HOP'N Home: Intervention description and process evaluation of a childhood obesity prevention project

Background: Home environments are critical settings to prevent obesity in children. The Healthy Opportunities for Physical Activity and Nutrition (HOP'N) Home project linked child care settings to home environments by developing children's asking skills for healthful home environmental change through curricular activities. Purpose: The primary aim of this study was to describe the intervention and process evaluation of the project-based learning HOP'N Home project in children 3-to-5 years-of-age. Methods: Informed by Social Cognitive Theory, HOP'N Home consisted of continuous teacher training to implement quality elements: group time activities, dramatic play, meal prompts, musical social narratives, and a weekly home connection activity. Two full-day preschool classrooms were randomized to receive the 12-week HOP'N program (n=12) or serve as control (n=12). Classrooms were observed four days, and teachers completed weekly checklists assessing implementation. Parental surveys evaluated receipt/use of intervention. Results: Teachers were successful at implementing quality elements. Parents reported making changes in their home (91%), being satisfied with HOP'N (91%), and receiving HOP'N materials (100%). Many parents reported children asked to do an active activity after school (55%), and eat healthy breakfast food (55%) at least three days per week. Fewer parents reported that children asked to do an inactive activity (36%), or to eat unhealthy food (18%). Parents reported providing healthy (100%) or unhealthy foods (36%), and active (82%) or inactive (46%) opportunities, after child asked. Conclusions: HOP'N Home was a novel intervention to impact home environments through preschool settings, and equipping children to influence parents toward environmental change at home.