Summary: Communities for healthy living (CHL) – A family-centered childhood obesity prevention program integrated into Head Start services.

Why does obesity matter in preschool?

  • In the US, 13.9% of 2 – 5 year old children have obesity. (1)
  • Childhood obesity has substantial short- and long-term health consequences. (2) Contrary to popular belief, obesity in childhood increases the risk for obesity in adulthood; children don’t simply “grow out of it.”
  • Nutrition habits take shape early in life. (3) Early childhood is a critical period for promoting long-term health.

What is being done at the community level to address obesity among preschoolers?

Communities for Healthy Living (CHL) is an obesity prevention program created by Head Start staff and parents in the Greater Boston Area working in partnership with a research team from the Harvard T.H. Chan School of Public Health. The research team, led by Dr. Kirsten Davison, includes EVERGREEN member Jake Beckerman, other students, post-doctoral fellows, and professors from the Harvard T.H. Chan School of Public Health, and researchers from the University at Albany School of Public Health and Massachusetts General Hospital for Children.

The community-research partnership resulted in a program that takes into account the broader context of families – social, cultural, economic, etc. The partnership has also allowed CHL to be integrated into existing Head Start services, allowing families to benefit from CHL without going elsewhere or finding additional time in their busy schedules. A paper recently published in Contemporary Clinical Trials describes the full design of the CHL program, how it is hypothesized to promote healthy weight among preschoolers, and how it is being tested.

In brief, CHL has three main components. The first, Parents Connect for Healthy Living (PConnect), is a 10-week health and empowerment class for Head Start parents and caregivers. The class covers topics ranging from the child level (e.g., healthy eating recommendations for preschoolers) to the community level (e.g., parental advocacy), helping parents build knowledge and skills, expand their social networks, and connect to resources. Unlike many health education classes, which are led by researchers or other health professionals, PConnect is led by a Head Start staff member and a Head Start parent working together as a co-facilitation team. Training and supporting community members to lead PConnect is an important way that empowerment is built into CHL.

The other two CHL components are designed to build the capacity of Head Start programs to promote child health. CHL’s Enhanced Nutrition Support component includes training and resources to support Head Start staff when they communicate with parents about child health. CHL’s Media Campaign component includes print and electronic materials that Head Start programs can use to inform parents about the topics most important for healthy weight in preschoolers (e.g., nutrition, physical activity, sleep, screen time) and connect parents to resources in their communities.

Interested in learning more? Click here for a link to the full-text publication. 


Beckerman, J. P., Aftosmes-Tobio, A., Kitos, N., Jurkowski, J. M., Lansburg, K., Kazik, C., . . . Davison, K. K. (2019). Communities for healthy living (CHL) – A family-centered childhood obesity prevention program integrated into Head Start services: Study protocol for a pragmatic cluster randomized trial. Contemp Clin Trials, 78, 34-45. doi: 10.1016/j.cct.2019.01.002


1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity Among Adults and Youth: United States, 2015-2016. NCHS Data Brief. 2017;(288):1-8. Accessed October 5, 2018.
2. Daniels SR. The consequences of childhood overweight and obesity. Futur Child. 2006;16(1):47-67. Accessed December 14, 2018.
3. Beckerman JP, Alike Q, Lovin E, Tamez M, Mattei J. The Development and Public Health Implications of Food Preferences in Children. Front Nutr. 2017;4:66. doi:10.3389/fnut.2017.00066.