Intervention effects of a kindergarten-based health promotion programme on obesity related behavioural outcomes and BMI percentiles

Abstract

In recent decades, prevalence of childhood overweight has increased worldwide and became a public health concern. One reason is children's insufficient engagement in physical activity (PA) which may lead to deficient motor skills, which are interdependent. Therefore, early health promotion such as the kindergarten-based health promotion programme “Join the Healthy Boat” is necessary. In order to evaluate the programme's effectiveness on children's BMI percentiles (BMIPCT), PA and endurance capacity, a randomised controlled trial including intervention (IG) and control group (CG) was conducted. 973 kindergarten children (3.6 ± 0.6 years; 47.1% male) in 57 kindergartens were assessed at baseline and 558 of them at follow-up. Anthropometrics and endurance capability (3-minute-run) were assessed on site. PA behaviour and socio-economic data were assessed using parental report. Linear regression models were used to determine intervention effects for all health outcomes, adjusting for baseline values, age, gender, BMIPCT and socio-economic variables. After one year, a significant positive intervention effect on children's BMIPCT was found ( p ≤ 0.04). Children in the IG spent significantly more days in sufficient PA than children in the CG (3.1 ± 2.1 days vs. 2.5 ± 1.9 days; p ≤ 0.005). Children in the IG performed significantly better in the three minute endurance run than their counterparts in the CG (305.8 ± 46.2 m vs. 286.9 ± 43.2 m; p ≤ 0.001). This teacher-centred health promotion using a low-dose bottom-up approach with action alternatives achieved significant positive effects in the reduction of BMIPCT and significant increases in endurance capacity and daily PA. The programme is therefore ideal for integrating health promotion more intensively into the everyday life of children.

Effectiveness of a Physical Education Program on the Motor and Pre-literacy Skills of Preschoolers From the Training-To-Health Project: A Focus on Weight Status

“…As preschoolers currently perform lower than recommended PA levels by increasing the associated health risk and compromising skill development and later school achievement, we suggest that, based on our results, children would spend more time in structured PA in kindergartens (Gu, 2016;Kippe and Lagestad, 2018;Kobel et al, 2019). Therefore, we suggest that this PEP could be adopted as an educational strategy to improve motor and pre-literacy skills in preschool children, known to be a peculiar growth period for the development of these characteristics.…”

Parental Self-Efficacy as a Predictor of Children’s Nutrition and the Potential Mediator Effect between the Health Promotion Program “Join the Healthy Boat” and Children’s Nutrition

“…Parental self-efficacy could not be identified as a mediator between the health promoting intervention and children’s nutrition, which might be explained by the disappearance of the significant influence on fruit and vegetable intake, as well as by the fact that the intervention had neither a significant effect on the mediator nor on the children. In the evaluation study of the program “Join the Healthy Boat” [ 47 ], no significant differences between the intervention and the control group were found with regards to consuming fruit, vegetables, and sugar sweetened beverages. However, the percentage of sugar sweetened beverages consumed daily or several times a day decreased by 4.8% in the intervention group at follow-up, whereas, in the control group, it remained the same [ 47 ].…”

“…In the evaluation study of the program “Join the Healthy Boat” [ 47 ], no significant differences between the intervention and the control group were found with regards to consuming fruit, vegetables, and sugar sweetened beverages. However, the percentage of sugar sweetened beverages consumed daily or several times a day decreased by 4.8% in the intervention group at follow-up, whereas, in the control group, it remained the same [ 47 ]. In this work, intake of sugar sweetened beverages was divided into two categories: “less than once a week” and “once a week or more”.…”

“…The following instruments and methods were used for the data analysis of this study; other instruments of the intervention study are described elsewhere [ 47 ]. Using a parental questionnaire, sociodemographic data and dietary intake of parents and children were assessed.…”

Intervention Effects of a Kindergarten-Based Health Promotion Programme on Motor Abilities in Early Childhood

“…The here reported results were assessed as a secondary outcome of the programme. Primary outcomes as well as other secondary aspects of the programme are reported elsewhere (39)(40)(41)(42).…”