Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia.
Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
BMC Public Health. 2023 Jun 6;23(1):1082. doi: 10.1186/s12889-023-16023-w.
Toybox is a kindergarten-based intervention program that targets sedentary behavior, snacking and drinking habits, as well as promoting physical activity in an effort to improve healthy energy balance-related behaviors among children attending kindergartens in Malaysia. The pilot of this program was conducted as a randomized controlled trial (RCT) involving 837 children from 22 intervention kindergartens and 26 control kindergartens respectively. This paper outlines the process evaluation of this intervention.
We assessed five process indicators: recruitment, retention, dosage, fidelity, and satisfaction for the Toybox program. Data collection was conducted via teachers' monthly logbooks, post-intervention feedback through questionnaires, and focus group discussions (FGD) with teachers, parents, and children. Data were analyzed using quantitative and qualitative data analysis methods.
A total of 1072 children were invited. Out of the 1001 children whose parents consented to join, only 837 completed the program (Retention rate: 88.4%). As high as 91% of the 44 teachers and their assistants engaged positively in one or more of the process evaluation data collection methods. In terms of dosage and fidelity, 76% of parents had received newsletters, tip cards, and posters at the appropriate times. All teachers and their assistants felt satisfied with the intervention program. However, they also mentioned some barriers to its implementation, including the lack of suitable indoor environments to conduct activities and the need to make kangaroo stories more interesting to captivate the children's attention. As for parents, 88% of them were satisfied with the family-based activities and enjoyed them. They also felt that the materials provided were easy to understand and managed to improve their knowledge. Lastly, the children showed positive behaviors in consuming more water, fruits, and vegetables.
The Toybox program was deemed acceptable and feasible to implement by the parents and teachers. However, several factors need to be improved before it can be expanded and embedded as a routine practice across Malaysia.
Toybox 是一个基于幼儿园的干预项目，旨在针对久坐行为、零食和饮料习惯进行干预，并促进身体活动，以努力改善马来西亚幼儿园儿童的健康能量平衡相关行为。该项目的试点研究采用随机对照试验（RCT）进行，共纳入 22 所干预幼儿园和 26 所对照幼儿园的 837 名儿童。本文概述了该干预措施的过程评估。
我们评估了 Toybox 项目的 5 个过程指标：招募、保留、剂量、忠实度和满意度。通过教师每月的日志、干预后的问卷调查以及教师、家长和儿童的焦点小组讨论（FGD）收集数据。使用定量和定性数据分析方法进行数据分析。
共邀请了 1072 名儿童。在同意参加的 1001 名儿童中，只有 837 名儿童完成了该项目（保留率：88.4%）。高达 91%的 44 名教师及其助理积极参与了 1 项或多项过程评估数据收集方法。在剂量和忠实度方面，76%的家长在适当的时间收到了时事通讯、提示卡和海报。所有教师及其助理对干预项目感到满意。然而，他们也提到了实施过程中的一些障碍，包括缺乏适合开展活动的室内环境，以及需要使袋鼠故事更有趣以吸引孩子们的注意力。至于家长，88%的人对基于家庭的活动感到满意并喜欢这些活动。他们还认为所提供的材料易于理解，并能够提高他们的知识。最后，孩子们在饮用更多水、水果和蔬菜方面表现出积极的行为。
家长和教师认为 Toybox 项目是可以接受和实施的。然而，在将其扩展并嵌入马来西亚各地的常规实践之前，还需要改进一些因素。
