Evaluation of the implementation process of a kindergarten-based intervention (‘TigerKids’) to promote a healthy lifestyle.
Design:
Questionnaire survey among kindergarten teachers about programme implementation and acceptance.
Setting:
Kindergartens in Bavaria, Germany.
Methods:
Two hundred and fifteen kindergartens were included; 96.3 % returned informative questionnaires. ‘TigerKids’ is a multi-approach behavioural intervention programme to increase physical activity level and to promote healthy eating in preschool children. Project elements and materials are designed for kindergarten teachers, children, and their parents. The main outcome measures of the study are implementation, acceptance, and estimated effectiveness of the intervention programme.
Results:
The elements for promoting healthy lifestyle were implemented regularly in the participating kindergartens: 94.2 % used the drinking station daily, 75.8 % prepared the magic fruit plate daily, and 63.3 % carried out the activity programme at least two times per week. The educators reported that the children ate more fruits and vegetables, drank more non-sugared beverages, and were more active. The designed materials and elements for the children, the educators, and the parents were also evaluated positively by the kindergarten teachers.
Conclusion:
The ‘TigerKids’ programme is a suitable instrument for health promotion in the kindergarten setting.
KoletzkoBGirardetJPKlishW. Obesity in children and adolescents worldwide: Current views and future directions. Working group report of the first world congress of pediatric gastroenterology, hepatology, and nutrition. J Pediatr Gastroenterol Nutr, 2002: 35: 205–12.
2.
LobsteinTBaurLUauyR. Obesity in children and young people: A crisis in public health. Obes Rev, 2004: 5: 1–104.
3.
SummerbellCDWatersEEdmundsL. Interventions for preventing obesity in children. Cochrane Database Syst Rev, 2005: 3: CD001871.
KoletzkoB. Childhood obesity: Time for treatment or prevention?Eur J Lipid Sci Technology, 2004: 106: 287–8.
6.
ProcterKL. The aetiology of childhood obesity: A review. Nutr Res Rev, 2007: 20: 29–45.
7.
RoblinL. Childhood obesity: Food, nutrient, and eating-habit trends and influences. Appl Physiol Nutr Metab, 2007: 32: 635–645.
8.
LaniganJBarberSSinghalA. Symposium on ‘dietary management of disease’. Session 3 (joint with the British Dietetic Association): Management of obesity. Prevention of obesity in preschool children. Proc Nutr Soc, 2010: 69: 204–10.
9.
KaliesHLenzJvon KriesR. Prevalence of overweight and obesity and trends in body mass index in German pre-school children, 1982–97. Int J Obes Relat Metab Disord, 2002: 26: 1211–17.
10.
MoßAWabitschMKromeyer-HauschildK. Prävalenz von Übergewicht und Adipositas bei deutschen Einschulkindern [Prevalence of overweight and obesity of German children at the age of starting school]. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz, 2007: 50: 1424–31.
11.
WeberEHieblAStorrU. Prävalenz und Einflussfaktoren von Übergewicht und Adipositas bei Einschulungskindern [Prevalence and influencing factors of children at the age of starting school]. Dtsch Arztebl, 2008: 105(51–52): 883–889.
12.
ColeTJ. Children grow and horses race: Is the adiposity rebound a critical period for later obesity?BMC Pediatr, 2004: 4: 1–7.
13.
DanielsSRArnettDKEckelRH. Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment. Circulation, 2005: 111: 1999–2012.
14.
OgdenCLTroianoRPBriefelRR. Prevalence of overweight among preschool children in the United States, 1971 through 1994. Pediatrics, 1997: 99(4): 1–7.
15.
CampbellKJHeskethKD. Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obes Rev, 2007: 8(4): 327–338.
16.
BondMWyattKLloydJ. Systematic review of the effectiveness and cost-effectiveness of weight management schemes for the under fives: A short report. Health Technology Assessment, 2009: 13(61): 1–75.
17.
KaphingstKMStoryM. Child care as an untapped setting for obesity prevention: State child care licensing regulations related to nutrition, physical activity, and media use for preschool-aged children in the United States. Prev Chronic Dis, 2009: 6(1): 1–13.
SharmaM. International school-based interventions for preventing obesity in children. Obes Rev, 2006: 8: 155–67.
20.
BlufordDASherryBScanlonKS. Interventions to prevent or treat obesity in preschool children: A review of evaluated programs. Obesity, 2007: 15(6): 1356–72.
21.
BanduraA (eds). Social Learning Theory. Englewood Cliffs, NJ: Prentice-Hall, 1977.
22.
BayerOvon KriesRStrauss. Short- and mid-term effects of a setting based prevention program to reduce obesity risk factors in children: A cluster-randomized trial. Clin Nutr, 2009: 28(2): 122–8.
23.
TigerKids. Homepage. Online. Available: www.tigerkids.de (accessed 3 October 2011).
24.
JamesJThomasPCavanD. Preventing childhood obesity by reducing consumption of carbonated drinks: Cluster randomised controlled trial. BMJ, 2004: 328: 1237–42.
25.
FlodmarkC-EMarcusCBrittonM. Interventions to prevent obesity in children and adolescents: A systematic literature review. Int J Obes, 2006: 30: 579–89.
26.
BrownTSummerbellC. Systematic review of school-based interventions that focus on changing dietary intake and physical activity levels to prevent childhood obesity: An update to the obesity guidance produced by the National Institute for Health and Clinical Excellence. Obes Rev, 2009: 10: 110–41.
27.
Jiménez-PavónDKellyJReillyJJ. Associations between objectively measured habitual physical activity and adiposity in children and adolescents: Systematic review. Int J Pediatr Obes, 2010: 5(1): 3–18.
28.
LibudaLKerstingM. Soft drinks and body weight development in childhood: Is there a relationship?Curr Opin Clin Nutr Metab Care, 2009: 12(6): 596–600.
29.
BereEVeierødMBBjellandM. Free school fruit – sustained effect 1 year later. Health Educ Res, 2006: 21: 268–75.
30.
TroianoRPBriefelRRCarrollMD. Energy and fat intakes of children and adolescents in the United States: Data from the National Health and Nutrition Examination Surveys. Am J Clin Nutr, 2000: 72: 1343–53.
31.
WelshJACogswellMERogersS. Overweight among low-income preschool children associated with the consumption of sweet drinks: Missouri, 1999–2002. Pediatrics, 2005: 115: e223–9.
32.
StoryMKaphingstKMFrenchS. The role of child care settings in obesity prevention childhood obesity. Future Child, 2006: 16: 143–68.
33.
MuckelbauerRLibudaLClausenK. Promotion and provision of drinking water in schools for overweight prevention: Randomized, controlled cluster trial. Pediatrics, 2009: 123: e661–7.
34.
KhanLKSobushKKeenerD. Recommended community strategies and measurements to prevent obesity in the United States. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and Reports/Centers for Disease Control, 2009: 58: 1–26.
35.
ReillyJJ. Tackling the obesity epidemic: New approaches. Arch Dis Child, 2006: 91: 724–6.
