Abstract
Interventions promoting young children’s healthy energy balance-related behaviours (EBRBs) should also examine changes in the family environment as this is an important determinant that may affect the effectiveness of the intervention. This study examines family environmental effects of the Increased Health and Wellbeing in Preschools (DAGIS) intervention study, and whether these effects differed when considering three parental educational level (PEL) groups. The DAGIS intervention was conducted in preschools and involving parents in Southern Finland from September 2017 to May 2018. It was designed as a randomised trial, clustered at preschool-level. Parents of 3–6-year-olds answered questionnaires recording PEL, parental role modelling for EBRBs, and the family environment measured as EBRBs availability and accessibility. Linear Mixed Models with Repeated Measures were used in order to detect intervention effects. Models included group by time interactions. When examining intervention effects separated by PEL groups, models with three-level interactions (group × time-points × PEL) were evaluated. There was an interaction effect for the availability of sugary everyday foods and drinks (p = 0.002). The analyses showed that the control group increased availability (p = 0.003), whereas in the intervention group no changes were detected (p = 0.150). In the analysis separated by PEL groups, changes were found only for the accessibility of sugary treats at home; the high PEL control group increased the accessibility of sugary treats (p = 0.022) (interaction effect: p = 0.027). Hence, results suggest that the DAGIS multicomponent intervention had a limited impact on determinants for children’s healthy EBRBs, and no impact was found in the low PEL group.
Highlights
Young children’s energy balance-related behaviours (EBRBs), such as physical activity (PA), screen time (ST), and food intake are highly dependent on the environment in which they spend most of their time [1,2]
This study showed that the DAGIS intervention had some effects on food availability and accessibility of foods at home, even though these effects were small
The DAGIS intervention did not detect any noteworthy effects on parental role modelling
Summary
Young children’s energy balance-related behaviours (EBRBs), such as physical activity (PA), screen time (ST), and food intake are highly dependent on the environment in which they spend most of their time [1,2]. Preschool and family interventions aiming to promote healthy EBRBs among 3–6-year-olds have yielded positive effects, mostly on food intake such as increased consumption of fruit and vegetables (FV) and decreased consumption of sugar-sweetened beverages [4,5], whereas in general fewer effects have been reported on physical activity [6,7]. The interventions have focused either on one specific behaviour [8,9], or have been more complex, aiming to change several EBRBs such as reducing sugary foods and drink consumption and decreasing screen time [7,10,11]. Little knowledge exists about how to reach parents with low socio-economic position or educational level in universal interventions [12,13]
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