(sic)Miranos! a comprehensive preschool obesity prevention programme in low-income Latino children: 1-year results of a clustered randomised controlled trial

Objective:To test a culturally tailored obesity prevention intervention in low-income, minority preschool age children. Design:A three-group clustered randomised controlled trial. Setting:Twelve Head Start centres were randomly assigned to a centre-based intervention, a combined centre- and home-based intervention, or control using a 1:1:1 ratio. The centre-based intervention modified centre physical activity and nutrition policies, staff practices, and child behaviours, while the home-based intervention supported parents for obesity prevention at home. Study outcomes:The primary end point was change in children's BMI (kg/m(2)) at post-test immediately following completion of the 8-month intervention. Secondary end points included standardised scores for BMI (BMIz) and body weight (WAZ), and BMI percentiles (BMI pctl). Participants:Three-year-old children enrolled in Head Start in San Antonio, Texas, with written parent consent (n 325), 87 % Latino, 57 % female with mean age (sd) of 3.58 years (0.29). Results:Change in BMI at post-test was 1.28 (0.97), 1.28 (0.87) and 1.41 (0.71) in the centre + home-based intervention, centre-based intervention and control, respectively. There was no significant difference in BMI change between centre + home-based intervention and control or centre-based intervention and control at post-test. BMIz (adjusted difference -0.12 (95 % CI, -0.24, 0.01), P = 0.06) and WAZ (adjusted difference, -0.09 (-0.17, -0.002), P = 0.04) were reduced for children in centre + home-based intervention compared with control group. Conclusions:There was no reduction in BMI at post-test in children who received the intervention. Findings shed light on methodological challenges in childhood obesity research and offer future directions to explore health equity-oriented obesity prevention.