Background: Commercial off-the-shelf activity trackers (eg, Fitbit) allow users to self-monitor their daily physical activity (PA), including the number of steps, type of PA, amount of sleep, and other features. Fitbits have been used as both measurement and intervention tools. However, it is not clear how they are being incorporated into PA intervention studies, and their use in specific age groups across the life course is not well understood. Objective: This narrative review aims to characterize how PA intervention studies across the life course use Fitbit devices by synthesizing and summarizing information on device selection, intended use (intervention vs measurement tool), participant wear instructions, rates of adherence to device wear, strategies used to boost adherence, and the complementary use of other PA measures. This review provides intervention scientists with a synthesis of information that may inform future trials involving Fitbit devices. Methods: We conducted a search of the Fitabase Fitbit Research Library, a database of studies published between 2012 and 2018. Of the 682 studies available on the Fitabase research library, 60 interventions met the eligibility criteria and were included in this review. A supplemental search in PubMed resulted in the inclusion of 15 additional articles published between 2019 and 2020. A total of 75 articles were reviewed, which represented interventions conducted in childhood; adolescence; and early, middle, and older adulthood. Results: There was considerable heterogeneity in the use of Fitbit within and between developmental stages. Interventions for adults typically required longer wear periods, whereas studies on children and adolescents tended to have more limited device wear periods. Most studies used developmentally appropriate behavior change techniques and device wear instructions. Regardless of the developmental stage and intended Fitbit use (ie, measurement vs intervention tool), the most common strategies used to enhance wear time included sending participants reminders through texts or emails and asking participants to log their steps or synchronize their Fitbit data daily. The rates of adherence to the wear time criteria were reported using varying metrics. Most studies supplemented the use of Fitbit with additional objective or self-reported measures for PA. Conclusions: Overall, the heterogeneity in Fitbit use across PA intervention studies reflects its relative novelty in the field of research. As the use of monitoring devices continues to expand in PA research, the lack of uniformity in study protocols and metrics of reported measures represents a major issue for comparability purposes. There is a need for increased transparency in the prospective registration of PA intervention studies. Researchers need to provide a clear rationale for the use of several PA measures and specify the source of their main PA outcome and how additional measures will be used in the context of Fitbit-based interventions.

Background/Objectives: Preschool children from low-income, ethnically diverse communities face disproportionate rates of behavioral challenges and early expulsion from early care and education (ECE) programs. This study evaluated the efficacy, feasibility, and utility of Jump Start on the Go (JS Go), a bilingual, AI-enabled mobile application. JS Go is designed to deliver a 14-week early childhood mental health consultation model in under-resourced ECE settings. Methods: This mixed-methods study compared JS Go to the standard in-person Jump Start (JS) program. Participants included 28 teachers and 114 children from six centers (three JS Go, three JS). Quantitative measures assessed teacher classroom practices and child psychosocial outcomes at baseline and post-intervention. App usability and acceptability were only evaluated post-intervention. Seven semi-structured interviews were conducted post-intervention with JS Go directors/teachers to assess the app’s feasibility for implementing the four program pillars: safety, behavior support, self-care, and communication. Results: JS Go was more effective than JS in promoting teacher classroom practices related to behavior support and resiliency. Both programs were similar in improving children’s protective factors and reducing internalizing behaviors, with consistent effects across English and Spanish-speaking children. Teachers rated the JS Go app with high acceptability, though predicted future usage showed greater variability. Rapid qualitative analysis showed that participants found the app easy to use, frequently accessed its resources, and considered it helpful for reinforcing key strategies across the four program pillars. Conclusions: JS Go is a novel approach to providing mental health consultation. It represents a promising mobile adaptation of the established JS consultation model, with important implications for future practice and research.

Background/Objectives: High-quality inclusive education is important for promoting the positive development of children with disabilities in early childhood care and education (ECCE) settings. However, ECCE teachers may not have the knowledge and skills to manage challenging behaviors in young children, especially those with disabilities. Infant and Early childhood mental health consultation (IECMHC) is one mechanism to support the professional development of teachers. This study explored the impact of an evidence-based IECMHC program, Jump Start Plus COVID Support (JS+CS), on outcomes for teachers in classrooms including children with disabilities. Methods: Utilizing a RE-AIM framework, we examined the extent that JS+CS impacted teacher outcomes related to classroom practice and teacher attitudes after the initial intervention period. In addition, we examined the extent that the classroom children with disability ratio moderated the impact of the intervention on teacher outcomes. Using a cluster randomized controlled trial in a sample of 138 racially and ethnically diverse teachers in 31 ECCE centers, we examined the reach, effectiveness, adoption, and implementation of JS+CS. Results: The results indicate that the JS+CS program shows promise as an intervention to support ECCE teachers working in classrooms with children with disabilities, particularly in improving teacher safety practices, behavior management skills, and resiliency coping. In addition, the program was adopted equally in classrooms that served children with and without disabilities. Conclusions: This is a unique contribution to the literature given that no previous IECMHC programs have examined adoption in classrooms serving children with disabilities. Further investigation is needed to determine the specific factors that impact program implementation considering that this study was conducted during various phases of the COVID-19 pandemic.

One in five preschool-aged children in the United States is obese, and children with disabilities are significantly impacted. This study aimed to determine the association between age at solid food initiation and obesity prevalence in preschool-aged children while considering disability status, ethnicity, gestational age, and birth weight. Analysis was conducted on a sample of 145 children aged 2 to 5 years who were enrolled in ten childcare centers. Parents completed a survey assessing disability status, race and ethnicity, birth weight, gestational age, and age of solid food initiation. Height and weight were collected concurrently. Multivariable logistic regression models generated the odds of developing obesity based on age at solid food initiation, disability status, ethnicity, gestational age, and birth weight. There was no significant difference in the odds of being obese based on age at solid food introduction. Children with disabilities (OR = 0.17, 95% CI 0.04–0.6, p = 0.01) and children born preterm (OR = 0.28, 95% CI 0.08–0.79, p = 0.03) had significantly lower odds of being obese. Hispanic children (OR = 4.93, 95% CI 1.91–15.32, p = 0.002) and children with higher birth weights (OR = 1.47, 95% CI 1.17–1.92, p = 0.002) were more likely to be obese. With pediatric obesity rates continuing to rise, these findings can inform future intervention efforts.

Background/Objectives: Early care and education programs promote children’s social–emotional development, predicting later school success. The COVID-19 pandemic worsened an existing youth mental health crisis and increased teacher stress. Therefore, we applied an infant and early childhood mental health consultation model, Jump Start Plus COVID Support (JS+CS), aiming to decrease behavioral problems in children post-pandemic. Methods: A cluster randomized controlled trial compared JS+CS to an active control, Healthy Caregivers–Healthy Children (HC2), at 30 ECE centers in low-income areas in South Florida. Participants were not blinded to group assignment. Teachers reported on children’s social–emotional development at baseline and post-intervention using the Devereux Early Childhood Assessment and Strengths and Difficulties Questionnaire. We assessed whether teacher stress, classroom practices, and self-efficacy mediated the relationship between JS+CS and child outcomes. We also explored whether baseline behavior problems moderated JS+CS effects on child protective factors, relative to HC2. Results: Direct group-by-time differences between JS+CS and HC2 were limited. However, JS+CS demonstrated significant within-group improvements in teacher-reported child protective factors, behavior support practices, and classroom safety practices. Classroom safety practices consistently mediated positive changes in child behaviors, including the DECA total protective factor score and subdomains of initiative and self-regulation. Additionally, teacher perceptions of behavior support mediated gains in child attachment. Conclusions: JS+CS shows promise in building protective systems around children through intentional support for teachers, underscoring the value of whole-child, whole-environment approaches in early intervention.