The keys to healthy family child care homes intervention: study design and rationale.




Østbye, Truls
Mann, Courtney M
Vaughn, Amber E
Namenek Brouwer, Rebecca J
Benjamin Neelon, Sara E
Hales, Derek
Bangdiwala, Shrikant I
Ward, Dianne S

Journal Title

Journal ISSN

Volume Title

Repository Usage Stats


Citation Stats


BACKGROUND: Obesity is a major public health problem for which early preventive interventions are needed. Large numbers of young children are enrolled in some form of child care program, making these facilities influential environments in children's development. Family child care homes (FCCH) are a specific type of child care in which children are cared for within the provider's own residence. FCCHs serve approximately 1.5 million children in the U.S.; however, research to date has overlooked FCCH providers and their potential to positively influence children's health-related behaviors. METHODS: Keys to Healthy Family Child Care Homes (Keys) is a cluster-randomized controlled trial testing the efficacy of an intervention designed to help providers become healthy role models, provide quality food- and physical activity-supportive FCCH environments, and implement effective business practices. The intervention is delivered through workshops, home visits, tailored coaching calls, and educational toolkits. Primary outcomes are child physical activity measured via accelerometry data and dietary intake data collected using direct observation at the FCCH. Secondary outcomes include child body mass index, provider weight-related behaviors, and observed obesogenic environmental characteristics. CONCLUSION: Keys is an innovative approach to promoting healthy eating and physical activity in young children. The intervention operates in a novel setting, targets children during a key developmental period, and addresses both provider and child behaviors to synergistically promote health.


Journal article





Children, Family child care homes, Obesity, Overweight, Randomized controlled trial, Accelerometry, Child Care, Child, Preschool, Diet, Exercise, Female, Health Behavior, Health Promotion, Humans, Infant, Male, Massage, Research Design, Sedentary Lifestyle, Self Efficacy, Single-Blind Method, Socioeconomic Factors, United States


Published Version (Please cite this version)


Publication Info

Østbye, Truls, Courtney M Mann, Amber E Vaughn, Rebecca J Namenek Brouwer, Sara E Benjamin Neelon, Derek Hales, Shrikant I Bangdiwala, Dianne S Ward, et al. (2015). The keys to healthy family child care homes intervention: study design and rationale. Contemp Clin Trials, 40. pp. 81–89. 10.1016/j.cct.2014.11.003 Retrieved from

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.



Rebecca Brouwer

Dir, Research Initiatives

My overarching goal is to facilitate effective research and collaborations for the Duke research community, through the delivery of targeted programs, tools, and individual consultations.

Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.