My Baby, My Move+


woman and man hugging

My Baby, My Move+ (MBMM+, 2019-2021) is a peer-led wellness intervention which aims to reduce excessive gestational weight gain (EGWG) by targeting prenatal physical activity, mood, and sleep quality. Up to 50% of pregnant women in the U.S. gain weight in excess of the Institute of Medicine guidelines. EGWG leads to poor maternal and child outcomes. It also sets the stage for long-term overweight/obesity for both mother and child.

A pilot randomized controlled two arm trial (MBMM+ intervention; Baby Basics program) will be conducted. Up to 100 pregnant women (50 intervention arm, 50 control arm) will be recruited from the Denver Metro and surrounding areas. Women in the intervention arm will participate in the 12-week MBMM+ intervention. The intervention will be offered both virtually and in-person. The overall goal of the MBMM+ intervention is to instill healthy habits (e.g., physical activity, good sleep hygiene, stress management) during and beyond pregnancy. Findings from this study will be used to inform a future, larger randomized trial.

PI: Dr. Jenn Leiferman
Program Director: Dr. Charlotte Farewell

Integrated Nutrition Education Program


Child reaching to grab strawberries off of the kitchen counter

The Integrated Nutrition Education Program (INEP) is a creative and fun way for kids to learn about healthy eating in their classroom and to share what they learn with their families. Each lesson includes a hands-on cooking activity that teaches students how to prepare and taste new fruits and vegetables. INEP is funded by SNAP-Ed and conducted through partnerships with the University of Colorado and various school districts and schools from around the state. 

INEP’s goal is to instill life-long nutrition behaviors to prevent obesity, type 2 diabetes, cancer, and heart disease. To accomplish this goal, INEP targets increased fruit and vegetable consumption, overall healthy eating, children’s willingness to try new foods and increased physical activity. 

PI: Dr. Jini Puma
Program Director: Divyani Pendleton
Biostatistician: Sharon Scarbro

For more information, please visit the RMPRC school wellness programs website.

INEP

Culture of Wellness in Preschools


Child swinging on a swing

Childhood obesity has more than doubled in the past thirty years (Ogden, Carroll, Kit, & Flegal, 2014) with low-income and ethnic minority children being disproportionately affected (Wang & Beydoun, 2007). Early childhood is a critical time to combat the childhood obesity epidemic for two reasons: 1) early development of basic motor skills, which are linked to later physical activity levels (Goodway, Robinson, & Crowe, 2010), begin in early childhood; and 2) food- and nutrition-related attitudes, preferences, and behaviors are developed during these formative years (Birch & Sullivan, 1991). Children who are obese in their preschool years are more likely to be obese in adolescence and adulthood (Sharma et al., 2009) and to develop diabetes, hypertension, hyperlipidemia, asthma, and sleep apnea (Krebs et al., 2007). As such, prevention and early intervention are key and are a public health priority (Larson, Ward, Neelon, & Story, 2011). COWP is a comprehensive and collaborative early childhood obesity program, which aims to promote a “culture of wellness” in preschool settings by increasing fruit and vegetable consumption and physical activity levels. This is accomplished by bringing the following to preschool sites throughout Colorado:

  • Classroom-based nutrition education
  • Preschool physical activity professional development program
  • Parent wellness workshop series
  • Staff workplace wellness program
  • A strategic planning process to make health-promoting policy, system and environment
    changes

All program components are evidence-based or promising practices. From its inception, Culture of Wellness in Preschools (COWP) has reached 40,000 students, parents and teachers, 150 low-income preschools and early childhood education centers, and 14 Colorado counties.

PI: Dr. Jini Puma

Program Director: Deanna LaFlamme

Biostatistician: Sharon Scarbro

For more information, please visit the RMPRC school wellness programs website.

culture of wellness in preschools chart

Text2LiveHealthy


Various text messages on phone

Text2LiveHealthy (T2LH) is a nutrition and physical activity digital health outreach effort that links existing INEP and COWP youth nutrition and physical activity education provided in the classrooms to the home via text messaging in order to influence behavior change for Supplemental Nutrition Assistance Program (SNAP) eligible families across Colorado.

This program was created based on the Theory of Planned Behavior. Subscribers receive 2-3 text messages per week, sent in English or Spanish, depending on the language preference on the following core themes: increasing consumption of fruits and vegetables, increasing physical activity, increasing consumption of water and decreasing consumption of sugar sweetened beverages. Each messaging cycle consists of 30 core messages and supplemental local messages. After each theme, evaluation questions are sent out via text to determine the impact of the texts on subscribers’ goal setting and health behaviors. Quantitative and qualitative evaluation results demonstrate a positive impact of subscribers, with a significantly greater impact on Spanish speaking subscribers.

T2LH is currently in Year 3 of implementation, with a reach of over 3,000 participants. There are several partnerships underway to adapt Text2LiveHealthy for the older adults and their caregivers, the Lakota tribal community, Colorado refugee and tribal communities, as well as partnerships with states and agencies receiving SNAP-Ed funding.

PI: Dr. Jini Puma

For more information, please visit the Text2LiveHealthy website.

Enhancing Patient-Provider Communication: Identification and Treatment of Perinatal Mood Disorders


woman wearing a surgical mask holding a newborn baby

Utilizing online technology to improve provider-patient communication on prenatal mood disorders

Prenatal depression is associated with numerous, deleterious maternal and child health outcomes. Pregnant women have expressed a need for help in identifying and treating their depressive symptoms. Healthcare providers play a significant role in managing (i.e. identifying and treating/referring to care) prenatal depression as they are often the sole exposure to mental health resources for women. However, many providers may not be meeting these recommendations. Identifying women who are exhibiting depressive symptomatology and providing guidance based on evidence-based practices and/or utilizing linkages to mental health specialists are all integral to providing optimal patient-centered care. This study will conduct a pilot, randomized-controlled trial to test the preliminary effects of an online training with a diverse group of providers on the management of prenatal depression.   

The present study intends to test an evidence-based, online training for a diverse group of providers on how to manage prenatal depression. Providers will be recruited from two states, Colorado and Virginia.   

Our online training provides an overview of the harmful effects of prenatal depression on numerous maternal and child outcomes, as well as provides a framework that uses the 5As model (i.e. Assess, Advise, Agree, Assist and Arrange) to teach providers how to 1) assess for depression, 2) advise the patient on treatment options, 3) agree on a treatment plan, 4) assist patient in any problem solving related to obtaining treatment, and 5) arrange for supports for the patient (e.g. link patients to mental health resources in the community).   

PI: Dr. Jenn Leiferman

Research Coordinator: Angela Lee-Winn

 

For more information, see the AHRQ study flyer.

Fostering Resilience Among Mothers Early


Past research suggests that maternal depression during the pre- and post-natal periods is positively associated with obesity in early and middle childhood; however, the findings vary by timing and duration of exposure. Additionally, not all mothers suffering from depression will experience the same detrimental maternal and child health outcomes. Internal and external factors foster resilience, or positive adaptation to adversity, and can promote maternal mental health during these early critical periods.

Consideration of the determinants of obesity within a broader multi-level framework emphasize the upstream influences of maternal mental health and resilience beginning very early in the life course. The FRAME project will have significant impacts on women’s health. If accumulation of maternal depression from the prenatal period through five-years of age is more predictive of childhood development outcomes compared to exposure solely during the prenatal period, the Life Course Health Development model can be used to explicate the ways in which adversity and resilience may aggregate over time and affect the intergenerational transmission of poor mental health. Additionally, findings may strengthen and expand evidence-based research related to mental health by targeting internal and external resilience supports for mothers.

PI: Dr. Charlotte Farewell

Fostering Resilience in Early Education Program


nurse holding a baby

Working in early childhood education (ECE) settings is a stressful profession and ECE teachers face significant challenges including low pay and poor working conditions. ECE teachers are also disproportionately impacted by mental and physical health outcomes. For example, the rates of depression with ECE teachers is three times the national average. The Fostering Resilience in Early Education (FREE) program is a two-generation, two-component ECE center-based intervention focused on ensuring that ECE teachers have access to workplace supports that improve their well-being, in turn promoting high-quality relationships with the children in their care and fostering resilience. Two evidence-based strategies will be implemented:

FREE Component 1: ECE Teacher-Focused Intervention

Teachers will have the opportunity to participate in an evidence-based strategic planning process to implement policy, system, and environment (PSE) changes that promote ECE teacher well-being in their workplaces. An example of a systems-level change is hosting a center-specific Adverse Childhood Experiences (ACEs) training to understand the impact of teachers’ own experiences and self-awareness on their teaching practice.

FREE Component 2: ECE Child-Focused Intervention

Follow-up coaching sessions will be adapted from the evidence-based Kindness Curriculum, which highlights the importance of ECE teachers’ well-being in the development and maintenance of supportive teacher-student relationships. Evidence suggests that implementation of this curriculum results in improvements in multiple domains of child development, thus fostering resilience among preschool-aged children.

PI: Drs. Charlotte Farewell and Jini Puma

Program Manager: Emily Maiurro

Prevention of Adverse Childhood Experiences (ACEs)


Positive Activities Lead to Success Logo

The Colorado Department of Health and Environment (CDPHE) Positive Activities Lead to Success (PALS), and the Rocky Mountain Prevention Research Center (RMPRC) are collaborating to reduce the impact of ACEs and mental health illnesses in the San Luis Valley. PALs is a licensed after-school and summer children program for children ages 5 to 10 combating instability in their home. The mission of PALS is to provide children who have experienced trauma and ACEs a structured environment. The environment of PALS supports social-emotional learning, creativity, exploration, and nurture.

This collaboration between CDPHE, PALs, and the RMPRC aims to achieve three main goals. First, PALs will provide a modified, intense version of their program. This intensified version will provide increased one-on-one time for the children with a PALS’s staffer. Second, PALs will host monthly workshops for parents in the San Luis Valley (SLV) with each focused on different topics including parenting knowledge, skillsets, competence, and emotional regulations. Third, PALs will connect parents who experienced high ACEs/mental health illnesses to behavioral health telemedicine at The Children’s Hospital in Aurora, Colorado. While PALs will be implementing these three goals, the RMPRC will conduct a program evaluation where the team will evaluate both the intensified program and monthly workshops, as well as evaluating the impact of the behavioral telehealth medicine on the parents.

PI: Dr. Jenn Leiferman