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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

Author

Listed:
  • Marieke De Craemer

    (Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
    Research Foundation Flanders, 1000 Brussels, Belgium)

  • Vera Verbestel

    (Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium)

  • Maïté Verloigne

    (Research Foundation Flanders, 1000 Brussels, Belgium
    Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium)

  • Odysseas Androutsos

    (Department of Nutrition and Dietetics, School of Physical Education, University of Thessaly, Sport Science and Dietetics, 421 00 Trikala, Greece)

  • Luis Moreno

    (Department of Physiatry and Nursing, GENUD (Growth, Exercise, Drinking Behaviour and Development), University of Zaragoza, 50001 Zaragoza, Spain)

  • Violeta Iotova

    (Department of Pediatrics, Medical University Varna, 9002 Varna, Bulgaria)

  • Berthold Koletzko

    (Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, 80337 Munich, Germany)

  • Piotr Socha

    (Children’s Memorial Institute, 04-730 Warsaw, Poland)

  • Yannis Manios

    (Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17778 Athens, Greece)

  • Greet Cardon

    (Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium)

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.

Suggested Citation

  • Marieke De Craemer & Vera Verbestel & Maïté Verloigne & Odysseas Androutsos & Luis Moreno & Violeta Iotova & Berthold Koletzko & Piotr Socha & Yannis Manios & 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," IJERPH, MDPI, vol. 17(19), pages 1-20, October.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:19:p:7312-:d:424532
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    References listed on IDEAS

    as
    1. Saunders, Ruth P. & Wilcox, Sara & Baruth, Meghan & Dowda, Marsha, 2014. "Process evaluation methods, implementation fidelity results and relationship to physical activity and healthy eating in the Faith, Activity, and Nutrition (FAN) study," Evaluation and Program Planning, Elsevier, vol. 43(C), pages 93-102.
    2. Saunders, Ruth P. & Ward, Dianne & Felton, Gwen M. & Dowda, Marsha & Pate, Russell R., 2006. "Examining the link between program implementation and behavior outcomes in the lifestyle education for activity program (LEAP)," Evaluation and Program Planning, Elsevier, vol. 29(4), pages 352-364, November.
    3. Rosen, L. & Manor, O. & Engelhard, D. & Zucker, D., 2006. "In defense of the randomized controlled trial for health promotion research," American Journal of Public Health, American Public Health Association, vol. 96(7), pages 1181-1186.
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