Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention

Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew’s Intervention Mapping approach considering Bandura’s social-cognitive theory and Bronfenbrenner’s ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation.Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID:DRKS00010089.

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Intervention Effects of a School-Based Health Promotion Programme on Obesity Related Behavioural Outcomes

Journal of Obesity ◽

10.1155/2014/476230 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 27

Author(s):

Susanne Kobel ◽

Tamara Wirt ◽

Anja Schreiber ◽

Dorothea Kesztyüs ◽

Sarah Kettner ◽

...

Keyword(s):

Health Promotion ◽

Healthy Lifestyle ◽

Intervention Group ◽

Later Life ◽

Primary School Children ◽

Control Group ◽

Health Promotion Programme ◽

Randomised Study ◽

Low Education ◽

Education Levels

Studies have shown preventive effects of an active lifestyle during childhood on later life; therefore, health promotion has to start early. The programme “Join the Healthy Boat” promotes a healthy lifestyle in primary school children. In order to evaluate it, children’s behaviours in respect of increased physical activity (PA), a decrease in screen media use (SMU), more regular breakfast, and a reduction of the consumption of soft drinks (SDC) were investigated. 1943 children (7.1 ± 0.6 years) participated in the cluster-randomised study and were assessed at baseline and 1736 of them at follow-up. Teachers delivered lessons, which included behavioural contracting and budgeting of SMU and SDC. Daily SMU, PA behaviours, SDC, and breakfast patterns were assessed via parental questionnaire. After one-year intervention, significant effects were found in the intervention group for SMU of girls, children without migration background, and children with parents having a low education level. In the control group, second grade children skipped breakfast significantly more often. Tendencies but no significant differences were found for PA and SDC. This intervention seems to affect groups, which are usually hard to reach, such as children of parents with low education levels, which shows that active parental involvement is vital for successful interventions.

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A multifaceted approach increased staff confidence to develop outside of school hours care as a health promoting setting

BMC Public Health ◽

10.1186/s12889-021-12360-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Karen Forde ◽

Leesa Costello ◽

Amanda Devine ◽

Ros Sambell ◽

Ruth Wallace

Keyword(s):

Health Promotion ◽

Intervention Strategy ◽

Health Behaviours ◽

Overweight And Obesity ◽

Minimum Requirement ◽

Self Confidence ◽

Menu Planning ◽

Training Post ◽

Health Promoting ◽

High Level

Abstract Background Outside-of-school-hours-care (OSHC) services are well positioned to influence the health behaviours of 489, 800 Australian children, and are an important setting for health promotion given the current rates of childhood overweight and obesity and associated health risks. OSHC Professionals are ideally placed to become positive influencers in this setting, although they may require training and support to confidently perform this role. This study piloted a multifaceted intervention strategy to increase OSHC Professional’s confidence and competencies, to support a health promoting OSHC environment with a nutrition and physical activity focus. Methods A mixed methods approach was used. Nineteen OSHC Professionals participated in the study, including a face-to-face workshop, supported by a closed Facebook group and website. Role adequacy (self-confidence) and legitimacy (professional responsibility) were measured pre and post workshop and evaluated using non-parametric statistics. Facebook interactions were monitored, and four participants undertook qualitative exit interviews to discuss their experiences with the intervention. Results Pre-workshop 68% of participants had not received any OSHC-specific health promotion training. Post-workshop significant improvements in confidence about menu planning, accessing nutrition information, activities and recipes was observed (P < 0.05 for all). A significant improvement was observed in role support and role related training (P < 0.05). A high level of support and interaction was observed between participants on Facebook and the website was reported a useful repository of information. Conclusions Health promotion training, combined with positive social connections, shared learning experiences, and a website improved OSHC Professionals confidence and capacity to provide a health promoting OSHC environment. Health promotion professional development for OSHC professionals should be mandated as a minimum requirement, and such learning opportunities should be scaffolded with support available through social media interactions and website access.

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The Program Niño Sano, Adulto Sano Improves Mothers’ Nutrition Knowledge and Food Practices, and Reduces Obesity in School-aged Children from a Low-income Setting in Mexico (FS16-02-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz050.fs16-02-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Yolitzin C Hernandez ◽

Gilda Zacarias ◽

Olga García

Keyword(s):

Nutrition Education ◽

Low Income ◽

Cognitive Theory ◽

Nutrition Knowledge ◽

Overweight And Obesity ◽

Controlled Study ◽

Control Group ◽

Nutrition Program ◽

School Aged Children ◽

Food Practices

Abstract Objectives Evaluate the effect of the nutrition program Niño Sano, Adulto Sano (Healthy Child, Healthy Adult) on mother's nutrition knowledge and food practices. Also, to determine its effect on Body Mass Index (BMI) of both mothers and their children. Methods A total of 43 mothers (35 ± 5 y) and their school-aged children (9 ± 3 y) participated in a 6-month longitudinal controlled study. Participants were residents of two low income communities in Queretaro, Mexico. The program Niño Sano, Adulto Sano was developed using the Intervention Mapping Approach and Social Cognitive Theory and consisted on six nutrition education sessions (1 per month) and six cooking workshops. The control group received three sessions (1 every 2 months) of nutrition education following the Mexican Official Guidelines. Height and weight of mothers and children were taken at baseline and after 6 months to determine mother's BMI and children's BMI-for-age z-score following WHO procedures. Mothers answered a validated questionnaire that consisted of eight Likert-type questions to evaluate nutrition knowledge and food practices at the beginning and end of the study. The data was analyzed by T-student of dependent variables using SPSSv19. Results The combined prevalence of overweight and obesity at baseline was 88.3% and 51.4% for the mothers and their children, respectively. 47% of the children were girls. Mothers that participated in the nutrition program improved their nutrition related knowledge and food practices by 2.99 points (3.14, 95%CI: 1.21, 4.76; P = 0.0001) compared to the control group (1.27, 95%CI: 0.15, 2.39; P = 0.028). Children of the mothers that participated in the program significantly reduce their BMI for age by −0.27 units (0.30, 95%CI: 0.22, 0.39; P = 0.0001) compared with the control group (0.02, 95%IC: −0.11, 0.17 P = 0.70). No differences were observed between groups in the mothers’ BMI at the end of the study. Conclusions The nutrition intervention Niño Sano, Adulto Sano improved nutrition knowledge and food practices of participating mothers, it reduced BMI for age a of their children, but had no effect on mother's BMI. Funding Sources Fondo de Proyectos Especiales de Rectoría (FOPER) of the Universidad Autónoma de Querétaro.

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Developing the Choosing Health digital weight loss and maintenance intervention using an Intervention Mapping approach (Preprint)

10.2196/preprints.34089 ◽

2021 ◽

Author(s):

Iga Palacz-Poborczyk ◽

Paulina Idziak ◽

Anna Januszewicz ◽

Aleksandra Luszczynska ◽

Eleanor Quested ◽

...

Keyword(s):

Health Promotion ◽

Weight Loss ◽

Body Weight ◽

Intervention Mapping ◽

Health Intervention ◽

Overweight And Obesity ◽

Excess Body Weight ◽

Evidence Based ◽

Intervention Mapping Protocol ◽

Health Promotion Programs

BACKGROUND Digital health promotion programs tailored to the individual are a potential cost-effective and scalable solution to enable self-management and provide support to people with excess body weight. However, solutions that are personalised, theory- and evidence- based and widely accessible are still limited. OBJECTIVE This study aimed to develop a digital behaviour change program, Choosing Health, that could identify modifiable predictors of weight loss and maintenance for each individual and utilise these to provide tailored support. METHODS We applied an Intervention Mapping protocol to design the program. This systematic approach to develop theory- and evidence-based health promotion programs consisted of 6 steps: development of (1) a logic model of the problem, (2) model of change, (3) intervention design and (4) production, (5) the implementation plan, and (6) evaluation plan. The decisions made during the Intervention Mapping process were guided by theory, existing evidence, and our own research (including four focus groups, N=40, expert consultations, N=12 and interviews, N=11). The stakeholders included researchers, public representatives (including individuals with overweight and obesity), and experts from the variety of relevant backgrounds (including nutrition, physical activity, and healthcare sector). RESULTS Following a structured process, we developed a tailored intervention that has potential to reduce excess body weight and support behaviour changes in people with overweight and obesity. The Choosing Health intervention consists of tailored personalised text messages and email support that correspond with theoretical domains potentially predictive of weight outcomes for each participant. Intervention content includes behaviour change techniques to support motivation maintenance, self-regulation, habit formation, environmental restructuring, social support and addressing physical and psychological resources. CONCLUSIONS Use of an Intervention Mapping protocol enabled the systematic development of the Choosing Health intervention and guided the implementation and evaluation of the program. Through the involvement of different stakeholders, including representatives of general public, we were able to map out program facilitators and barriers while increasing ecological validity of the program, to ensure that we build an intervention that is useful, user friendly, and informative. We also summarised lessons learnt for the Choosing Health intervention development and for other health promotion programs. CLINICALTRIAL This is an Intervention Mapping study which is currently evaluated through a Randomised Controlled Trial. This trial was registered with www.clinicaltrials.gov; registration number NCT04291482. INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2020-040183

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Health Promotion Intervention to Improve Diet Quality in Children

Health Promotion Practice ◽

10.1177/1524839916634096 ◽

2016 ◽

Vol 18 (2) ◽

pp. 253-262 ◽

Cited By ~ 4

Author(s):

Rafaela Rosário ◽

Ana Araújo ◽

Patrícia Padrão ◽

Oscar Lopes ◽

André Moreira ◽

...

Keyword(s):

Health Promotion ◽

Dietary Intake ◽

Diet Quality ◽

Quality Index ◽

Intervention Program ◽

Cognitive Theory ◽

Vegetable Consumption ◽

Control Group ◽

Diet Quality Index ◽

The Impact

Objective. This study aims to evaluate the impact of an intervention program, taught by trained teachers, on foods and nutrients components of the Diet Quality Index–International among children in Grades 1 to 4. Method. A total of 464 children (239 female, 6-12 years) from seven elementary Portuguese schools participated in this randomized trial. Three schools were allocated to the intervention, and four to the control group. The intervention program was based on the health promotion model and social cognitive theory. Teachers previously trained by researchers in nutrition, healthy eating, and healthy cooking implemented the intervention in the classroom from November 2008 to March 2009. Sociodemographic, anthropometric, physical activity, and dietary assessments were performed before (2007/2008) and at the end of the intervention (2009). Dietary intake was gathered by a 24-hour dietary recall and the components of Diet Quality Index–International were defined. Results. Children from the intervention schools reported a significantly higher adequacy in vegetable consumption (p = .018) and a significantly higher moderation in sodium consumption (p = .032) compared with the controllers. Conclusion. Our study provides further support for the success of intervention programs that aim to enhance children’s dietary intake. Implementing similar interventions can be promising to support vegetable consumption and moderate sodium intake.

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Intervention Effects of the Health Promotion Programme “Join the Healthy Boat” on Objectively Assessed Sedentary Time in Primary School Children in Germany

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17239029 ◽

2020 ◽

Vol 17 (23) ◽

pp. 9029

Author(s):

Susanne Kobel ◽

Jens Dreyhaupt ◽

Olivia Wartha ◽

Sarah Kettner ◽

Belinda Hoffmann ◽

...

Keyword(s):

Screen Time ◽

Primary School Children ◽

Control Group ◽

Health Promotion Programme ◽

Randomised Study ◽

Targeted Interventions ◽

Promotion Programme ◽

Significant Difference ◽

One Year

Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme “Join the Healthy Boat” promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children’s SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children’s SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children’s SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children’s SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.

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Effectiveness of the VAMOS Strategy for Increasing Physical Activity and Healthy Dietary Habits: A Randomized Controlled Community Trial

Health Education & Behavior ◽

10.1177/1090198118820095 ◽

2019 ◽

Vol 46 (3) ◽

pp. 406-416 ◽

Cited By ~ 3

Author(s):

Simone Teresinha Meurer ◽

Aline Cristine Souza Lopes ◽

Fabio Araujo Almeida ◽

Raquel de Deus Mendonça ◽

Tânia Rosane Bertoldo Benedetti

Keyword(s):

Physical Activity ◽

Cognitive Theory ◽

Dietary Habits ◽

Vegetable Intake ◽

Intervention Group ◽

Control Group ◽

Self Monitoring ◽

Intention To Treat ◽

Randomized Controlled ◽

Community Trial

This study aimed to evaluate the effectiveness of the VAMOS strategy (Health-Improving Active Life) in improving physical activity (PA), dietary habits, and anthropometric variables of primary health care (PHC) users in Brazil. A randomized controlled community trial was conducted at two units of the Health Academy Program (HAP; a service provided by PHC), which were randomly assigned either to control group (CG) or intervention group (IG). Participants in both groups (CG = 156 and IG = 135) took part in physical activity classes provided by HAP facilities with those in IG also participating in the VAMOS strategy for 12 weeks. This strategy is based on social cognitive theory. The main behavioral constructs addressed were self-efficacy, goal setting, self-monitoring, identification of social support and barriers, and solutions for the identified barriers. Physical activity was measured with accelerometers, and nutritional status was assessed using dietary habits questionnaires and anthropometric measurements. Intention-to-treat analysis revealed that participants in IG increased the daily time of moderate-vigorous PA and the frequency of raw vegetable intake, while the intake of ultra-processed foods was reduced. Weight loss among participants who were classified as overweight/obese at baseline was observed in the intervention group compared to control. These results suggest that the VAMOS strategy was effective in increasing PA, healthy dietary habits, and decreasing weight among PHC users. Therefore, VAMOS could be used as a strategy to strengthen individuals’ autonomy regarding healthy choices and improve their overall health.

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Project SoL—A Community-Based, Multi-Component Health Promotion Intervention to Improve Healthy Eating and Physical Activity Practices among Danish Families with Young Children Part 2: Evaluation

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15071513 ◽

2018 ◽

Vol 15 (7) ◽

pp. 1513 ◽

Cited By ~ 5

Author(s):

Bent Mikkelsen ◽

Paul Bloch ◽

Helene Reinbach ◽

Tine Buch-Andersen ◽

Lise Lawaetz Winkler ◽

...

Keyword(s):

Physical Activity ◽

Health Promotion ◽

Healthy Eating ◽

Quantitative Methods ◽

Formative Evaluation ◽

Health Indicators ◽

Health Behaviours ◽

Research Capacity ◽

Overweight And Obesity ◽

Future Research

Project SoL is implemented over a period of four years with the aim to promote healthy eating and physical activity among children aged 3–8 years by targeting the families in a Danish municipality based on the multi-component, supersetting strategy. Interventions are implemented in childcare centres, schools and supermarkets in three local communities as well as in local mass media and social media during a 19 months period in the Municipality of Bornholm. The matching Municipality of Odsherred serves as a control site based on its similarity to Bornholm regarding several socio-demographic and health indicators. The present paper gives an account of the design used for the summative and formative evaluation based on a realistic evaluation and a mixed methods approach combining qualitative and quantitative methods. Summative studies are conducted on changes of health behaviours among the involved families and within the municipalities in general, changes in community awareness of the project, changes in purchase patterns, changes in overweight and obesity among the targeted children and changes in knowledge and preferences among children due to sensory education workshops. The formative research comprises studies on children’s perceptions of health, perceptions of staff at supermarkets and media professionals on their roles in supporting the health promotion agenda, and motivations and barriers of community stakeholders to engage in health promotion at community level. The paper discusses operational issues and lessons learnt related to studying complex community interventions, cross-disciplinarily, interfaces between practice and research and research capacity strengthening; and suggests areas for future research. The development and implementation of the intervention and its theoretical foundation is described in a separate paper.

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Impact of the HealthMatters Train-the-Trainer Program on the Health and Health Behaviors of Staff Supporting Adults With Intellectual and Developmental Disabilities

Workplace Health & Safety ◽

10.1177/2165079919828739 ◽

2019 ◽

Vol 67 (8) ◽

pp. 423-435 ◽

Cited By ~ 1

Author(s):

Beth Marks ◽

Jasmina Sisirak ◽

Yen-Ching Chang ◽

Ryan Murphy

Keyword(s):

Developmental Disabilities ◽

Health Behaviors ◽

Vegetable Intake ◽

Intervention Group ◽

Outcome Expectations ◽

Fruit And Vegetable Intake ◽

Control Group ◽

Intellectual And Developmental Disabilities ◽

Fruit And Vegetable ◽

Train The Trainer

The health status and health behaviors among support staff providing daily support for people with intellectual and developmental disabilities (IDD-SS) in community-based organizations (CBOs) have not been systematically studied. This study examined the health impact of IDD-SS workers who participated in a HealthMatters Program: Train-the-Trainer Certified Instructor Workshop followed by implementing a 12-week HealthMatters Program for people with intellectual and developmental disabilities (IDD) that they care for as part of their employment. A total of 48 IDD-SS were enrolled into either an intervention ( n = 28) or control group ( n = 20). IDD-SS in the intervention group received an 8-hour HealthMatters Program: Train-the-Trainer Workshop immediately prior to teaching a 12-week HealthMatters Program for people with IDD. Assessments were conducted with IDD-SS before and after completing the 12-week HealthMatters Program to evaluate whether IDD-SS experienced any benefit of the training and teaching the program on their own health and health behaviors. Relative to the control group, the IDD-SS in the intervention group showed significant improvements in social/environmental supports for nutrition ( F = 4.92, p = .032), exercise outcome expectations ( F = 6.58, p = .014), nutrition outcome expectations ( F = 8.87, p = .005), fruit and vegetable intake ( F = 13.62, p = .001), knowledge of fruit and vegetable intake recommendations ( F = 11.25, p = .002), and stages of change for eating fruits and vegetables ( F = 6.86, p = .012). Results demonstrated that IDD-SS benefited from the health education programming. Findings support the need to develop programs and organizational policies for health promotion activities for direct care staff.

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Effects of a Health Promotion Program Based on a Train-the-Trainer Approach on Quality of Life and Mental Health of Long-Term Unemployed Persons

BioMed Research International ◽

10.1155/2015/719327 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Heribert Limm ◽

Mechthild Heinmüller ◽

Harald Gündel ◽

Katrin Liel ◽

Karin Seeger ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Health Promotion ◽

Health Promotion Program ◽

Control Group ◽

Train The Trainer ◽

Promotion Program ◽

Positive Effects

Background. Long-term unemployment is associated with poorer mental health. The aim of this study was to evaluate the effectiveness of a health promotion program using the train-the-trainer approach on health-related quality of life (HRQoL) and mental health of long-term unemployed persons.Methods. A prospective parallel-group study was conducted among 365 long-term unemployed persons. 287 participants (179 members of the intervention group IG and 108 members of the control group) were reassessed after three months. The intervention comprised both individual sessions based on Motivational Interviewing and participatory group sessions; no health promotion program was administered in the control group. The endpoints were HRQoL (SF-12), depression, and anxiety. The effect size of the change across time in the IG and CG was measured by Cohen’sd. To assess the significance of group differences in the change across time, a random effects model was used.Results. Within three months HRQoL improved and anxiety and depression decreased significantly in the IG. A significant intervention effect was observed for anxiety (p= 0.012). Effect sizes in the IG were small to moderate in terms of Cohen’sd(anxiety:d=-0.33; SF-12 mental:d=0.31; depression:d=-0.25; SF-12 physical:d=0.19).Conclusions. The health promotion program, based on a train-the-trainer approach, showed positive effects on HRQoL and mental health, especially anxiety, of long-term unemployed persons, a highly burdened target group where an improvement in mental health is a crucial prerequisite to social participation and successful reintegration into the job market.

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