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PLoS One. 2015 Feb 13;10(2):e0116876. doi: 10.1371/journal.pone.0116876. eCollection 2015.

Effectiveness of a universal parental support programme to promote healthy dietary habits and physical activity and to prevent overweight and obesity in 6-year-old children: the Healthy School Start Study, a cluster-randomised controlled trial.

Author information

1
Karolinska Institutet, Department of Public Health Sciences, Tomtebodavägen 18 A, 171 65 Solna, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Box 1497, 171 29 Solna, Sweden.
2
Karolinska Institutet, Department of Public Health Sciences, Tomtebodavägen 18 A, 171 65 Solna, Sweden.
3
Karolinska Institutet, Department of Clinical Neuroscience, Nobels väg 9, 171 65 Solna, Sweden.
4
Karolinska Institutet, Institute of Environmental Medicine, Box 210, 171 77 Stockholm, Sweden.

Abstract

OBJECTIVE:

To develop and evaluate the effectiveness of a parental support programme to promote healthy dietary and physical activity habits and to prevent overweight and obesity in Swedish children.

METHODS:

A cluster-randomised controlled trial was carried out in areas with low to medium socio-economic status. Participants were six-year-old children (n = 243) and their parents. Fourteen pre-school classes were randomly assigned to intervention (n = 7) and control groups (n = 7). The intervention lasted for 6 months and included: 1) Health information for parents, 2) Motivational Interviewing with parents and 3) Teacher-led classroom activities with children. Physical activity was measured by accelerometry, dietary and physical activity habits and parental self-efficacy through a questionnaire. Body weight and height were measured and BMI standard deviation score was calculated. Measurements were conducted at baseline, post-intervention and at 6-months follow-up. Group differences were examined using analysis of covariance and Poisson regression, adjusted for gender and baseline values.

RESULTS:

There was no significant intervention effect in the primary outcome physical activity. Sub-group analyses showed a significant gender-group interaction in total physical activity (TPA), with girls in the intervention group demonstrating higher TPA during weekends (p = 0.04), as well as in sedentary time, with boys showing more sedentary time in the intervention group (p = 0.03). There was a significantly higher vegetable intake (0.26 servings) in the intervention group compared to the control group (p = 0.003). At follow-up, sub-group analyses showed a sustained effect for boys. The intervention did not affect the prevalence of overweight or obesity.

CONCLUSIONS:

It is possible to influence vegetable intake in children and girls' physical activity through a parental support programme. The programme needs to be intensified in order to increase effectiveness and sustain the effects long-term. These findings are an important contribution to the further development of evidence-based parental support programmes to prevent overweight and obesity in children.

TRIAL REGISTRATION:

Controlled-trials.com ISRCTN32750699.

PMID:
25680096
PMCID:
PMC4332680
DOI:
10.1371/journal.pone.0116876
[Indexed for MEDLINE]
Free PMC Article

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