Targeting Preschool Children to Promote Cardiovascular Health: Cluster Randomized Trial

Abstract

BACKGROUND School programs can be effective in modifying knowledge, attitudes, and habits relevant to long-term risk of chronic diseases associated with sedentary lifestyles. As part of a long-term research strategy, we conducted an educational intervention in preschool facilities to assess changes in preschoolers’ knowledge, attitudes, and habits toward healthy eating and living an active lifestyle. METHODS Using a cluster design, we randomly assigned 14 preschool facilities in Bogotá, Colombia to a 5-month educational and playful intervention (7 preschool facilities) or to usual curriculum (7 preschool facilities). A total of 1216 children aged 3–5 years, 928 parents, and 120 teachers participated. A structured survey was used at baseline, at the end of the study, and 12 months later to evaluate changes in knowledge, attitudes, and habits. RESULTS Children in the intervention group showed a 10.9% increase in weighted score, compared with 5.3% in controls. The absolute adjusted difference was 3.90 units (95% confidence interval [CI], 1.64–6.16; P <.001). Among parents, the equivalent statistics were 8.9% and 3.1%, respectively (absolute difference 4.08 units; 95% CI, 2.03 to 6.12; P <.001), and among teachers, 9.4% and 2.5%, respectively (absolute difference 5.36 units; 95% CI, −0.29–11.01; P = .06). In the intervened cohort 1 year after the intervention, children still showed a significant increase in weighted score (absolute difference of 6.38 units; P <.001). CONCLUSIONS A preschool-based intervention aimed at improving knowledge, attitudes, and habits related to healthy diet and active lifestyle is feasible, efficacious, and sustainable in very young children.

Obesity prevention interventions in early childhood education and care settings with parental involvement: a systematic review

“…A table was also created to show the main outcome variables in each study (see Table 4). Fifteen studies were included from a number of high-and middle-income countries around the world including Australia (de Zask, Adams, Brooks, & Hughes, 2012), Switzerland (Puder et al, 2011), USA (Dennison, Russo, Burdick, & Jenkins, 2004;Fitzgibbon et al, 2005Fitzgibbon et al, , 2006Natale, Lopez-Mitnik, Uhlhorn, Asfour, & Messiah, 2014;Story et al, 2012;Yin et al, 2012), Belgium (De Coen et al, 2012), Germany (Bayer et al, 2009;Bock, Fischer, Hoffmann, & Renz-Polster, 2010), China (Hu et al, 2010), Columbia (Cespedes et al, 2013) and Scotland (Reilly et al, 2006). Two studies have multiple papers explaining the study Notes: 1, yes; 0, no; 0*, unable to determine.…”

Toward a multidimensional understanding of culture for health interventions

“…SW's local adaptation of the Healthy Habits for Life curriculum and its prioritization of working closely with governments and local NGOs resulted in a successful intervention in these countries. Research shows that children exposed to the intervention had significant improvements in knowledge, attitudes, and habits related to healthy eating and active lifestyles (C espedes et al, 2013;CINCO, 2009) that remained even one year post-intervention.…”

Health care professionals’ perceptions of health promotion with preschool children

“…[1][2][3][4] Lifestyle changes should be brought about early in life, ideally during the pre-school years [1][2][3][4][5][6][7][8][9][10] or earlier [11] and in cooperation between the parents and pre-school teachers. Sev-eral authors state that health promotion activities with parents and teachers would be most effective if they took into consideration the parents' and teachers' opinions as well as their contexts.…”

“…Sev-eral authors state that health promotion activities with parents and teachers would be most effective if they took into consideration the parents' and teachers' opinions as well as their contexts. [5,12] This indicates that an interdisciplinary way of working with the promotion of children's health would be preferable. Interdisciplinary and intersectional ways of working are in line with one of the seven guiding principles for health promotion according to the Ottawa Charter.…”