Children’s Lifestyle, Diet & Exercise Intervention (CHILDREN)

Our continuing goal at the Children program of Mount Sinai Heart at Icahn School of Medicine is to promote cardiovascular health in the five boroughs of New York city’s tiniest hearts by providing children with the knowledge and skills to avoid cardiovascular risk factors throughout their lives. Our pioneering educational initiate will administer a heart-health curriculum called the SI! Program (SaludIntegral)to children ages four to five covering the topics of Healthy Diet, Body and Heart, Physical Activity, and Emotional Management. Our team will train teachers on the materials and provide monitoring and support throughout the four-month school-based intervention.

This project, launched in the winter of 2020, aims to reduce the epidemic of childhood obesity and better understand how child behavior and environment intersect to contribute to cardiovascular disease in our communities. Growing evidence implicates an unhealthy lifestyle in childhood as a major contributor to health loss and disease in adulthood. By providing comprehensive preventative techniques, including an innovative curriculum unit on Emotional Management,we want to reduce each child’s future risk of obesity, heart disease, stroke, and type 2 diabetes and create a family and community-based “culture of health”.

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Putting into action the insights developed over 10 years of Heart Health Education with the SI! (Salud Integral) Program in Colombia, Spain, and Harlem, NYC, the Childrenprogram aims to provide a comprehensive health curriculum to almost 2000 kindergartens throughout the five boroughs of NYC. This multi-level health promotion will feature a new implementation design including a re-intervention at 2nd grade, analysis of the socioeconomic background, and evaluation of teacher motivation and stress. Building on past evidence and experience will serve to improve the sustainability of our program, encourage scaling-up of health education interventions, and provide much-needed data on the educational environments of NYC schools.

In addition to directly helping children and their families, we are also conducting research. Over time, our investigators will measure the effects of early childhood heart health education through qualitative and quantitative assessment tools. Our ultimate hope is not just to instill heart-healthy habits in children, their parents/caregivers, and their teachers, but also to encourage further preventative early childhood health education.

How We Began

The Children program began in the winter of 2020 for a Pilot study in five NYC public schools. In fall of 2021, the full study will launch, initially recruiting in Manhattan before expanding to all five boroughs. However, our background in childhood health interventions goes back much further. The Children program applies evidence-based practices developed over decades of past research led by our principal investigator Dr. Fuster. The project builds upon the success of the FAMILIA Project in Harlem and similar programs in Bogota, Colombia, and throughout Spain. The American Heart Association (AHA) recognized Dr. Fuster’s successful research findings as one of the top 10 research advances of 2013. After years of further research, Dr. Fuster continues to push for community health and preventative medicine through the work in the The Children’s Lifestyle, Diet & Exercise Intervention. The SI! NYC-CHILDREN PROGRAM is a multi-faceted program designed to promote cardiovascular health across the five boroughs of NYC. Taking a school-based approach, we are working to develop a culture of health in our community.

Child Interventions

Our four-month kindergarten intervention, geared to four- to five-year-olds, is a multiplatform curriculum constructed to engage young children and their families. It contains five units, each with audiovisuals, interactive materials, and art/play-based learning activities:

  • Body and Heart
  • PhysicalActivity
  • HealthyDiet
  • Emotional Management
  • CelebratingWhatWe’veLearned

The curriculum features characters such as Dr. Ruster, a puppet version of our principal investigator Dr. Fuster, and an energetic cartoon heart named Cardio, who presents most of the materials. The Icahn School of Medicine at Mount Sinai also gratefully acknowledges Sesame Workshop for making available the Sesame Street characters and content from its Healthy Habits for Life programs for use in educating children and their families in connection with this project.

The program is partly based on and adapted from educational initiatives by Sesame Workshop and the Foundation for Science, Health and Education. We use interactive resources and age-appropriate materials to support and engage young children in the learning of our Heart Health program, while providing training and technical assistance to teachers throughout the intervention.

The SI! NYC-CHILDREN PROGRAM addresses these topics:

  • Maintaining a healthydiet
  • Performing regular physical activity
  • Understanding how the body and heart work
  • Managing emotions to avoid unhealthy lifestyle decisions

We are assessing the impact of our program on children’s physical activity and food consumption through a questionnaire called the Healthy Kids Survey delivered to the parents and through obesity indicators such as Body Mass Index (BMI) calculated from children’s height and weight.

Elementary schools enrolled in this study will receive either one or two educational interventions. One group of schools will receive the SI! Program in both Kindergarten and 2nd grade, while another group will receive an intervention only in 2nd grade. Through conserved assessment procedures, we will use comparative data from these two groups to determine if re-intervention is an effective strategy to improve the sustainability of our program’s effect.

Adult Interventions

As part of our multi-level intervention, teachers will receive training on the SI! NYC-CHILDREN PROGRAM curriculum including information on healthy diet, importance of physical activity, and health-promoting lifestyle decisions. Parents will take part in specially designed family activities, as well as receive newsletters with information on the SI! Program, aiming to create a culture of health. Our goal with CHSEI is to increase the benefit to the children by involving their immediate environment: teachers and family.

Both parents and teachers involved in the Children intervention will also receive assessment questionnaires that will address physical activity level, food intake, smoking habits, and quality of life. We will also record the height, weight, and blood pressure of teachers (directly assessed) and parents (self-reported) in a continuing effort to involve and support the entire school community in our push for Heart Health.

We hope that through the consistent involvement of parents and teachers in our health intervention, we can improve the health of children who may be at higher risk for cardiovascular disease or who have a barrier to maintaining a heart-healthy lifestyle. This goal will support our mission of creating long-lasting lifestyle changes for young children and their families.

The Children program is currently in the process of recruiting NYC Department of Education (DOE) Public Schools for participation in our study. We will be seeking out District and Charter Schools with a minimum of three kindergarten classrooms throughout all five boroughs of NYC.

The Children program of Mount Sinai Heart is made up of a premier, multidisciplinary team of leading physician-scientists, researchers, educators, and staff carrying out the pioneering early childhood heart health intervention programs in New York City Elementary schools for children and their teachers and caregivers.