ToyBox Study Malaysia: Improving healthy energy balance and obesity‐related behaviours among pre‐schoolers in Malaysia

Reeves, Sue; Poh, Bee Koon; Essau, Cecilia A.; Summerbell, Carolyn; Cheah, Whye Lian; Koh, Denise; Lee, Julia Ai Cheng; Ruzita, A. T.; Gibson, E.L.

doi:10.1111/nbu.12340

Cited by 10 publications

(7 citation statements)

References 31 publications

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“…Using a two-armed randomised controlled trial (RCT) research design, recruitment was done for both intervention and control groups among communities from different cultures and ethnicities of Malaysia. This project was one of the first national-level intervention studies in Malaysia focusing on children and their parents that involved environment modification and training kindergarten teachers [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Process evaluation of a kindergarten-based intervention for obesity prevention in early childhood: the Toybox study Malaysia

et al. 2023

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Background 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. Methods 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. Results 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. Conclusions 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.

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Section: Introductionmentioning

confidence: 99%

Process evaluation of a kindergarten-based intervention for obesity prevention in early childhood: the Toybox study Malaysia

et al. 2023

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“…This methodological study was conducted among preschool children in three different states in Malaysia, namely, Kuala Lumpur, Johor, and Sarawak. These three states were chosen as their population composition is similar to the ToyBox Study Malaysia population target [15]. It is important to note, however, that participants in this study were not the same participants as those who participated in the ToyBox Study Malaysia intervention program, although they share similar cultural backgrounds.…”

Section: Methodsmentioning

confidence: 99%

“…This study is part of ToyBox Study Malaysia [15], which is a feasibility study to apply healthy lifestyle intervention first designed for European preschool children. The original ToyBox-study used an FFQ developed and validated by Mouratidou et al [16] to assess the food intake of European preschool children.…”

Section: Introductionmentioning

confidence: 99%

Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

Hafizah

Ang

Yap

et al. 2019

IJERPH

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As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman’s correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman’s correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach’s alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children’s food intake.

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“…2% (2006) to 20.7% (2016). Similar indings were also highlighted on childhood obesity, with 10% of children were overweight, and 12% were categorised as obese (Reeves et al, 2018). It is imperative to elucidate the association between the children eating behaviour and their body weight to design a suitable intervention for healthy eating among children in this age range, thus resolving the issue of double burden.…”

Section: Introductionmentioning

confidence: 55%

The Relationship between Child Eating Behaviour with Body Mass Index among Toddlers Aged Two to Four Years Old

Hassan

Arepen

Addnan

et al. 2020

ijrps

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Children eating behaviour was hypothesised as one of the factors associated with growth development as well as malnutrition among toddlers. This study aimed to explore the relationship between child eating behaviour among toddlers aged two to four years old and their respective Body Mass Index (BMI) or BMI for Age Z (BAZ). A cross-sectional study was conducted among parents and caregivers with toddlers between two to four years old, in the Klang Valley. The validated Children’s Eating Behaviour Questionnaire (CEBQ) was used to measure their child eating habit and behaviours. A total of 96 parents or caregivers of toddlers participated. Girls had lower BAZ than boys (-1.20 vs -0.15, p=0.030), and significantly higher satiety responsiveness and food fussiness scores (3.14 vs 2.80, p=0.005 and 2.83 vs 2.44, p=0.005 respectively). Emotional overeating had opposite effects on BMI and BAZ between genders. In this study, girls aged two to four year old had lower BMI and BAZ than boys; and demonstrated higher food avoidance behaviour. Emotional overeating is associated with opposite effects on BMI and BAZ between boys and girls. Among all toddlers, satiety responsiveness and food fussiness were associated with lower BAZ.

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ToyBox Study Malaysia: Improving healthy energy balance and obesity‐related behaviours among pre‐schoolers in Malaysia

Cited by 10 publications

References 31 publications

Process evaluation of a kindergarten-based intervention for obesity prevention in early childhood: the Toybox study Malaysia

Process evaluation of a kindergarten-based intervention for obesity prevention in early childhood: the Toybox study Malaysia

Validity and Reliability of a Food Frequency Questionnaire (FFQ) to Assess Dietary Intake of Preschool Children

The Relationship between Child Eating Behaviour with Body Mass Index among Toddlers Aged Two to Four Years Old

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