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Color Me Healthy

Evidence Summary

Underlying Theory: Color Me Healthy (CMH) uses the individual, inter-personal and organizational levels of the Socioecologic Model and constructs from the Social Cognitive

Theory including: behavioral capability, outcome expectancy, outcome expectation, observational learning, reinforcement, social support and reciprocal determinism.

Strategies Used: Color Me Healthy includes strategies for healthy eating and physical activity that have been adapted to child care settings, including:

  • School-based Physical Activity and Physical Education also applies to childcare settings; the Color Me Healthy curriculum includes opportunities for the children to be active by dancing, as well as lessons about why it’s important for kids to be active. Parents also receive information about physical activity via parent newsletters and website content.
  • School-based Nutrition Programs to Promote Healthy Eating also applies to childcare settings; the Color Me Healthy curriculum emphasizes choosing fruits and vegetables, as well as general lessons about healthy eating. Parents also receive information about healthy eating via parent newsletters and website content. 

Research Findings and Evaluation Outcomes: Color Me Healthy was developed in the field and its efficacy was evaluated as a randomized controlled trial, with random assignment at the child care center level.  The intervention group consisted of 10 child care centers (n=165), while the comparison group comprised of 7 child care centers (n=98); all study sites were based in Boise, Idaho. The main outcome was fruit and vegetable snack consumption of the children; however, process evaluation data were also collected, such as children’s attendance and teacher surveys to assess perceptions of fruit and vegetable snack acceptability among children. 

Children were given fruit and vegetable snacks at three time points - 1 week before the CMH program was implemented, then at 1 week and 3 months after program completion.  As a snack, children were provided 1 cup of mixed fresh fruit or 1 cup of mixed fresh vegetables.  Measurement of snack consumption included weighing of the snack prior to being served to children and again after the children had the opportunity to consume the snack.  Teachers were instructed to avoid encouragement or commenting about the snacks to the children.

Intervention Effect (fruit & vegetable behavior): When presented with a fruit or vegetable snack, children who participated in the CMH program significantly increased fruit snack consumption by approximately 21% and vegetable snack consumption by about 33% within their child care centers, from baseline to 3-months after completion of the CMH program (p<0.001).

Intervention Effect (child care providers’ perceived impact):  Teacher surveys were completed by all 10 lead teachers who implemented the CMH program.  Ninety percent thought the children were more willing to try new foods and the children were consuming more fruits and vegetables, while all the teachers reported improved fruit and vegetable recognition, since program initiation.

Practice-based data that were available for this review show similar results in child care providers’ perceived impact (Dunn et al., 2006).  Eight-week follow-up surveys were completed by child care providers from 47 counties and the Cherokee reservation in North Carolina, who attended a CMH training (n = 486).  Of those participants, 92% perceived an increase in physical activity of the children in their care, while 92% indicated that the CMH program increased the children’s knowledge about movement.  In addition, 93% perceived that using the CMH program increased the children’s knowledge about healthy eating, while 79% indicated that the children were more willing to try new foods and 82% reported that the curriculum had improved fruit and vegetable recognition.

Data on changes in physical activity or any behaviors outside of the child care setting among children involved in the study were not available at the time of this review.