STRONG Kids Program Subproject: The Role of Head Start and Child Care Classrooms in Early Childhood Obesity—A Cumulative Risk Model


The purpose of this study is to develop a knowledge base regarding childcare environments and provider feeding practices that can guide Head Start and childcare settings in the development of strategies designed to combat the childhood obesity epidemic. Attendance in childcare is an established risk factor for childhood obesity. However, the causes contributing to this risk are not fully understood. Since 8.6 million preschool children attend childcare, consume up to five meals and snacks per day, and spend majority of their waking hours in such settings, Head Start and childcare environments can be a major force in shaping children’s dietary intake, feeding behaviors, and energy balance. Most obesity prevention efforts are focused on schools; however, given that 25% of preschool (2-5 years) children are already overweight intervening before school entry should be a priority. Therefore, Head Start and childcare settings offer untapped opportunities to combat the childhood obesity epidemic. Specific research questions include:

  • Which risk factors in the Six Cs Ecological Model, as computed by a cumulative risk index, are predictive of preschool children’s increased obesity risk?
  • Are teacher feeding practices during mealtimes supportive of children’s internal cues of hunger and satiety necessary for self-regulation of energy intake and thereby obesity prevention?
  • What are the factors that influence Head Start teachers and childcare providers' feeding practices and verbal communication during mealtimes?
  • What are Head Start and childcare administrators' perceptions of current nutrition standards for early care and education programs; and motivators, facilitators and perceived barriers for inclusion of nutrition activities based on current standards within their programs?

​A clear outcome of the study will be identification of key determinants of childhood obesity, existing at different ecological levels (cell, child, clan, community, country, and culture) within the Six Cs model. The proposed multi-level, collaborative, and bottom-up approach to data collection will provide Head Start and childcare policy makers and program developers with meaningful directions and implications for future interventions and policy development that addresses childhood obesity.

Research Team

  • Brent McBride, PhD, Director, Child Development Laboratory, Human Development and Family Studies
  • Dipti Dev, PhD, Doctoral Candidate, Nutritional Sciences


  • Illinois Transdiciplinary Obesity Prevention Program (I-TOPP) Seed Grant, 2011
  • Head Start Graduate Student Research Grant from U.S. Department of Health and Human Services: Administration for Children and Families (ACF), 2011


Brent McBride
Principal Investigator
Phone: 217-333-0971