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Combining effect and process evaluation on European preschool children’s snacking behavior in a kindergarten-based, family-involved cluster randomized controlled trial : the ToyBox study

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Abstract
This study aimed at (1) studying the effect of the standardized ToyBox intervention on European preschoolers’ snacking behavior, and (2) studying whether a higher process evaluation score from teachers and parents/caregivers was associated with a more positive result for preschoolers’ snack intake. A sample of 4970 preschoolers (51.4% boys, 4.74 ± 0.44 years) from six European countries provided information on snack intake with the use of a Food Frequency Questionnaire. To investigate the effect of the intervention, multilevel repeated measures analyses were executed for the total sample and the six country-specific samples. Furthermore, questionnaires to measure process evaluation were used to compute a total process evaluation score for teachers and parents/caregivers. No significant intervention effects on preschoolers’ snack intake were found (all p > 0.003). In general, no different effects of the intervention on snack intake were found according to kindergarten teachers’ and parents’/caregivers’ process evaluation scores. The lack of effects could be due to limited intervention duration and dose. To induce larger effects on preschoolers’ snack intake, a less standardized intervention which is more tailored to the local needs might be needed.
Keywords
intervention, effect evaluation, process evaluation, snacking behavior, preschoolers

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MLA
De Craemer, Marieke, et al. “Combining Effect and Process Evaluation on European Preschool Children’s Snacking Behavior in a Kindergarten-Based, Family-Involved Cluster Randomized Controlled Trial : The ToyBox Study.” INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, vol. 17, no. 19, 2020, doi:10.3390/ijerph17197312.
APA
De Craemer, M., Verbestel, V., Verloigne, M., Androutsos, O., Moreno, L., Iotova, V., … Cardon, G. (2020). Combining effect and process evaluation on European preschool children’s snacking behavior in a kindergarten-based, family-involved cluster randomized controlled trial : the ToyBox study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 17(19). https://doi.org/10.3390/ijerph17197312
Chicago author-date
De Craemer, Marieke, Vera Verbestel, Maïté Verloigne, Odysseas Androutsos, Luis Moreno, Violeta Iotova, Berthold Koletsko, Piotr Socha, Yannis Manios, and Greet Cardon. 2020. “Combining Effect and Process Evaluation on European Preschool Children’s Snacking Behavior in a Kindergarten-Based, Family-Involved Cluster Randomized Controlled Trial : The ToyBox Study.” INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 17 (19). https://doi.org/10.3390/ijerph17197312.
Chicago author-date (all authors)
De Craemer, Marieke, Vera Verbestel, Maïté Verloigne, Odysseas Androutsos, Luis Moreno, Violeta Iotova, Berthold Koletsko, Piotr Socha, Yannis Manios, and Greet Cardon. 2020. “Combining Effect and Process Evaluation on European Preschool Children’s Snacking Behavior in a Kindergarten-Based, Family-Involved Cluster Randomized Controlled Trial : The ToyBox Study.” INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 17 (19). doi:10.3390/ijerph17197312.
Vancouver
1.
De Craemer M, Verbestel V, Verloigne M, Androutsos O, Moreno L, Iotova V, et al. Combining effect and process evaluation on European preschool children’s snacking behavior in a kindergarten-based, family-involved cluster randomized controlled trial : the ToyBox study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH. 2020;17(19).
IEEE
[1]
M. De Craemer et al., “Combining effect and process evaluation on European preschool children’s snacking behavior in a kindergarten-based, family-involved cluster randomized controlled trial : the ToyBox study,” INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, vol. 17, no. 19, 2020.
@article{8677024,
  abstract     = {This study aimed at (1) studying the effect of the standardized ToyBox intervention on
European preschoolers’ snacking behavior, and (2) studying whether a higher process evaluation score
from teachers and parents/caregivers was associated with a more positive result for preschoolers’ snack
intake. A sample of 4970 preschoolers (51.4% boys, 4.74 ± 0.44 years) from six European countries
provided information on snack intake with the use of a Food Frequency Questionnaire. To investigate
the effect of the intervention, multilevel repeated measures analyses were executed for the total sample
and the six country-specific samples. Furthermore, questionnaires to measure process evaluation were
used to compute a total process evaluation score for teachers and parents/caregivers. No significant
intervention effects on preschoolers’ snack intake were found (all p > 0.003). In general, no different
effects of the intervention on snack intake were found according to kindergarten teachers’ and
parents’/caregivers’ process evaluation scores. The lack of effects could be due to limited intervention
duration and dose. To induce larger effects on preschoolers’ snack intake, a less standardized
intervention which is more tailored to the local needs might be needed.},
  articleno    = {7312},
  author       = {De Craemer, Marieke and Verbestel, Vera and Verloigne, Maïté and Androutsos, Odysseas and Moreno, Luis and Iotova, Violeta and Koletsko, Berthold and Socha, Piotr and Manios, Yannis and Cardon, Greet},
  issn         = {1660-4601},
  journal      = {INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH},
  keywords     = {intervention,effect evaluation,process evaluation,snacking behavior,preschoolers},
  language     = {eng},
  number       = {19},
  pages        = {20},
  title        = {Combining effect and process evaluation on European preschool children’s snacking behavior in a kindergarten-based, family-involved cluster randomized controlled trial : the ToyBox study},
  url          = {http://dx.doi.org/10.3390/ijerph17197312},
  volume       = {17},
  year         = {2020},
}

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