SI! Program for Cardiovascular Health Promotion in Early Childhood

Summary

The SI! Program (Salud Integral–Comprehensive Health) is a preschool-based health education intervention delivered at Head Start preschools in Harlem, New York. The goal of the intervention was to improve children’s knowledge, attitudes, and habits related to diet, physical activity, body/heart awareness, and emotion management. The intervention was delivered by trained teachers over a 4-month period, with 37 hours of content. Compared with the control group, children’s knowledge, attitudes, and habits scores were 2.2 times higher in the intervention group.

Overview

Purpose of Intervention:

The SI! Program (Salud Integral–Comprehensive Health) is a multilevel and multicomponent school-based intervention for the promotion of cardiovascular health, aimed at achieving lasting lifestyle changes among preschool-age children.

Intervention Type:

Research-Tested — Interventions with strong methodological rigor that have demonstrated short-term or long-term positive effects on one or more targeted health outcomes to improve minority health and/or health disparities through quantitative measures; Studies have a control or comparison group and are published in a peer-review journal; No pilot, demonstration or feasibility studies.

Intervention Details

Intervention was Primarily Driven, Led, or Managed by:

Academic/Clinical Researchers Only

Citations:

Fernandez-Jimenez R, Jaslow R, Bansilal S, Santana M, Diaz-Munoz R, Latina J, Soto AV, Vedanthan R, Al-Kazaz M, Giannarelli C, Kovacic JC, Bagiella E, Kasarskis A, Fayad ZA, Hajjar RJ, Fuster V. Child Health Promotion in Underserved Communities: The FAMILIA Trial. Journal of the American College of Cardiology. 2019 Apr 30;73(16):2011-2021. PubMed DOI

Adaptation of Another Research-based Intervention:

Yes

Name of Original Intervention:

Colombian Initiative for Healthy Heart Study

URL to original Intervention:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365993/

Citations:

Céspedes J, Briceño G, Farkouh ME, Vedanthan R, Baxter J, Leal M, Boffetta P, Woodward M, Hunn M, Dennis R, Fuster V. Targeting preschool children to promote cardiovascular health: cluster randomized trial. The American journal of medicine. 2013 Jan;126(1):27-35.e3. Epub 2012 Oct 9. PubMed PubMed Central DOI
Peñalvo JL, Santos-Beneit G, Sotos-Prieto M, Bodega P, Oliva B, Orrit X, Rodríguez C, Fernández-Alvira JM, Redondo J, Vedanthan R, Bansilal S, Gómez E, Fuster V. The SI! Program for Cardiovascular Health Promotion in Early Childhood: A Cluster-Randomized Trial. Journal of the American College of Cardiology. 2015 Oct 6;66(14):1525-1534. PubMed DOI

Intervention Primary Outcomes were comparable to the original:

Yes

Contact Information

Primary Contact Affiliation:

Icahn School of Medicine at Mount Sinai, New York, New York

Intervention URL:

https://www.sciencedirect.com/science/article/pii/S0735109719336903?via%3Dihub

Results

Intention

Improve minority health or the health of other populations with health disparities (e.g. rural populations, populations with low SES)

Intervention Primary Outcome:

Overall knowledge, attitudes, and habits

Intervention Secondary Outcome:

Emotion comprehension and change in body mass index

Key Findings:

Mean relative change from baseline in the overall knowledge, attitudes and habits (KAH) score was ∼2.2 fold higher in the intervention group (average absolute difference of 2.86 points; 95% confidence interval: 0.58 to 5.14; p = 0.014). Maximal effect was observed in children who received >75% of the curriculum. Physical activity and body/heart awareness components, and knowledge and attitudes, were the main drivers of the effect (p values <0.05). Changes in emotion comprehension trended toward favoring intervened children.

Statistical Method Used:

Multilevel linear mixed-effects models that account for the hierarchical cluster randomized design were used to test for the adjusted intervention effect

Was statistical method used to analyze data from original Intervention comparable to the original:

Yes

Demographic and Implementation Description

Diseases, Disorders, or Conditions:

Cardiovascular Diseases

Race/Ethnicity:

African American or Black, Hispanic or Latino

Populations with Health Disparities:

People with Lower Socioeconomic Status (SES), Racial and Ethnic Minority Populations

Age:

Children (1 - 9 years)

Characteristics and Implementation

Intervention Focus Area:

Behavior Change

Disease Continuum:

Primary Prevention

Delivery Setting:

Daycare / Preschool

Mode of Delivery:

In-person

Who delivered the Intervention?:

Skilled Professional (n/a)

Adaptations and Modifications

Were modifications made?

Intervention Elements	Modified
Content	Yes
Context	No
Implementation	No
Funding	No
Organization	No
Participants	No
Providers	No
Sociopolitical	No
Stages of Occurrence	Yes

Impact, Lessons, Components

Produced an impact or change beyond the primary or secondary outcome:

No

Essential Aspects for Success:

There might be teacher-related factors affecting implementation and efficacy of school-based health promotion programs which warrants future research. Teachers are one of the cornerstones in children’s behavior development as they educate and shape views and habits, especially in preschool children.

Products, Materials, and Funding

Expertise, Partnerships, and Funding Sources

	Used for Implementation	Needed for Sustainability
Expertise
Health Education / Health Literacy	Yes	Yes
Partnerships
School system (e.g. school administrators, health educators, daycares, preschools, private & public schools)	Yes	Yes
Funding Sources
Private funding (e.g., foundations, corporations, institutions, facilities)	Yes	Yes

Product/Material/Tools

	Tailored For Language	Language(s) if other than English	Material
Outreach/Recruitment Tools
Videos	Yes	Spanish	Please contact the researcher directly to inquire about this material.
Participant Educational Tools
Questionnaires	Yes	Spanish	Please contact the researcher directly to inquire about this material.
Measurement Tools
Standardized Instrument/Measures	Yes	Spanish	Please contact the researcher directly to inquire about this material.

Implementation Materials and Products

	Material
Implementation/Delivery Materials
Curricula	Attachment available for request at the bottom of the page.
Implementation/Output Materials
No Implementation/Output Materials provided.

Articles Related to Submitted Intervention

	Article
Reports/Monographs
No Reports/Monographs provided.
Additional Articles
Qualitative findings	Attachment available for request at the bottom of the page.
Qualitative findings	Attachment available for request at the bottom of the page.
Qualitative findings	Attachment available for request at the bottom of the page.
Methodology	Attachment available for request at the bottom of the page.
Qualitative findings	Attachment available for request at the bottom of the page.
Methodology	Attachment available for request at the bottom of the page.
Qualitative findings	Attachment available for request at the bottom of the page.

Materials Available for Request

FAMILIA Project- Body and Heart unit sample.pdf
Peñalvo et al 2013B_1year results.pdf
Fernandez-Jimenez 2019 FAMILIA results.pdf
Céspedes et al. 2013A_FU1.pdf
Peñalvo et al 2013A_design.pdf
Peñalvo et al. JACC 2015.pdf
Rationale and Design of FAMILIA_AHJ 2017.pdf
Céspedes et al. 2013B_3years results.pdf

Intervention IP-059: SI! Program for Cardiovascular Health Promotion in Early Childhood