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Effect and process evaluation of a cluster randomized control trial on water intake and beverage consumption in preschoolers from six European countries : the ToyBox-study

(2016) PLOS ONE. 11(4).
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Abstract
BACKGROUND: Within the ToyBox-study, a kindergarten-based, family-involved intervention was developed to prevent overweight and obesity in European preschoolers, targeting four key behaviours related to early childhood obesity, including water consumption. The present study aimed to examine the effect of the ToyBox-intervention (cluster randomized controlled trial) on water intake and beverage consumption in European preschoolers and to investigate if the intervention effects differed by implementation score of kindergartens and parents/caregivers. METHOD: A sample of 4964 preschoolers (4.7±0.4 years; 51.5% boys) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain) was included in the data analyses. A standardized protocol was used and parents/caregivers filled in socio-demographic data and a food-frequency questionnaire. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and for the six country-specific samples. Based on the process evaluation questionnaire of teachers and parents/caregivers, an implementation score was constructed. To assess differences in water intake and beverage consumption by implementation score in the total sample, multilevel repeated measures analyses were performed. RESULTS: Limited intervention effects on water intake from beverages and overall beverage consumption were found. However, important results were found on prepacked fruit juice consumption, with a larger decrease in the intervention group compared to the control group. However, also a decline in plain milk consumption was found. Implementation scores were rather low in both kindergartens and parents/caregivers. Nevertheless, more favorable effects on beverage choices were found in preschoolers whose parents/caregivers and kindergarten teachers had higher implementation scores compared to those with lower implementation scores. CONCLUSION: The ToyBox-intervention can provide the basis for the development of more tailor-made interventions. However, new strategies to improve implementation of interventions should be created.
Keywords
SEDENTARY TIME, ENERGY-PROJECT, HYDRATION STATUS, CHILDHOOD OBESITY, FLUID INTAKE, PREVENT OBESITY, SOCIOECONOMIC-STATUS, PHYSICAL-ACTIVITY, SUGAR-SWEETENED BEVERAGES, FAMILY-INVOLVED INTERVENTION

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MLA
Pinket, An-Sofie, et al. “Effect and Process Evaluation of a Cluster Randomized Control Trial on Water Intake and Beverage Consumption in Preschoolers from Six European Countries : The ToyBox-Study.” PLOS ONE, vol. 11, no. 4, 2016, doi:10.1371/journal.pone.0152928.
APA
Pinket, A.-S., Van Lippevelde, W., De Bourdeaudhuij, I., Deforche, B., Cardon, G., Androutsos, O., … De Craemer, M. (2016). Effect and process evaluation of a cluster randomized control trial on water intake and beverage consumption in preschoolers from six European countries : the ToyBox-study. PLOS ONE, 11(4). https://doi.org/10.1371/journal.pone.0152928
Chicago author-date
Pinket, An-Sofie, Wendy Van Lippevelde, Ilse De Bourdeaudhuij, Benedicte Deforche, Greet Cardon, Odysseas Androutsos, Berthold Koletzko, et al. 2016. “Effect and Process Evaluation of a Cluster Randomized Control Trial on Water Intake and Beverage Consumption in Preschoolers from Six European Countries : The ToyBox-Study.” PLOS ONE 11 (4). https://doi.org/10.1371/journal.pone.0152928.
Chicago author-date (all authors)
Pinket, An-Sofie, Wendy Van Lippevelde, Ilse De Bourdeaudhuij, Benedicte Deforche, Greet Cardon, Odysseas Androutsos, Berthold Koletzko, Luis A Moreno, Piotr Socha, Violeta Iotova, Yannis Manios, and Marieke De Craemer. 2016. “Effect and Process Evaluation of a Cluster Randomized Control Trial on Water Intake and Beverage Consumption in Preschoolers from Six European Countries : The ToyBox-Study.” PLOS ONE 11 (4). doi:10.1371/journal.pone.0152928.
Vancouver
1.
Pinket A-S, Van Lippevelde W, De Bourdeaudhuij I, Deforche B, Cardon G, Androutsos O, et al. Effect and process evaluation of a cluster randomized control trial on water intake and beverage consumption in preschoolers from six European countries : the ToyBox-study. PLOS ONE. 2016;11(4).
IEEE
[1]
A.-S. Pinket et al., “Effect and process evaluation of a cluster randomized control trial on water intake and beverage consumption in preschoolers from six European countries : the ToyBox-study,” PLOS ONE, vol. 11, no. 4, 2016.
@article{7252923,
  abstract     = {{BACKGROUND: Within the ToyBox-study, a kindergarten-based, family-involved intervention was developed to prevent overweight and obesity in European preschoolers, targeting four key behaviours related to early childhood obesity, including water consumption. The present study aimed to examine the effect of the ToyBox-intervention (cluster randomized controlled trial) on water intake and beverage consumption in European preschoolers and to investigate if the intervention effects differed by implementation score of kindergartens and parents/caregivers.
METHOD: A sample of 4964 preschoolers (4.7±0.4 years; 51.5% boys) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain) was included in the data analyses. A standardized protocol was used and parents/caregivers filled in socio-demographic data and a food-frequency questionnaire. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and for the six country-specific samples. Based on the process evaluation questionnaire of teachers and parents/caregivers, an implementation score was constructed. To assess differences in water intake and beverage consumption by implementation score in the total sample, multilevel repeated measures analyses were performed.
RESULTS: Limited intervention effects on water intake from beverages and overall beverage consumption were found. However, important results were found on prepacked fruit juice consumption, with a larger decrease in the intervention group compared to the control group. However, also a decline in plain milk consumption was found. Implementation scores were rather low in both kindergartens and parents/caregivers. Nevertheless, more favorable effects on beverage choices were found in preschoolers whose parents/caregivers and kindergarten teachers had higher implementation scores compared to those with lower implementation scores.
CONCLUSION: The ToyBox-intervention can provide the basis for the development of more tailor-made interventions. However, new strategies to improve implementation of interventions should be created.}},
  articleno    = {{e0152928}},
  author       = {{Pinket, An-Sofie and Van Lippevelde, Wendy and De Bourdeaudhuij, Ilse and Deforche, Benedicte and Cardon, Greet and Androutsos, Odysseas and Koletzko, Berthold and Moreno, Luis A and Socha, Piotr and Iotova, Violeta and Manios, Yannis and De Craemer, Marieke}},
  issn         = {{1932-6203}},
  journal      = {{PLOS ONE}},
  keywords     = {{SEDENTARY TIME,ENERGY-PROJECT,HYDRATION STATUS,CHILDHOOD OBESITY,FLUID INTAKE,PREVENT OBESITY,SOCIOECONOMIC-STATUS,PHYSICAL-ACTIVITY,SUGAR-SWEETENED BEVERAGES,FAMILY-INVOLVED INTERVENTION}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{19}},
  title        = {{Effect and process evaluation of a cluster randomized control trial on water intake and beverage consumption in preschoolers from six European countries : the ToyBox-study}},
  url          = {{http://doi.org/10.1371/journal.pone.0152928}},
  volume       = {{11}},
  year         = {{2016}},
}

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