropriate access for CSHCN. Given that the program was being delivered during the COVID-19 pandemic, special modifications were made to follow CDC safety standards. The primary outcome measures included the Environment and Policy Assessment and Observation (EPAO) tool, standardized dietary intake and PA assessments, and the child BMI percentile. CCCs are an ideal setting for targeting CSHCN for obesity prevention efforts as they provide an opportunity to address modifiable risk factors.<\/jats:p>","DOI":"10.3390\/nu16091274","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T05:26:13Z","timestamp":1714022773000},"page":"1274","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Randomized Controlled Cluster Trial of an Obesity Prevention Program for Children with Special Health Care Needs: Methods and Implications"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6393-7296","authenticated-orcid":false,"given":"Ruby","family":"Natale","sequence":"first","affiliation":[{"name":"Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Schladant","sequence":"additional","affiliation":[{"name":"Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha H.","family":"Bloyer","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Miami, Coral Gables, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julieta","family":"Hernandez","sequence":"additional","affiliation":[{"name":"Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Palenzuela","sequence":"additional","affiliation":[{"name":"Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6422-4674","authenticated-orcid":false,"given":"Yaray","family":"Agosto","sequence":"additional","affiliation":[{"name":"Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youmeizi","family":"Peng","sequence":"additional","affiliation":[{"name":"Mailman Center for Child Development, Department of Pediatrics, University of Miami School of Medicine, Miami, FL 33136, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6685-2175","authenticated-orcid":false,"given":"Sarah E.","family":"Messiah","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA"},{"name":"Center for Pediatric Population Health, University of Texas Health Science Center at Houston School of Public Health, Dallas, TX 75207, USA"},{"name":"Department of Pediatrics, McGovern Medical School, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1001\/jama.2014.732","article-title":"Prevalence of Childhood and Adult Obesity in the United States, 2011\u20132012","volume":"311","author":"Ogden","year":"2014","journal-title":"JAMA"},{"key":"ref_2","unstructured":"Fryar, C.D., Carroll, M.D., and Afful, J. 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