Healthy children for a lifetime of better health.
Canada’s children are falling behind their peers in other developed countries. One in four are overweight or obese. Thirty percent are at risk for cardiovascular disease in adulthood. And 25 percent of very young children are not even ready developmentally to start school. The burden of these issues is disproportionately experienced by children from low-income families, who are 70 percent more likely to be overweight or obese, and twice as likely to experience developmental vulnerabilities. Unchecked, these issues will have a major impact on chronic disease, economic productivity and wellbeing into adulthood.
Research has shown that enriching environments early in life – like those which encourage healthy eating habits, physical activity and social interaction – can protect against childhood obesity and enhance cardiometabolic health, mental health, child development and lifetime success. Access to quality childcare in the preschool years is key. Yet, for many low-income families, childcare is cost prohibitive. That means many families face difficult decisions in choosing between employment, childcare, shelter and nutritious food.
We think that centre-based childcare, starting at or before one year of age, will reduce childhood obesity and enhance cardio-metabolic health, mental health and child development. The NuRISH trial will leverage the proven clinical trial methods of TARGet Kids! (Canada’s largest, primary care research network that aims to improve health of Canadian children) to evaluate whether connecting families with centre-based childcare through the primary health-care system vs. usual care (i.e., whatever the family would have done had they not been involved in the trial) can improve the physical, mental and developmental health of preschool age children from low-income families.
600 healthy children from low-income households participating in 10 TARGet Kids! primary care practices will be individually randomized for the NuRISH trial. The 300 children in the intervention group will receive funded, centre-based childcare starting at or before one year of age. The 300 children in the control group will receive usual care.
HOW WE’LL MEASURE IMPACT
The primary outcome will be the impact on childhood obesity at two years of age. Secondary outcomes include cardio-metabolic risk factors including waist circumference, blood pressure, serum lipids, dietary intake and child development. A cost-effectiveness analysis will evaluate the monetary costs or gains from funded childcare.
WHY THIS MATTERS
Accessible childcare is a highly promising intervention to address inequities in childhood obesity, mental health and development. NuRISH will provide much needed evidence to inform policy decisions about centre-based childcare as a therapeutic intervention to improve health and productivity over the life course.