1. Implementing Color Me Healthy in Jackson County Mississippi Head Start Centers: Successes, Struggles, and Future Implications (Year Two Results)
Danielle Fastring, PhD, MS, MPH
University of Southern Mississippi
College of Health
Department of Public Health

2. Introduction and Background
Initiative of the MS Gulf Coast Youth Health Coalition
Color Me Healthy:
Intervention used to teach healthy eating and physical activity habits to 3-5 year old children
12 circle time activities
Rated according to activity level
Incorporate original songs
Encourage imagination and physical activity
Teach about healthy snacks and TV substitutes
Parent newsletters
Colorful posters and picture cards for reinforcement
Healthy People 2020
Reduce the proportion of children aged 2 to 5 years who are considered obese
Prevent inappropriate weight gain in children aged 2 to 5 years
Increase the variety and contribution of fruits and vegetables to the diets of the population aged 2 years and older
MS has one of the highest rates of childhood obesity in the nation, with 40% of school aged children and youth classified as overweight or obese.

3. Methods Partnered with Jackson County Head Start Centers (n=23)
Control Site: Taconi (5)
Intervention Sites : Gautier (7), Pascagoula (7), and Vancleave (4)
Quasi-Experimental Study Design
Two group pre-test / post-test
O O2
O1 X O2
Utilized a “Train the Trainer” Model
All teachers in Jackson County Head Start Centers (n=130 over 2 years)
Program delivery training
Fruit and Vegetable Consumption Data Collection Tool

4. Data Collection Demographic Information: Anthropometric Data:
Age, Race, Sex
Anthropometric Data:
Height, Weight, Waist Circumference, Calculated BMI
Knowledge Items:
Recognition of Fruits and Vegetables
Intervention Fidelity
Teacher’s report of activities
Behavioral Data for Children:
One week of fruit and vegetable consumption
Parent Survey
Child’s fruit and vegetable consumption patterns at home
Screen time
Physical activity time
Sugary snacks and beverages
Child’s Satisfaction with the Program
Teachers’ Readiness to Change

5. Results: BMI Baseline BMI: control Group BMI: Intervention Group
Underweight: < 5th, Healthy weight: 5th – 85th, Overweight: >85th - < 95th, Obese: 95th +

6. Results: Fruit and Vegetable Recognition
Taconi
(Control Site)
Gautier (Intervention Site)
Pascagoula (Intervention Site)
Vancleave (Intervention Site)
Mean (sd)
Pre
Post
Fruit Recognition
4.58 (1.33)
5.56 (0.97)
4.18 (1.54)
5.13 (1.06)
4.05 (1.53)
5.50 (1.02)
4.30 (1.41)
5.65 (1.22)
Vegetable Recognition
2.13 (1.36)
3.66 (1.42)
1.81 (1.48)
3.30 (1.58)
1.70 (1.46)
3.85 (1.36)
1.93 (1.36)
4.14 (1.77)
There was a significant increase in fruit and vegetable recognition across all intervention group sites from pre-test to post test and when compared to results in the control group (p < 0.001).

7. Fruit &Vegetable Consumption
Teachers in the classroom used direct observation to record whether a child ate “all, some, or none” of their fruit and vegetable servings at breakfast, lunch, and two snacks daily for one week pre- and post-intervention.

8. Results: Parent Survey
Asked for each CMH food:
What is your child’s experience with the following foods?
Ex. Apples
My child has tried this food and enjoys eating it
My child has tried this food but does not enjoy eating it
My child has been introduced to this food but would not try it
My child has never been introduced to this food
Parents in the intervention groups reported a significantly greater number of “tried” and “tried and enjoyed” fruits and vegetables than did the control group post-intervention (p<0.001).
Screen Time
Parents in the intervention groups reported that their children were significantly less likely to engage in screen time than were control children post-intervention (p<0.005)
Sugary Snacks and Beverages
Parents in the intervention groups were significantly more likely to report that their child “always or often” chose a fruit or vegetable for snack than did control group parents post-intervention (p<0.005).
Physical Activity
No significant difference in physical activity between groups.

9. Results: Child and Teacher Satisfaction
Child Satisfaction
Teacher Satisfaction
Which picture shows how you feel about the Color Me Healthy Program?
95.2% of children reported they “liked it” or “liked it very much”
94% of teachers reported that the circle time activities were “easy” or “very easy” to complete
100% of teachers characterized children’s responses to circle time activities and color me active activities as “happy” or “very happy”
94% of teachers reported that they would be “interested” or “very interested” in continuing the CMH program in their classroom

10. Future Implications
The Color Me Healthy curriculum was effective in improving the knowledge and behaviors of children in our study.
Research shows that beliefs and attitudes adopted in early life carry over into adulthood.
Mississippi’s adult obesity rate continues to be the highest in the nation.
Further longitudinal studies are needed to determine if healthy attitudes and behaviors toward nutrition and physical activity adopted in early childhood are maintained into adulthood.