Programs that Work
Hip-Hop to Health Jr.
Healthy and Safe Children
Children experiencing good physical health
Age of Child
Early Childhood (0-8)
Type of Setting
Child Care / Preschool
Type of Service
Type of Outcome Addressed
Evidence Level (What does this mean?)
Hip-Hop to Health Jr. was a community-based program that aimed to promote healthy eating and physical activity habits in young children ages 3-5 years. The 14-week intervention was implemented within existing Head Start programs in Chicago and included 45-minute instructional sessions three times each week. The sessions began with a five-minute transitional period, followed by a 20-minute hands-on activity related to healthy eating and exercise, and concluding with a 20-minute aerobic activity. Parents of the participating children were sent weekly newsletters related to the topic being reviewed in class, and they were also sent weekly homework assignments related to the newsletter content. Parents were compensated $5 for completing each homework assignment. The intervention also included free, voluntary, 30-minute low-impact aerobic sessions for the parents twice each week (Fitzgibbon et al., 2002).
Latino and African American preschool students between 3 and 5 years of age
Fitzgibbon et al. (2005) evaluated Hip-Hop to Health Jr. in 12 primarily African American Head Start programs administered through the Archdiocese of Chicago. The Head Start centers were paired according to class size, and one center in each pair was randomly assigned to the 14-week Hip-Hop to Health Jr. intervention. The other center in each pair was assigned to a general health intervention that involved one 20-minute session each of the 14 weeks on general health topics and did not include any information on physical activity or nutrition. All children attending each of the centers were eligible to participate in the intervention offered at their site. A total of 197 children enrolled in the Hip-Hop to Health Jr. intervention across the six intervention schools, while 212 children were enrolled in the general health intervention in the six control schools.
Outcomes were assessed at baseline and at 1 and 2 years post-intervention and included children's
- absolute body mass index (BMI, weight in kilograms/height in meters)
- BMI z-scores (standard deviation) for age and sex based on 2000 Centers for Disease Control and Prevention population estimates
- 24-hour dietary intake as reported by parents to a trained dietician
- physical activity and television viewing as reported by the parent.
Key Evaluation Findings
Children participating in Hip-Hop to Health Jr. had significantly lower increases in BMI compared with control children at the 1- and 2-year follow-ups (1-year follow-up: 0.06 versus 0.59 kg/m2 increase; 2-year follow-up: 0.54 versus 1.08 kg/m2 increase).
Additionally, children participating in Hip-Hop to Health Jr. had a lower percentage of calories from saturated fat at year 1 (11.6 versus 12.8 percent); however, these results were not sustained at year 2. Other measures of dietary intake showed no significant differences at either follow-up.
There were no significant differences in physical activity or television viewing across the groups at either follow-up.
Public and private preschools
Funding for initial program implementation and research was provided by the National Institutes of Health.
- The intervention was delivered in three 45-minute sessions per week for 14 weeks.
- Each session included a 20-minute lesson that introduced a new concept related to healthy eating or exercise, and 20 minutes of physical activity.
- Parents in the Hip-Hop to Health Jr. intervention received weekly newsletters related to the curriculum the children were studying. Parents also received short homework assignments related to the newsletters, which they could turn into the Head Start instructor for a $5 incentive.
Issues to Consider
This program received a "promising" rating. This is due to the small number of Head Start centers (6 in each condition) as well as the baseline differences across treatment and control groups in the Fitzgibbon et al. (2005) study, which indicates some lack of comparability in the two groups. Also note that baseline levels of dietary intake and physical activity were not reported in this study. A similarly designed evaluation of the Hip-Hop to Health Jr. program among primarily Latino Head Start Centers in Chicago found no impact of the program on any measured outcomes at the year 1 and year 2 follow-ups (Fitzgibbon et al., 2006). These findings indicate either that the program may not be effective in different populations, or that it cannot be replicated to produce similar results, further supporting the "promising" designation.
Chicago Head Start Centers
Marian L. Fitzgibbon
Institute for Health Research and Policy
University of Illinois at Chicago
1747 West Roosevelt Road, Room 558
Chicago, IL 60608
See Fitzgibbon et al. (2002) for a detailed description of the curriculum development process. For information on curriculum materials, contact the author.
Fitzgibbon, Marian L., Melinda R. Stolley, Alan R. Dyer, Linda VanHorn, and Katherine Kauferchristoffel, "A Community-Based Obesity Prevention Program for Minority Children: Rationale and Study Design for Hip-Hop to Health Jr.,"
Vol. 34, No. 2, February 2002, pp. 289-297.
Fitzgibbon, Marian L., Melinda R. Stolley, Linda Schiffer, Linda Van Horn, Katherine Kauferchristoffel, and Alan Dyer, "Two-Year Follow-Up Results for Hip-Hop to Health Jr.: A Randomized Controlled Trial for Overweight Prevention in Preschool Minority Children," Journal of Pediatrics, Vol. 146, No. 5, May 2005, pp. 618-625.
Fitzgibbon, Marian L., Melinda R. Stolley, Linda Schiffer, Linda VanHorn, Katherine Kauferchristoffel, and Alan R. Dyer, "Hip-Hop to Health Jr. for Latino Preschool Children," Obesity, Vol. 14, 2006, pp. 1616-1625.