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Development and evaluation of evidence-based interventions to change young children's energy balance-related behaviours

Vera Verbestel (UGent)
(2014)
Author
Promoter
(UGent) and (UGent)
Organization
Project
POP Study
Project
IDEFICS
Abstract
The prevalence of childhood overweight and obesity has increased during the past decades and is considered to be a public health problem. Although stabilizing trends in overweight and obesity prevalence have been identified in different parts of Europe, preventive efforts in children are still needed. A small positive energy balance is required for children to grow and develop normally but overweight and obesity occurs when energy intake extensively exceeds energy expenditure for an extended period of time. The literature extensively acknowledges the role of diet, physical activity and sedentary behaviour in determining children’s energy balance. The international evidence base on intervention strategies to change children’s energy balance-related behaviours has accumulated over the past years but still remains unclear. Therefore, the present thesis aims to contribute to the literature by addressing the development and evaluation of evidence-based interventions to change energy balance-related behaviours in toddlers (1-3 years), pre-schoolers (3-5 years) and school-aged children (5-10 years). The aims of the original research included in the thesis were threefold: a first aim was to improve the understanding of physical activity and sedentary behaviour in young children. Secondly, we aimed to develop an evidence-based and culturally adaptable intervention aiming to prevent childhood obesity by changing energy balance-related behaviours in pre-schoolers and school-aged children. A third aim was to evaluate interventions to change energy balance-related behaviours in toddlers, pre-schoolers and school-aged children. With respect to the first aim, the results of the observational study demonstrated the great potential of the preschool setting to promote physical activity and reduce sedentary behaviour in pre-schoolers. The results also emphasised the necessity of promoting physical activity during after school hours and during weekend days in future intervention studies. Results of the methodological study showed that context-specific measures of physical activity (e.g. outdoor play) and sedentary behaviour (e.g. screen time) are not representative for children’s overall physical activity and sedentary time. Context-specific and objective measures of physical activity and sedentary time should therefore be complemented, depending on the aim of the study. The studies that addressed the second aim resulted in a detailed description of the developmental process and content of the IDEFICS intervention, consisting of ten intervention modules to prevent childhood overweight and obesity in 2-9 year old children in eight European countries. The intervention modules aimed to change energy balance-related behaviours by targeting environmental and personal factors through the family, the school and the community, and allowed for cultural adaptation. This way, our research resulted in the development, implementation and evaluation of the first cross-national and full socio-ecological intervention model in Europe. Finally, results of the studies addressing the third aim showed that healthy lifestyle interventions were not able to change children’s energy balance-related behaviours in toddlers, pre-schoolers and school-aged children. However, a family-based healthy lifestyle intervention implemented through existing day cares showed promises for early obesity prevention. Despite the lack of behavioural intervention effects, energy balance-related behaviours were found to develop in unhealthy direction in both the intervention and the control group and emphasized the importance of initiating health promotion interventions early in life.

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Citation

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Chicago
Verbestel, Vera. 2014. “Development and Evaluation of Evidence-based Interventions to Change Young Children’s Energy Balance-related Behaviours”. Ghent, Belgium: Ghent University. Faculty of Medicine and Health Sciences.
APA
Verbestel, V. (2014). Development and evaluation of evidence-based interventions to change young children’s energy balance-related behaviours. Ghent University. Faculty of Medicine and Health Sciences, Ghent, Belgium.
Vancouver
1.
Verbestel V. Development and evaluation of evidence-based interventions to change young children’s energy balance-related behaviours. [Ghent, Belgium]: Ghent University. Faculty of Medicine and Health Sciences; 2014.
MLA
Verbestel, Vera. “Development and Evaluation of Evidence-based Interventions to Change Young Children’s Energy Balance-related Behaviours.” 2014 : n. pag. Print.
@phdthesis{4419522,
  abstract     = {The prevalence of childhood overweight and obesity has increased during the past decades and is considered to be a public health problem. Although stabilizing trends in overweight and obesity prevalence have been identified in different parts of Europe, preventive efforts in children are still needed. A small positive energy balance is required for children to grow and develop normally but overweight and obesity occurs when energy intake extensively exceeds energy expenditure for an extended period of time. The literature extensively acknowledges the role of diet, physical activity and sedentary behaviour in determining children{\textquoteright}s energy balance. The international evidence base on intervention strategies to change children{\textquoteright}s energy balance-related behaviours has accumulated over the past years but still remains unclear. Therefore, the present thesis aims to contribute to the literature by addressing the development and evaluation of evidence-based interventions to change energy balance-related behaviours in toddlers (1-3 years), pre-schoolers (3-5 years) and school-aged children (5-10 years). The aims of the original research included in the thesis were threefold: a first aim was to improve the understanding of physical activity and sedentary behaviour in young children. Secondly, we aimed to develop an evidence-based and culturally adaptable intervention aiming to prevent childhood obesity by changing energy balance-related behaviours in pre-schoolers and school-aged children. A third aim was to evaluate interventions to change energy balance-related behaviours in toddlers, pre-schoolers and school-aged children. With respect to the first aim, the results of the observational study demonstrated the great potential of the preschool setting to promote physical activity and reduce sedentary behaviour in pre-schoolers. The results also emphasised the necessity of promoting physical activity during after school hours and during weekend days in future intervention studies. Results of the methodological study showed that context-specific measures of physical activity (e.g. outdoor play) and sedentary behaviour (e.g. screen time) are not representative for children{\textquoteright}s overall physical activity and sedentary time. Context-specific and objective measures of physical activity and sedentary time should therefore be complemented, depending on the aim of the study. The studies that addressed the second aim resulted in a detailed description of the developmental process and content of the IDEFICS intervention, consisting of ten intervention modules to prevent childhood overweight and obesity in 2-9 year old children in eight European countries. The intervention modules aimed to change energy balance-related behaviours by targeting environmental and personal factors through the family, the school and the community, and allowed for cultural adaptation. This way, our research resulted in the development, implementation and evaluation of the first cross-national and full socio-ecological intervention model in Europe. Finally, results of the studies addressing the third aim showed that healthy lifestyle interventions were not able to change children{\textquoteright}s energy balance-related behaviours in toddlers, pre-schoolers and school-aged children. However, a family-based healthy lifestyle intervention implemented through existing day cares showed promises for early obesity prevention. Despite the lack of behavioural intervention effects, energy balance-related behaviours were found to develop in unhealthy direction in both the intervention and the control group and emphasized the importance of initiating health promotion interventions early in life.},
  author       = {Verbestel, Vera},
  language     = {eng},
  pages        = {254},
  publisher    = {Ghent University. Faculty of Medicine and Health Sciences},
  school       = {Ghent University},
  title        = {Development and evaluation of evidence-based interventions to change young children's energy balance-related behaviours},
  year         = {2014},
}