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Efficacy of Center-based Childcare to Mitigate Unhealthy Weight Gain in Preschoolers from Low-income Households During the Summer

Award Number: R01HD116435
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/15/2025
PERIOD OF PERFORMANCE END DATE: 06/30/2030

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Efficacy of Center-based Childcare to Mitigate Unhealthy Weight Gain in Preschoolers from Low-income Households During the Summer - Studies show that preschool-age children are especially vulnerable to accelerated weight gain during the summer, with those from low-income households (≤185% poverty level or Medicaid eligible - the target population for this study) exhibiting the greatest risk of unhealthy weight gain. Despite numerous interventions designed to prevent OWOB, none target preschoolers during summer. For families from low-income households, attending center-based childcare is associated with a lower risk of developing OWOB by 1st grade compared to attending home-based care. We believe center-based childcare lowers the risk of OWOB through daily rules/routines that promote healthy behaviors. For families from low-income households, publicly funded center-based childcares (e.g., needs-based pre-K, Head Start) typically operate on an academic/school 9-month calendar (Aug-May). During summer, fewer than 30% of preschoolers attend center-based childcare. For many preschoolers from lower-income households, summer may serve as an extended period away from formal center-based childcare, because the out-of-pocket expense may prohibit attendance. This may promote unhealthy behaviors and excessive weight gain. In the majority of US states, publicly funded center-based childcare during the academic/school year for families from underserved populations is free; however, center-based childcare during the summer is an out-of-pocket expense for many of these families. Despite parents’ desire for childcare during the summer, a major reason children from low-income households do not attend center-based care during summer is cost. This creates unequal access to resources and likely exacerbates health disparities for families from low-income households. Using a structural intervention approach, our study will test the impact of providing free center-based childcare in the summer. For this R01, we will rigorously test the impact of providing free center-based childcare during the summer on weight status (i.e., BMI z-score/BIA - primary outcome) and health behaviors (physical activity, diet, sleep and screentime - secondary outcomes) of preschoolers from low-income households (≤185% of poverty level or Medicaid eligible). We will also evaluate the impact of the intervention on parental well-being and employment. Using a pragmatic randomized design, we will randomize 300 preschoolers from low-income households to either free center-based childcare during the summer or a comparison/control group. The Specific Aims are: Evaluate changes in A) preschoolers’ weight status (primary), B) preschoolers’ health behaviors (secondary) and C) parental well-being and paid employment (tertiary) between intervention and control groups; Examine changes in A) preschoolers’ health behaviors and B) parental well-being as potential mediators of changes in preschoolers’ weight status between the intervention and control groups; and Evaluate the incremental cost effectiveness of the intervention in terms of additional cost per weight status reduced and compare this to published childhood obesity cost effectiveness prevention/treatment interventions.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $627,740 )
2026	2026	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	2	6/25/2026	NON-COMPETING CONTINUATION	$627,740
														Subtotal = $627,740

Issue Date FY: 2025 ( Subtotal = $609,354 )
2025	2025	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	1	9/12/2025	NEW	$609,354
														Subtotal = $609,354

Grand Total All Awards = $1,237,094

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Efficacy of Center-based Childcare to Mitigate Unhealthy Weight Gain in Preschoolers from Low-income Households During the Summer

Award Number: R01HD116435

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/15/2025

PERIOD OF PERFORMANCE END DATE: 06/30/2030

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