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

Marieke De Craemer, Vera Verbestel, Maïté Verloigne, Odysseas Androutsos, Luis Moreno, Violeta Iotova, Berthold Koletzko, Piotr Socha, Yannis Manios and Greet Cardon
Additional contact information
Marieke De Craemer: Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
Vera Verbestel: Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
Maïté Verloigne: Research Foundation Flanders, 1000 Brussels, 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

IJERPH, 2020, vol. 17, issue 19, 1-20

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 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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