Clinical Research Directory

Implementing Modified Practices to Leverage Evidence for Movement, Engagement, and Nutrition Topics in Early Childcare and Education

The goal of this cluster-randomized, controlled trial is to learn if a professional development program for childcare educators, called the Boston Healthy Child Care Initiative, can help improve the nutritional quality of meals/snacks served and the availability of physical activity opportunities in childcare programs, and also to learn if this results in improved diet quality and physical activity for young children who attend childcare, especially in under-resourced settings. The main questions it aims to answer are: Do childcare programs that receive professional development through the Boston Healthy Child Care Initiative improve the nutritional quality of the meals they serve, as measured by the Healthy Eating Index (HEI-2020), and do they also provide more physical activity opportunities to young children throughout the day? Do young children (ages 2-5 years) attending childcare programs that receive the Boston Healthy Child Care Initiative eat more nutritious foods/beverages (as measured by the HEI-2020) and engage in less sedentary time at childcare? Researchers will compare a group of childcare programs who participate in the Boston Healthy Child Care Initiative, and a sample of children who attend those programs, to a similar group of childcare programs who do not participate to see if the quality of meals served, the amounts of physical activity opportunities scheduled, young children's dietary quality, and the minutes/day spent in physical activity increase from before to after the Boston Healthy Child Care Initiative. Childcare educator participants will: * Complete the Boston Healthy Child Care Initiative professional development program (for the intervention group only) * Share copies of menus, schedules, and written policies about nutrition and physical activity in the childcare program Child participants will: * Wear ActiGraph wGT3X-BT accelerometers for two days while at childcare to measure physical activity levels. They will do this for two days each at baseline, midline, and follow-up after the initiative concludes. * Be observed during mealtimes by trained researchers to visually estimate how much they consume at meals and snacks in childcare.

Providing Grandchild Care in Later Life

Grandchild care is a modern global phenomenon arising from increased life expectancy , and, correlated with the rest of the world, the Turkish Statistical Institute's report on aging states that the prevalence of grandchild caregiving in Türkiye is 9.7% . Therefore, the health impacts of grandchild caregiving on older adults are attracting increasing attention. Various studies have shown that grandchild caregiving has both potential benefits and burdens for older individuals. While caregiving can provide physical activity, purpose, and emotional rewards, it can also create stress, reduce autonomy, and limit social participation and self-care, which is a significant determinant of healthy aging. Frailty, a multidimensional geriatric syndrome, is associated with disability, hospitalization, and death and is potentially reversible if diagnosed early. Furthermore, depression is another significant geriatric syndrome in the elderly and is associated with mortality; although various studies have shown that grandchild caregiving reduces depressive symptoms, some have found no association between grandchild caregiving and depression. The aim of this study is to investigate the relationship between grandchild care and frailty, depression, and self-neglect in patients presenting to geriatrics outpatients

Integrating Systems and Basic Income: Improving Outcomes for Families of Young Children

Early childhood is a critical period, laying the foundation for future growth and deveopment. This foundational period has an outsized effect, impacting health, well-being and achievement across one's lifespan. The U.S. lacks a cohesive early childhood system to support families with young children ages 0-5. The goal of this randomized controlled trial(RCT) is to test if community-based support via community health workers(CHWs) improves social and health services utilization, and child development. Furthermore, the trial will examine if income support enhances the impact of a CHW integrated system. Participants are English and Spanish speaking families with healthy newborns. This RCT was designed based on family priorities, community capacity and needs in a collective impact model. This trial is anchored at a university based children's hospital and involves many partners: families, county health, county leadership, a leading early childhood non-profit organization, the county's Medicaid managed care organization.

Sustainability Via Active Garden Education Wellness Implementation Strategies in Early Care and Education

This project compares four SAGE implementation strategies to evaluate effectiveness in implementation, sustainability, cost, and child health outcomes. Using the CFIR and MOST frameworks, the investigators will analyze key components to identify the most efficient and scalable strategies. Data will come from ECE site audits, surveys, social network analysis, and child health assessments. Findings will inform sustainable, cost-effective approaches to improve early childhood nutrition and physical activity.