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Background. Chronic stress and depression disproportionately affect families experiencing poverty, and likely contribute to disparities in early childhood developmental outcomes. Developing strategies to address chronic stress and depression may help mitigate these disparities. Early Head Start (EHS) and Head Start (HS) programs provide an important platform to address the disproportionate burden of stress and mental health issues experienced by EHS/HS families. However, few low-literacy, broad, scalable interventions improve parents' knowledge and attitudes around these topics. Objectives. We examined parents' knowledge and attitudes regarding stress and depression before and after a train-the-trainer (TTT) intervention delivered to 28 EHS/HS agencies across the United States. Methods. Following a TTT workshop, 18 agencies chose to deliver the stress training to 1,089 parents and 5 chose to deliver the depression training to 670 parents. Participating parents completed paper assessments at baseline and 3 months following the training. Paired T-tests and chi-square analyses tested whether responses significantly improved over time. Results. At baseline, 37.2% of parents reported feeling stressed most of the time and 13.4% reported feeling depressed most of the time. Following the trainings and reinforcement activities, parents' knowledge, attitudes and self-reported behaviors significantly improved, including willingness to seek help for depression, avoidance of negative health-risk behaviors and utilization of healthy stress management practices. At follow up, 18.6% of parents reported feeling stressed most of the time and 11% reported feeling depressed. Conclusion. Findings suggest this low-literacy TTT approach is potentially a promising health promotion intervention with broad dissemination potential. [ABSTRACT FROM AUTHOR]

Purpose: Examine the effectiveness of the "Eat Healthy, Stay Active!" pilot program, a multisite, 6-month educational intervention to promote healthy nutrition and physical activity among Head Start staff, parents, and children.Design: Comparison of within-group preintervention and postintervention knowledge and behavior, along with anthropomorphic measurements.Setting: The study was conducted in a convenience sample of six large Head Start agencies in five states.Subjects: Participants included 496 staff, 438 parents, and 112 preschool children.Intervention: The 6-month intervention consisted of core trainings and reinforcing activities for staff and parents that aligned with children's curricula.Measures: Pre-post questionnaires and anthropometric measurements examined changes in body mass index (BMI), knowledge, and behaviors related to nutrition and physical activity.Analysis: Paired t-tests to compare preintervention and postintervention weights and BMI; multiple regression analyses to examine associations between weight changes and other covariates, including knowledge and behavior changes, controlling for sociodemographic variables.Results: Each group of participants demonstrated significant reductions in BMI (mean  =  30.1 to 29.2; p < .001 in adults and 17.0 to 16.6; p < 0.001 in children) and in the proportion of obese children (30% to 21%; p < .001) and adults (45% to 40%; p < .001). Child weight changes correlated with parent weight changes.Conclusion: This intervention showed promising initial results, with potential effectiveness as an intervention to promote healthier behaviors among adults and children in Head Start settings. [ABSTRACT FROM AUTHOR]