The effects of a preschool-based intervention for Early Childhood Education and Care teachers in promoting healthy eating and physical activity in young children: A cluster randomised controlled trial.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Diet, Healthy* ; Exercise*; Health Promotion/*methods ; Teacher Training/*methods; Adult ; Child Day Care Centers ; Child, Preschool ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Netherlands

The need for excess weight gain prevention in disadvantaged young children is widely recognised. Early Childhood Education and Care teachers are potential key actors in early interventions to prevent overweight and obesity. This study examines the effects of a preschool-based intervention for teachers in promoting healthy eating and physical activity in young children. A cluster randomised controlled trial was conducted at 41 preschools in a deprived area of Amsterdam, The Netherlands. The intervention consisted of 2 programmes that were applied in succession: A Healthy Start and PLAYgrounds for TODdlers. The study period was 9 months. Primary outcomes were assessed via questionnaires and included teachers' knowledge, attitude, food/activity-related practices, and level of confidence in promoting healthy behaviours. Secondary outcomes in this study were teachers' and children's BMI (z-score), body composition, dietary intake and physical activity level. Intention-to-treat analyses were performed using linear mixed models. In total, 115 teachers and 249 children (mean age 3.0 (0.2) years) were included. A positive effect on teachers' knowledge about the Dutch dietary guidelines was found after the programme A Healthy Start (difference = 1.38; 1-sided 95% CL = 0.29; p = 0.02). This effect was not sustained at 9 months (difference = 0.34; 1-sided 95% CL = -0.76; p = 0.31). The overall intervention had a positive effect on 3 of the 5 attitude statements regarding a healthy lifestyle (difference ranged from 0.34 to 0.55) and on the practice scale Activity-related-Modelling (difference = 0.16; 1-sided 95% CL = 0.06; p = 0.01). No intervention effects were observed on food-related practice scales and the level of confidence in promoting healthy behaviours. At this stage, no effects were seen on teachers' and children's BMI (z-score). This study contributes to the professional development of Early Childhood Education and Care teachers and addresses the call for interventions to prevent overweight/obesity and to minimise health inequalities in young children.
Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: MJ developed the PLAYgrounds for TODdlers programme. All other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Eur J Clin Nutr. 1999 Apr;53(4):298-308. (PMID: 10334656)
Med Sci Sports Exerc. 2011 Aug;43(8):1575-81. (PMID: 21681120)
Prev Med. 2016 Jun;87:57-69. (PMID: 26876631)
Obes Rev. 2015 Dec;16(12):1055-70. (PMID: 26345462)
Health Educ Res. 2012 Feb;27(1):81-100. (PMID: 21804083)
Obes Rev. 2008 Sep;9(5):474-88. (PMID: 18331423)
Obesity (Silver Spring). 2014 Oct;22(10):2230-7. (PMID: 25044908)
Nutrients. 2015 Mar 27;7(4):2161-75. (PMID: 25825829)
Br J Sports Med. 2015 Feb;49(4):259-64. (PMID: 23293007)
BMC Public Health. 2011 May 08;11:282. (PMID: 21548998)
Am J Health Promot. 2012 Sep-Oct;27(1):e27-36. (PMID: 22950932)
Nutrition. 2001 Mar;17(3):248-53. (PMID: 11312069)
Obes Rev. 2011 May;12(5):e535-47. (PMID: 21348926)
Am J Clin Nutr. 1982 May;35(5 Suppl):1169-75. (PMID: 7081099)
Trials. 2010 Mar 24;11:32. (PMID: 20334632)
Int J Behav Nutr Phys Act. 2010 Nov 03;7:80. (PMID: 21047434)
BMC Public Health. 2014 Mar 01;14:215. (PMID: 24580983)
BMC Public Health. 2019 Mar 7;19(1):278. (PMID: 30845936)
BMJ. 2012 Sep 04;345:e5661. (PMID: 22951546)
Int J Behav Nutr Phys Act. 2019 Nov 21;16(1):110. (PMID: 31752917)
Prev Med. 2018 Jan;106:13-25. (PMID: 29038034)
Int J Environ Res Public Health. 2020 Jan 03;17(1):. (PMID: 31947735)
PLoS One. 2010 Feb 11;5(2):e9155. (PMID: 20161800)
Prev Med. 2017 Feb;95 Suppl:S37-S52. (PMID: 27693295)
BMC Public Health. 2011 Aug 01;11:611. (PMID: 21806791)
Lancet. 2017 Dec 16;390(10113):2627-2642. (PMID: 29029897)
Public Health Nutr. 2016 Aug;19(11):1964-75. (PMID: 26634610)
Pediatr Obes. 2012 Aug;7(4):284-94. (PMID: 22715120)
Int J Environ Res Public Health. 2019 Dec 10;16(24):. (PMID: 31835477)

figshare 10.21943/auas.6231254.v1

Date Created: 20210723 Date Completed: 20211108 Latest Revision: 20211108

20231215

PMC8302250

10.1371/journal.pone.0255023

34298547