Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Aug 26;12(9):2599.
doi: 10.3390/nu12092599.

Effects of the Preschool-Based Family-Involving DAGIS Intervention Program on Children's Energy Balance-Related Behaviors and Self-Regulation Skills: A Clustered Randomized Controlled Trial

Carola Ray  1   2 , Rejane Figuereido  1   3 , Henna Vepsäläinen  2 , Reetta Lehto  1   2 , Riikka Pajulahti  1   2 , Essi Skaffari  1   2 , Taina Sainio  1   4 , Pauliina Hiltunen  1   2 , Elviira Lehto  1   4 , Liisa Korkalo  2 , Katri Sääksjärvi  4 , Nina Sajaniemi  4   5 , Maijaliisa Erkkola  2 , Eva Roos  1   2   6
Affiliations
Randomized Controlled Trial

Effects of the Preschool-Based Family-Involving DAGIS Intervention Program on Children's Energy Balance-Related Behaviors and Self-Regulation Skills: A Clustered Randomized Controlled Trial

Carola Ray et al. Nutrients. .

Abstract

The study examines the effects of a preschool-based family-involving multicomponent intervention on children's energy balance-related behaviors (EBRBs) such as food consumption, screen time and physical activity (PA), and self-regulation (SR) skills, and whether the intervention effects differed among children with low or high parental educational level (PEL) backgrounds. The Increased Health and Wellbeing in Preschools (DAGIS) intervention was conducted as a clustered randomized controlled trial, clustered at preschool level, over five months in 2017-2018. Altogether, 802 children aged 3-6 years in age participated. Parents reported children's consumption of sugary everyday foods and beverages, sugary treats, fruits, and vegetables by a food frequency questionnaire, and screen time by a 7-day diary. Physical activity was assessed by a hip-worn accelerometer. Cognitive and emotional SR was reported in a questionnaire by parents. General linear mixed models with and without repeated measures were used as statistical methods. At follow-up, no differences were detected in EBRBs or SR skills between the intervention and control group, nor did differences emerge in children's EBRBs between the intervention and the control groups when stratified by PEL. The improvement in cognitive SR skills among low PEL intervention children differed from low PEL control children, the significance being borderline. The DAGIS multicomponent intervention did not significantly affect children's EBRBs or SR. Further sub-analyses and a comprehensive process evaluation may shed light on the non-significant findings.

Keywords: children; energy balance-related behaviors; intervention effects; intervention mapping; multicomponent intervention; parental educational level; preschoolers; randomized controlled trial; self-regulation skills.

PubMed Disclaimer

Conflict of interest statement

L.K. is a board member of the company TwoDads. The other authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow chart in the Increased Health and Wellbeing in Preschools (DAGIS) intervention study, in accordance with the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement [33].
Figure 2
Figure 2
Children’s EBRBs (heading (A–E)) and SR skills (headings (F,G)) at the baseline and follow-up in the intervention and control groups (means). For exact mean values, please see Table 2 (* p-value < 0.05, • p-value < 0.01 for the difference between the follow-up and baseline within the group).
Figure 3
Figure 3
Children’s EBRBs (headings (A–E)) and SR skills (headings (F,G)) within the intervention group separated by highest parental educational level (PEL) (means). For exact mean values, please see Supplementary Table S2 (* p-value < 0.05 for difference between follow-up and baseline within the group).
See this image and copyright information in PMC

References

    1. Kremers S.P.J., de Bruijn G.J., Visscher T.L.S., van Mechelen W., de Vries N.K., Brug J. Environmental Influences on Energy Balance-Related Behaviors: A Dual-Process View. Int. J. Behav. Nutr. Phys. Act. 2006;3:1–10. doi: 10.1186/1479-5868-3-9. - DOI - PMC - PubMed
    1. World Health Organization . Report of the Comission on Ending Childhood Obesity. WHO; Geneva, Switzerland: 2016.
    1. Halfon N., Larson K., Slusser W. Associations between Obesity and Comorbid Mental Health, Developmental, and Physical Health Conditions in a Nationally Representative Sample of US Children Aged 10 to 17. Acad. Pediatr. 2013;13:6–13. doi: 10.1016/j.acap.2012.10.007. - DOI - PubMed
    1. Reilly J.J., Methven E., Mcdowell Z.C., Hacking B., Alexander D., Stewart L., Kelnar C.J.H. Health Consequences of Obesity. Arch. Dis. Child. 2003;88:748–752. doi: 10.1136/adc.88.9.748. - DOI - PMC - PubMed
    1. Mantziki K., Vassilopoulos A., Radulian G., Borys J.-M., Du Plessis H., Gregorio M.J., Graca P., De Henauw S., Handjiev S., Visscher T. Inequities in Energy-Balance Related Behaviours and Family Environmental Determinants in European Children: Baseline Results of the Prospective EPHE Evaluation Study. BMC Public Health. 2015;15:1203. doi: 10.1186/s12889-015-2540-5. - DOI - PMC - PubMed

Publication types