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Health behaviour

Child-care diet/activity RCT and zBMI

Alkon A, Crowley AA, Neelon SE, et al. · BMC public health · 2014

Open access · cc by · source: Europe PMC

A seven-month child-care nutrition and activity intervention significantly reduced children's zBMI versus control centers.

Study at a glance

Design
RCT — Cluster RCT of nurse coach-supported nutrition/PA improvements in child care centres vs control
N
N=552 · 552 children aged 3–5 and 137 providers across CA, CT, and NC; seven-month trial
Population
Preschool children in US child care centres
Outcome
Change in child zBMI

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

Among 552 children and 137 providers, intervention versus control difference in mean zBMI change was significant (coeff -0.14; p=0.02).

Methodology

Child care centers in three US states were randomised to nurse coach-supported nutrition/physical-activity improvements versus control; children's zBMI and provider practices were compared.

Limitations

Center-level randomisation with socioeconomic imbalances requires cautious causal inference; follow-up was short.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsHealth Behaviourconcept

    A child-care nutrition and activity trial shifted zBMI slightly, with design caveats.

    In a child-care nutrition/activity RCT, intervention versus control differed in mean zBMI change (coeff about −0.14), with center-level randomisation and socioeconomic imbalances noted as caution flags.

    Evidence for the claim as stated.

  • SupportsHealth Behaviourconcept

    Randomised activity/diet programmes, observational lifestyle indices, and digital pilots measure different endpoints (minutes walked, zBMI, incident disease, logging, abstinence). Treating them as one efficacy number manufactures agreement that the designs do not support.

    Evidence for the claim as stated.

  • Child-care centres in three US states were randomised to nurse-coach nutrition and physical-activity improvements versus control. Among 552 children and 137 providers, the intervention-versus-control difference in mean zBMI change was significant (coefficient −0.14; p=0.02). Centre-level assignment with socioeconomic imbalances and a short, unblinded behavioural programme is not a placebo-fed feeding trial.

    Evidence for the claim as stated.

  • Who is blinded, and whether a placebo exists, disagrees across the four papers. SEPP blinded the collector while comparing an identifiable parenting programme with standard care. Partners PrEP adherence work sits inside a placebo-controlled antiretroviral trial but reports UPC/MEMS adherence (99.1%/97.2%), not a placebo-subtracted efficacy estimate. The child-care zBMI trial is an open cluster-style programme contrast. FibriCheck does not assign a treatment at all. One method label is doing four jobs.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

History

When this study was placed

Dated entries from the concept change log — when this paper was added or removed as support, challenge, or qualifier on a claim.

  1. 2026-09-14

    Removed as supporting evidence on Health Behaviour

    In older adults, a web-based activity programme increased ankle-measured daily activity (~46% vs ~12% in controls) and was associated with greater short-term weight and HbA1c improvements than control.

  2. 2026-09-14

    Placed as supporting evidence on Health Behaviour

    In a child-care nutrition/activity RCT, intervention versus control differed in mean zBMI change (coeff about −0.14), with center-level randomisation and socioeconomic imbalances noted as caution flags.

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