Changes in body mass index associated with head start participation.

OBJECTIVES: The goal of this study was to determine if Head Start participation is associated with healthy changes in BMI. METHODS: The sample included children participating in Head Start between 2005 and 2013 and children from 2 comparison groups drawn from a Michigan primary care health system: 5405 receiving Medicaid and 19,320 not receiving Medicaid. Change in BMI z score from the beginning to the end of each of 2 academic years and the intervening summer was compared between groups by using piecewise linear mixed models adjusted for age, gender, and race/ethnicity. RESULTS: The total sample included 43,748 children providing 83,239 anthropometric measures. The Head Start sample was 64.9% white, 10.8% black, and 14.4% Hispanic; 16.8% of the children were obese and 16.6% were overweight at the initial observation. Children who entered Head Start as obese exhibited a greater decline in the BMI z score during the first academic year versus the comparison groups (ß = -0.70 [SE: 0.05] vs -0.07 [0.08] in the Medicaid group [P < .001] and -0.15 [SE: 0.05] in the Not Medicaid group [P < .001]); patterns were similar for overweight children. Head Start participants were less obese, less overweight, and less underweight at follow-up than children in the comparison groups. CONCLUSIONS: Preschool-aged children with an unhealthy weight status who participated in Head Start had a significantly healthier BMI by kindergarten entry age than comparison children in a primary care health system (both those receiving and those not receiving Medicaid).

Partnering to translate evidence-based programs to community settings: bridging the gap between research and practice.

Implementing evidence-based programming in diverse community settings is an essential translational research step to make effective programs widely accepted and accessible and thereby improve public health. This process is challenging and complex, yet there are few examples to guide the efforts. The authors present their experience as an example of using a university-community partnership approach to aid in translating an evidence-based program (EBP) into a small community setting as a resource for researchers and community partners wishing to implement evidence-based programming in community settings. The authors review the steps of systematic planning and client needs assessment to decide on an EBP: adapting the EBP to appeal to the community while maintaining program fidelity, building staff and organizational capacity, arranging for implementation and family engagement, and carrying out program evaluation. The study focuses on research-to-practice links and highlights each partner's role and activities in facilitating successful translation of an EBP to this community setting. The lessons learned and recommendations are also presented. Using partnerships to prepare community-based organizations to implement EBPs is a vital mechanism for bridging the discovery-delivery gap and moving toward real-world applications of research discoveries.