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.

High-quality early care and education (ECE) programs, characterized by safe environments, emotionally supportive communication, proactive behavior supports, and teacher self-care practices, play a pivotal role in healthy child development. Early Childhood Mental Health Consultation (ECMHC) is an evidence-based approach designed to strengthen these environments and support young children’s social–emotional outcomes. However, the long-term impacts of ECMHC models remain understudied. Grounded in ECMHC, the purpose of this study is to evaluate the effectiveness of Jump Start Plus COVID Support (JS+CS) in supporting child psychosocial outcomes (prosocial behaviors and reduced externalizing/internalizing behaviors) over two school years. In a cluster-randomized trial, 12 ECE centers received the 14-week JS+CS intervention, and 12 attention control centers received a 14-week obesity prevention program. Children were followed over two school years to determine long-term impacts on behavior, measured by the Devereux Early Childhood Assessment (DECA) and the Strengths and Difficulties Questionnaire (SDQ). Over two school years, significant time-by-group interactions emerged for primary child outcomes. The JS+CS group showed greater improvements in DECA Initiative and Self-Regulation (p = 0.01 and p = 0.02, respectively) compared to controls. JS+CS significantly enhanced child psychosocial functioning, supporting its potential as an effective model for a scalable mental health consultation in ECE settings.

Childcare centers (CCCs) can provide opportunities to implement physical activity (PA) via health promotion interventions to prevent obesity and associated chronic disease risk factors in young children. This study evaluated the impact of the Healthy Caregivers-Healthy Children (HC2) intervention on body mass index percentile (PBMI) and the PA environment in CCCs serving children with disabilities (CWD) over one school year. Ten CCCs were cluster-randomized to either (1) an intervention arm that received the HC2 curriculum adapted for CWD or (2) an attention control arm. Mixed-effect linear regression models analyzed the relationship between change in child PBMI and CCC childcare center PA environment by experimental condition and child disability status over one school year. Findings showed a significant decrease in PBMI among children in the HC2 centers (−6.74, p = 0.007) versus those in control centers (−1.35, p = 0.74) over one school year. Increased PA staff behaviors (mean change 3.66, p < 0.001) and PA policies (mean change 6.12, p < 0.001) were shown in intervention centers during the same period. Conversely, there was a significant increase in sedentary opportunities (mean change 4.45, p < 0.001) and a decrease in the portable play environment (mean change −3.16, p = 0.03) and fixed play environment (mean change −2.59, p = 0.04) in control centers. No significant differences were found in PBMI changes between CWD and children without disabilities (beta = 1.62, 95% CI [−7.52, 10.76], p = 0.73), suggesting the intervention’s efficacy does not differ by disability status. These results underscore the importance of (1) including young CWD and (2) PA and the supporting environment in CCC health promotion and obesity prevention interventions.

Early Childhood Mental Health Consultation (ECMHC) promotes children’s social–emotional development and reduces challenging behaviors in early care and education (ECE) centers, yet implementation barriers increase teacher stress and reduce confidence. Scalable, efficient, and accessible approaches are needed to meet ECE center demands. This quasi-experimental match-controlled study evaluated two ECMHC programs in promoting children’s social–emotional development and improving teachers’ skills/attitudes compared to an attention control condition in 22 ECE centers in lower-resourced areas of BLINDED. We compared Jump Start (JS; traditional human consultation model), Jump Start Go (JS Go; AI-enhanced consultation model), and Healthy Caregivers–Healthy Children (HC2; obesity-prevention consultation model). Child social–emotional development, teacher workplace stress/confidence, and classroom practices were assessed at pre-and post-intervention. Children in JS and JS Go interventions demonstrated significant social–emotional gains (F = 13.55, p < 0.001), with the largest reductions in internalizing problems observed in children who received JS Go (−2.91 points; F = 9.65, p < 0.001). JS Go classrooms also showed greater improvements in prosocial behavior (F = 5.05, p = 0.012) and resiliency (F = 8.95, p < 0.001) than HC2 classrooms. Findings suggest that both traditional and AI-enhanced ECMHC approaches can promote teachers’ capacity to support children’s social–emotional development.