Pinket An-Sofie, Van Lippevelde Wendy, De Bourdeaudhuij Ilse, Deforche Benedicte, Cardon Greet, Androutsos Odysseas, Koletzko Berthold, Moreno Luis A, Socha Piotr, Iotova Violeta, Manios Yannis, De Craemer Marieke
Department of Public Health, Ghent University, Ghent, Belgium.
Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
PLoS One. 2016 Apr 11;11(4):e0152928. doi: 10.1371/journal.pone.0152928. eCollection 2016.
Within the ToyBox-study, a kindergarten-based, family-involved intervention was developed to prevent overweight and obesity in European preschoolers, targeting four key behaviours related to early childhood obesity, including water consumption. The present study aimed to examine the effect of the ToyBox-intervention (cluster randomized controlled trial) on water intake and beverage consumption in European preschoolers and to investigate if the intervention effects differed by implementation score of kindergartens and parents/caregivers.
A sample of 4964 preschoolers (4.7 ± 0.4 years; 51.5% boys) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain) was included in the data analyses. A standardized protocol was used and parents/caregivers filled in socio-demographic data and a food-frequency questionnaire. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and for the six country-specific samples. Based on the process evaluation questionnaire of teachers and parents/caregivers, an implementation score was constructed. To assess differences in water intake and beverage consumption by implementation score in the total sample, multilevel repeated measures analyses were performed.
Limited intervention effects on water intake from beverages and overall beverage consumption were found. However, important results were found on prepacked fruit juice consumption, with a larger decrease in the intervention group compared to the control group. However, also a decline in plain milk consumption was found. Implementation scores were rather low in both kindergartens and parents/caregivers. Nevertheless, more favorable effects on beverage choices were found in preschoolers whose parents/caregivers and kindergarten teachers had higher implementation scores compared to those with lower implementation scores.
The ToyBox-intervention can provide the basis for the development of more tailor-made interventions. However, new strategies to improve implementation of interventions should be created.
在“玩具盒”研究中，开发了一种以幼儿园为基础、家庭参与的干预措施，旨在预防欧洲学龄前儿童超重和肥胖，针对与儿童早期肥胖相关的四种关键行为，包括饮水情况。本研究旨在探讨“玩具盒”干预措施（整群随机对照试验）对欧洲学龄前儿童饮水摄入量和饮料消费的影响，并调查干预效果是否因幼儿园及家长/照顾者的实施得分而异。
数据分析纳入了来自六个欧洲国家（比利时、保加利亚、德国、希腊、波兰、西班牙）的4964名学龄前儿童（4.7±0.4岁；51.5%为男孩）。使用标准化方案，家长/照顾者填写社会人口统计学数据和食物频率问卷。为评估干预效果，对总样本和六个国家特定样本进行了多水平重复测量分析。根据教师及家长/照顾者的过程评估问卷构建了实施得分。为评估总样本中实施得分在饮水摄入量和饮料消费方面的差异，进行了多水平重复测量分析。
发现干预措施对饮料的饮水摄入量和总体饮料消费的影响有限。然而，在预包装果汁消费方面取得了重要成果，干预组的下降幅度大于对照组。不过，纯牛奶消费也有所下降。幼儿园和家长/照顾者的实施得分都相当低。尽管如此，与实施得分较低的学龄前儿童相比，家长/照顾者和幼儿园教师实施得分较高的学龄前儿童在饮料选择上有更有利的影响。
“玩具盒”干预措施可为制定更具针对性的干预措施提供基础。然而，应制定新的策略来提高干预措施的实施效果。
