Identifying effective behavioural models and behaviour change strategies underpinning preschool‐ and school‐based obesity prevention interventions aimed at 4–6‐year‐olds: a systematic review

Abstract

The aim of this comprehensive systematic review was to identify the most effective behavioural models and behaviour change strategies, underpinning preschool- and school-based interventions aimed at preventing obesity in 4-6-year-olds. Searching was conducted from April 1995 to April 2010 using MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library. Epidemiological studies relevant to the research question with controlled assignment of participants were included in the review, if they had follow-up periods of 6 months or longer. Outcomes included markers of weight gain; markers of body composition; physical activity behaviour changes and dietary behaviour changes. Twelve studies were included in the review. The most commonly used model was social cognitive theory (SCT)/social learning theory (SLT) either as a single model or in combination with other behavioural models. Studies that used SCT/SLT in the development of the intervention had significant favourable changes in one, or more, outcome measures. In addition, interventions that (i) combined high levels of parental involvement and interactive school-based learning; (ii) targeted physical activity and dietary change; and (iii) included long-term follow-up, appeared most effective. It is suggested that interventions should also be focused on developing children's (and parents') perceived competence at making dietary and physical changes.

An intervention for improving the lifestyle habits of kindergarten children in Israel: a cluster-randomised controlled trial investigation

“…This indicates the necessity not only for longer programmes but also the involvement of parents and determinants in the child's immediate environment, as proposed by behavioural change theory (21,39,40) . Table 3 Multivariate-adjusted effect of the intervention after 4 months for the two intervention groups v. the reference group: clusterrandomised controlled trial of an intervention programme to improve kindergarten children's eating and leisure habits, Israel There is a need to address the complexity of the issues surrounding obesity, especially at a young age.…”

“…International efforts towards change in policy reflect the current trends in knowledge that, already at young age, obesity requires attention (8) . Intervention strategies that are multifaceted in nature are recommended to combat the obesogenic environments in which younger children find themselves in order to facilitate the development of desirable healthy behaviours (21,49,50) . This should take place within the wider context of a systems approach of tackling obesity (19,51) .…”

“…Current recommendations are to institute interventions that address these factors based on behavioural change theory (18)(19)(20)(21) . School-based interventions targeting various outcomes, such as good eating habits and physical activity, have demonstrated significant changes in behaviour (22) .…”

Young children's food brand knowledge. Early development and associations with television viewing and parent's diet

“…As brand preference precedes purchase requests, marketing aims to build young children's knowledge of food brands and desires for them (McNeal, 1999;Story & French, 2004). A large body of research has concluded that television advertising influences eating behaviours (Gibson et al, 2012), creates taste expectancies (Harris, Brownell & Bargh, 2009), and prompts children's food requests (Coon & Tucker, 2002). Television advertising implicitly develops emotional associations with food brands and brand exposure earlier in childhood may create stronger and longer-lasting attachments (BraunLaTour, LaTour, & Zinkhan, 2010;Nairn & Fine, 2008).…”

“…This takes place through food provision; responses to children's requests; restriction and monitoring of eating; use of foods as rewards; and modelling of eating behaviours (Birch, 1999;Gibson et al, 2012;Skouteris, 2012;Slusser et al, 2012).…”