Effects of the Preschool-Based Family-Involving DAGIS Intervention on Family Environment: A Cluster Randomised Trial

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.

Sociodemographic factors, parental mental health and movement behaviours in the early years: the SUNRISE Finland study protocol

“…This questionnaire assesses sociodemographic and family-related factors (Fig. 2), such as living situation and property type with modified questions previously used in the Helsinki Health Study [51], occupational status with a question used in the FinHealth Study [52], personal and household income with questions used in the DAGIS Study [24,53], household assets with a question from the Whitehall Study [54], and marital status as well as relationship to the child and living with the child with questions developed for the SUNRISE Finland Study.…”

“…Caregiver's use of nicotine and tobacco products will be assessed with modified questions used in the FinHeath Study [52] and the use of alcohol with the short AUDIT-3 questionnaire [58]. Frequency of spending time in nature will be assessed with modified questions used in the DAGIS study [24,53], family PA and child's enjoyment of PA with questions from the Skilled Kids study and the JOY-PAM project [32,59], child's commute to the daycare centre with a question used in the JOYPAM project [32], and child's appetite with a question from the Healthy Start project [60].…”

“…Parents and family play an important role in children's lives, particularly during their early years. Thus, some interventions designed to modify health behaviours within the families of preschoolers have targeted parental knowledge of those behaviors, role modeling, and parents' own health behaviours [22][23][24]. Mental health disorders are among the major global health challenges and their contribution is rising [25].…”

Mitä DAGIS-tutkimus kertoo päiväkoti-ikäisten suomalaislasten terveydestä ja hyvinvoinnista?

“…intervention intensiteetin vaikutusta tuloksiin. Rohkaisevaa kuitenkin on, että inter ventio vaikutti suotuisasti kotiympäristöön: sokeripitoisten ruokien saatavuus ei kasvanut interventioryhmässä, kun taas kontrolliryhmässä saatavuus lisääntyi (63). On haastavaa osoittaa päiväkodin välityksellä toteutettavan intervention vaikutuksia lasten käyttäytymiseen, sillä päiväkodin mahdollisuudet vaikuttaa esimerkiksi kotiympäristöön ovat pienet.…”

Effects of the DAGIS randomized controlled trial on home environment and children’s food consumption according to the degree of implementation

“…Earlier, we have reported that the DAGIS intervention had no effect on children’s consumption of FV or sugary foods and drinks when measured in terms of consumption frequency [ 34 ]. However, some effects were found on the home environment related to food consumption [ 35 ]. Given the need for knowledge about change mechanisms of health behavior interventions and the important role of DOI found in previous studies, we wanted to examine the role of the DOI and mediated intervention effects in the DAGIS intervention.…”