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  • 1.
    Androutsos, O
    et al.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greec.
    Apostolidou, E
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greec.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Moreno, L
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain .
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Koletzko, B
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Process evaluation design and tools used in a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 74-80Article in journal (Refereed)
    Abstract [en]

    Process evaluation (PE) is used for the in-depth evaluation of the implementation process of health promotion programmes. The aim of the current paper was to present the PE design and tools used in the ToyBox-intervention. The PE design was based on a three-step approach, including the identification of ToyBox-specific PE elements (step 1), the development of PE tools and harmonization of procedures (step 2), and the implementation of PE using standardized protocol and tools across the intervention countries (step 3). Specifically, to evaluate the implementation of the intervention, teachers' monthly logbooks were recorded (dose delivered, fidelity, dose received); post-intervention questionnaires were completed by parents/caregivers and teachers (dose received); participation and attrition rates were recorded (recruitment, reach); and audit questionnaires and retrospective information on weather conditions were collected (physical and social environment within which the intervention was implemented). Regarding the teachers' training sessions, the researchers who performed the trainings completed evaluation forms and documented teachers' attendance after each training (dose delivered, fidelity, dose received) and teachers completed evaluation forms after each training (dose received). The PE performed in the ToyBox-intervention may contribute in the evaluation of its effectiveness, guide the revision of the intervention material and provide insights for future health promotion programmes and public health policy.

  • 2.
    Androutsos, O
    et al.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Katsarou, C
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Payr, A
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Geyer, C
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Wildgruber, A
    State Institute of Early Childhood Research, Munich, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Lateva, M
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    De Decker, E
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    De Craemer, M
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Moreno, L
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Koletzko, B V
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Designing and implementing teachers' training sessions in a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 48-52Article in journal (Refereed)
    Abstract [en]

    Since school-based interventions are mainly delivered by the school staff, they need to be well-trained and familiarized with the programme's aims, procedures and tools. Therefore, the institute, research group, governmental or non-governmental body in charge of the coordination and implementation of the programme needs to devote time and resources to train the school staff before programme's implementation. This is particularly crucial in multi-centre studies where more than one research teams are involved. Both research teams and school staff need to be trained, using standard protocols and procedures, to ensure that the intervention will be delivered in a standardized manner throughout the intervention centres. The ToyBox-intervention, a multi-component, kindergarten-based, family-involved intervention, focusing on water consumption, snacking, physical activity and sedentary behaviours in preschool children, was implemented over the academic year 2012-2013 in six European countries. As part of this intervention, three teachers' training sessions were delivered to motivate and train teachers in implementing the intervention. The local researchers were trained centrally before delivering the training sessions for the teachers and followed a common protocol using standardized presentations and procedures. The aim of the current paper is to describe the protocol and methodological issues related to the teachers' training sessions conducted within the ToyBox-intervention.

  • 3.
    De Craemer, M
    et al.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Decker, E
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Verloigne, M
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Duvinage, K
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Koletzko, B
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Ibrügger, S
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Grammatikaki, E
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Moreno, L
    Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain.
    Iotova, V
    Department of Social Medicine and Health Care Organization, Medical University Varna, Varna, Bulgaria.
    Socha, P
    Children’s Memorial Health Institute, Warsaw, Poland.
    Szott, K
    Children’s Memorial Health Institute, Warsaw, Poland.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Cardon, G
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Applying the Intervention Mapping protocol to develop a kindergarten-based, family-involved intervention to increase European preschool children's physical activity levels: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 14-26Article in journal (Refereed)
    Abstract [en]

    Although sufficient physical activity is beneficial for preschoolers' health, activity levels in most preschoolers are low. As preschoolers spend a considerable amount of time at home and at kindergarten, interventions should target both environments to increase their activity levels. The aim of the current paper was to describe the six different steps of the Intervention Mapping protocol towards the systematic development and implementation of the physical activity component of the ToyBox-intervention. This intervention is a kindergarten-based, family-involved intervention implemented across six European countries. Based on the results of literature reviews and focus groups with parents/caregivers and kindergarten teachers, matrices of change objectives were created. Then, theory-based methods and practical strategies were selected to develop intervention materials at three different levels: (i) individual level (preschoolers); (ii) interpersonal level (parents/caregivers) and (iii) organizational level (teachers). This resulted in a standardized intervention with room for local and cultural adaptations in each participating country. Although the Intervention Mapping protocol is a time-consuming process, using this systematic approach may lead to an increase in intervention effectiveness. The presented matrices of change objectives are useful for future programme planners to develop and implement an intervention based on the Intervention Mapping protocol to increase physical activity levels in preschoolers.

  • 4.
    De Miguel-Etayo, P.
    et al.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Department of Paediatrics, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain.
    Mesana, M. I.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Cardon, G.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, I.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Góźdź, M.
    he Children’s Memorial Health Institute, Warsaw, Poland.
    Socha, P.
    he Children’s Memorial Health Institute, Warsaw, Poland.
    Lateva, M.
    Department of Paediatrics, Medical University Varna , Varna, Bulgaria.
    Iotova, V.
    Department of Paediatrics, Medical University Varna , Varna, Bulgaria.
    Koletzko, B. V.
    Division of Metabolic Diseases and Nutritional Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
    Duvinage, K.
    Division of Metabolic Diseases and Nutritional Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
    Androutsos, O.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Manios, Y.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Reliability of anthropometric measurements in European preschool children: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 67-73Article in journal (Refereed)
    Abstract [en]

    The ToyBox-study aims to develop and test an innovative and evidence-based obesity prevention programme for preschoolers in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. In multicentre studies, anthropometric measurements using standardized procedures that minimize errors in the data collection are essential to maximize reliability of measurements. The aim of this paper is to describe the standardization process and reliability (intra- and inter-observer) of height, weight and waist circumference (WC) measurements in preschoolers. All technical procedures and devices were standardized and centralized training was given to the fieldworkers. At least seven children per country participated in the intra- and inter-observer reliability testing. Intra-observer technical error ranged from 0.00 to 0.03 kg for weight and from 0.07 to 0.20 cm for height, with the overall reliability being above 99%. A second training was organized for WC due to low reliability observed in the first training. Intra-observer technical error for WC ranged from 0.12 to 0.71 cm during the first training and from 0.05 to 1.11 cm during the second training, and reliability above 92% was achieved. Epidemiological surveys need standardized procedures and training of researchers to reduce measurement error. In the ToyBox-study, very good intra- and-inter-observer agreement was achieved for all anthropometric measurements performed.

  • 5.
    de Vries, Claire E. E.
    et al.
    Department of Surgery, OLVG, Amsterdam, The Netherlands.
    Terwee, Caroline B.
    Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, TheNetherlands.
    Al Nawas, May
    Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
    van Wagensveld, Bart A.
    Department of Surgery, NMC Royal Hospital, Abu Dhabi, United Arab Emirates.
    Janssen, Ignace M. C.
    Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis Ter Heide, The Netherlands.
    Liem, Ronald S. L.
    Department of Surgery, Groene Hart Hospital, Gouda, The Netherlands; Dutch Obesity Clinic, The Hague, The Netherlands.
    Nienhuijs, Simon W.
    Department of Surgery, Catharina Hospital Eindhoven, The Netherlands.
    Cohen, Ricardo, V
    The Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, S ̃ao Paulo, Brazil.
    van Rossum, Elisabeth F. C.
    Obesity Centre CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
    Brown, Wendy A.
    Department of Surgery, Central Clinical School, Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
    Ghaferi, Amir A.
    Department of Surgery, University of Michigan, Ann Arbor Michigan, USA.
    Ottosson, Johan
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery.
    Coulman, Karen D.
    Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, North Bristol NHS Trust, Bristol, UK.
    Petry, Tarissa B. Z.
    The Center for Obesity and Diabetes, Oswaldo Cruz German Hospital, S ̃ao Paulo, Brazil.
    Sogg, Stephanie
    Massachusetts General Hospital Weight Center, Harvard Medical School, Boston Massachusetts, USA.
    West-Smith, Lisa
    Department of Surgery, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati Ohio, USA.
    Halford, Jason C. G.
    School of Psychology, University of Leeds, Leeds, UK.
    Salas, Ximena Ramos
    Obesity Canada, Edmonton, Alberta, Canada; European Association for the Study of Obesity, Teddington, UK.
    Dixon, John B.
    Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
    Al-Sabah, Salman
    Department of Surgery, Jaber Al-Ahmad Hospital, Ministry of Health, Kuwait City, Kuwait.
    Lee, Wei-Jei
    Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan.
    Andersen, John Roger
    Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway; Centre of Health Research, Førde Hospital Trust, Førde, Norway.
    Flint, Stuart W.
    School of Psychology, University of Leeds, Leeds, UK; Scales Insights, Nexus, University of Leeds, Leeds, UK .
    Hoogbergen, Maarten M.
    Department of Plastic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
    Backman, Brooke
    Bariatric Surgery Registry, Monash University, Melbourne, Victoria, Australia.
    Govers, Ellen
    Amstelring and Dutch Knowledge Centre of Dietitians on Obesity (KDOO), Amsterdam, The Netherlands.
    Isack, Nadya
    Obesity Empowerment Network, London, UK.
    Clay, Caroline
    By-Band-Sleeve Study Patient Group, London, UK.
    Birney, Susie
    European Coalition for People Living with Obesity, Dublin, Ireland.
    Gunn, Maureen
    European Coalition for People Living with Obesity, Dublin, Ireland.
    Masterson, Paul
    European Coalition for People Living with Obesity, Dublin, Ireland.
    Roberts, Audrey
    European Coalition for People Living with Obesity, Dublin, Ireland.
    Nesbitt, Jacky
    European Coalition for People Living with Obesity, Dublin, Ireland.
    Meloni, Riccardo
    People Living with Obesity Representatives of the S.Q.O.T. Initiative, Amsterdam, The Netherlands.
    le Brocq, Sarah
    Obesity UK, Southport, UK.
    de Blaeij, Sandra
    KleinePorties, Kloetinge, The Netherlands.
    Kraaijveld, Christina
    People Living with Obesity Representatives of the S.Q.O.T. Initiative, Amsterdam, The Netherlands.
    van der Steen, Floor
    People Living with Obesity Representatives of the S.Q.O.T. Initiative, Amsterdam, The Netherlands.
    Visser, Bibian
    People Living with Obesity Representatives of the S.Q.O.T. Initiative, Amsterdam, The Netherlands.
    Hamers, Petra
    People Living with Obesity Representatives of the S.Q.O.T. Initiative, Amsterdam, The Netherlands.
    Monpellier, Valerie M.
    Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis Ter Heide, The Netherlands.
    Outcomes of the first global multidisciplinary consensus meeting including persons living with obesity to standardize patient-reported outcome measurement in obesity treatment research2022In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 23, no 8, article id e13452Article in journal (Refereed)
    Abstract [en]

    Quality of life is a key outcome that is not rigorously measured in obesity treatment research due to the lack of standardization of patient-reported outcomes (PROs) and PRO measures (PROMs). The S.Q.O.T. initiative was founded to Standardize Quality of life measurement in Obesity Treatment. A first face-to-face, international, multidisciplinary consensus meeting was conducted to identify the key PROs and preferred PROMs for obesity treatment research. It comprised of 35 people living with obesity (PLWO) and healthcare providers (HCPs). Formal presentations, nominal group techniques, and modified Delphi exercises were used to develop consensus-based recommendations. The following eight PROs were considered important: self-esteem, physical health/functioning, mental/psychological health, social health, eating, stigma, body image, and excess skin. Self-esteem was considered the most important PRO, particularly for PLWO, while physical health was perceived to be the most important among HCPs. For each PRO, one or more PROMs were selected, except for stigma. This consensus meeting was a first step toward standardizing PROs (what to measure) and PROMs (how to measure) in obesity treatment research. It provides an overview of the key PROs and a first selection of the PROMs that can be used to evaluate these PROs.

  • 6.
    Duvinage, K
    et al.
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig- Maximilians-University of Munich, München, Germany.
    Ibrügger, S
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig- Maximilians-University of Munich, München, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Wildgruber, A
    State Institute of Early Childhood Research, Munich, Germany.
    De Craemer, M
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    De Decker, E
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Lateva, M
    Department of Pediatrics and Medical Genetics, Medical University Varna, Varna, Bulgaria.
    Iotova, V
    Department of Pediatrics and Medical Genetics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    Children’s Memorial Health Institute, Warsaw, Poland.
    Zych, K
    Children’s Memorial Health Institute, Warsaw, Poland.
    Mouratidou, T
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Mesana Graffe, M I
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Koletzko, B
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig- Maximilians-University of Munich, München, Germany.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Developing the intervention material to increase physical activity levels of European preschool children: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 27-39Article in journal (Refereed)
    Abstract [en]

    Early childhood is an important period for adopting positive health-related behaviours. More than 95% of European preschool children attend kindergartens, making these settings ideal for the implementation of health promotion interventions. The ToyBox-intervention addressed preschool children, their parents/caregivers and teachers. The aim of the intervention was to improve four energy balance-related behaviours (i.e. healthy snacking, water consumption, physical activity and sedentary behaviour) by implementing a kindergarten-based, family-involved intervention in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). The intervention material was developed following the intervention mapping protocol, taking into account local and cultural differences among the intervention countries. The present paper focuses on the development of the physical activity component of the intervention. Parental involvement was addressed by providing parents/caregivers with two newsletters, two tip cards and a poster. Teachers received a handbook with guidance on environmental changes in the classroom, 26 physical education sessions and suggestions for fun, interactive classroom activities aiming at total class participation to increase preschoolers' physical activity levels. The ToyBox-intervention material was distributed according to a standard time frame. Teachers received their material prior to the start of the intervention and parents/caregivers received their material during the intervention when each energy balance-related behaviour was implemented.

  • 7.
    González-Gil, E. M.
    et al.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Mouratidou, T.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Cardon, G.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Androutsos, O.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    De Bourdeaudhuij, I.
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Góźdź, M.
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Usheva, N.
    Department of Social Medicine and Health Care Organization, Medical University Varna, Varna, Bulgaria.
    Birnbaum, J.
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Manios, Y.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Reliability of primary caregivers reports on lifestyle behaviours of European pre-school children: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 61-66Article in journal (Refereed)
    Abstract [en]

    Reliable assessments of health-related behaviours are necessary for accurate evaluation on the efficiency of public health interventions. The aim of the current study was to examine the reliability of a self-administered primary caregivers questionnaire (PCQ) used in the ToyBox-intervention. The questionnaire consisted of six sections addressing sociodemographic and perinatal factors, water and beverages consumption, physical activity, snacking and sedentary behaviours. Parents/caregivers from six countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain) were asked to complete the questionnaire twice within a 2-week interval. A total of 93 questionnaires were collected. Test-retest reliability was assessed using intra-class correlation coefficient (ICC). Reliability of the six questionnaire sections was assessed. A stronger agreement was observed in the questions addressing sociodemographic and perinatal factors as opposed to questions addressing behaviours. Findings showed that 92% of the ToyBox PCQ had a moderate-to-excellent test-retest reliability (defined as ICC values from 0.41 to 1) and less than 8% poor test-retest reliability (ICC < 0.40). Out of the total ICC values, 67% showed good-to-excellent reliability (ICC from 0.61 to 1). We conclude that the PCQ is a reliable tool to assess sociodemographic characteristics, perinatal factors and lifestyle behaviours of pre-school children and their families participating in the ToyBox-intervention.

  • 8.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science.
    Methodological procedures followed in a kindergarten-based, family-involved intervention implemented in six European countries to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15 Suppl 3, p. 1-4Article in journal (Refereed)
  • 9.
    Manios, Y
    et al.
    Department of Nutrition and Dietetics, Harokopio University , Athens , Greece.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University , Athens , Greece.
    Katsarou, C
    Department of Nutrition and Dietetics, Harokopio University , Athens , Greece.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Geyer, C
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Moreno, L
    GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain.
    Koletzko, B
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Designing and implementing a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 5-13Article in journal (Refereed)
    Abstract [en]

    The development of the ToyBox-intervention was based on the outcomes of the preliminary phase of the ToyBox-study, aiming to identify young children's key behaviours and their determinants related to early childhood obesity. The ToyBox-intervention is a multi-component, kindergarten-based, family-involved intervention with a cluster-randomized design, focusing on the promotion of water consumption, healthy snacking, physical activity and the reduction/ breaking up of sedentary time in preschool children and their families. The intervention was implemented during the academic year 2012-2013 in six European countries: Belgium, Bulgaria, Germany, Greece, Poland and Spain. Standardized protocols, methods, tools and material were used in all countries for the implementation of the intervention, as well as for the process, impact, outcome evaluation and the assessment of its cost-effectiveness. A total sample of 7,056 preschool children and their parents/caregivers, stratified by socioeconomic level, provided data during baseline measurements and participated in the intervention. The results of the ToyBox-study are expected to provide a better insight on behaviours associated with early childhood obesity and their determinants and identify effective strategies for its prevention. The aim of the current paper is to describe the design of the ToyBox-intervention and present the characteristics of the study sample as assessed at baseline, prior to the implementation of the intervention.

  • 10.
    Manios, Yannis
    et al.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Grammatikaki, Eva
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Chinapaw, MJ
    Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands.
    Gibson, EL
    Department of Psychology, Whitelands College, University of Roehampton, London, United Kingdom.
    Buijs, G
    Netherlands Institute for Health Promotion NIGZ, Woerden, Netherlands.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    The Children's Memorial Health Institute, Warsaw, Poland.
    Annemans, L
    Department of Public Health, Ghent University, Ghent, Belgium.
    Wildgruber, A
    State Institute for Early Childhood Research, Munich, Germany.
    Mouratidou, T
    GENUD (Growth Exercise NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Yngve, Agneta
    Department of Health, Nutrition and Management, Oslo and Akershus University College of Applied Science, Lillestrøm, Norway.
    Duvinage, K
    Dr von Hauner Children's Hospital, University of Munich Medical Centre, München, Germany.
    de Bourdheaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    A systematic approach for the development of a kindergarten-based intervention for the prevention of obesity: the Toy Box-study2012In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 13, no suppl1, p. 3-12Article, review/survey (Refereed)
    Abstract [en]

    The increasing childhood obesity epidemic calls for appropriate measures and effective policies to be applied early in life. Large-scale socioecological frameworks providing a holistic multifactorial and cost-effective approach necessary to support obesity prevention initiatives in this age are however currently missing. To address this missing link, ToyBox-study aims to build and evaluate a cost-effective kindergarten-based, family-involved intervention scheme to prevent obesity in early childhood, which could potentially be expanded on a pan-European scale. A multidisciplinary team of researchers from 10 countries have joined forces and will work to realize this according to a systematic stepwise approach that combines the use of the PRECEDE-PROCEED model and intervention mapping protocol. ToyBox-study will conduct systematic and narrative reviews, secondary data analyses, focus group research and societal assessment to design, implement and evaluate outcome, impact, process and cost effectiveness of the intervention. This is the first time that such a holistic approach has been used on a pan-European scale to promote healthy weight and healthy energy balance-related behaviours for the prevention of early childhood obesity. The results of ToyBox-study will be disseminated among key stakeholders including researchers, policy makers, practitioners and the general population.

  • 11.
    Mouratidou, T
    et al.
    GENUD (Growth Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Miguel, M L
    GENUD (Growth Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Cardon, G
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Kulaga, Z
    The Children’s Memorial Health Institute, Warszawa, Poland.
    Socha, P
    The Children’s Memorial Health Institute, Warszawa, Poland.
    Galcheva, S
    Medical University Varna, Varna, Bulgaria.
    Iotova, V
    Medical University Varna, Varna, Bulgaria.
    Payr, A
    Dr von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Koletzko, B
    Dr von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Moreno, L A
    GENUD (Growth Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Science, University of Zaragoza, Zaragoza, Spain.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Tools, harmonization and standardization procedures of the impact and outcome evaluation indices obtained during a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 53-60Article in journal (Refereed)
    Abstract [en]

    The ToyBox-intervention is a kindergarten-based, family-involved intervention targeting multiple lifestyle behaviours in preschool children, their teachers and their families. This intervention was conducted in six European countries, namely Belgium, Bulgaria, Germany, Greece, Poland and Spain. The aim of this paper is to provide a descriptive overview of the harmonization and standardization procedures of the baseline and follow-up evaluation of the study (and substudies). Steps related to the study's operational, standardization and harmonization procedures as well as the impact and outcome evaluation assessment tools used are presented. Experiences from the project highlight the importance of safeguarding the measurement process to minimize data heterogeneity derived from potential measurement error and country-by-country differences. In addition, it was made clear that continuing quality control and support is an important component of such studies. For this reason, well-supported communication channels, such as regular email updates and teleconferences, and regular internal and external meetings to ensure smooth and accurate implementation were in place during the study. The ToyBox-intervention and its harmonized and standardized procedures can serve as a successful case study for future studies evaluating the efficacy of similar interventions.

  • 12.
    Nethe, A
    et al.
    Netherlands Institute for Health Promotion NIGZ, Woerden, Netherlands.
    Dorgelo, A
    Netherlands Institute for Health Promotion NIGZ, Woerden, Netherlands.
    Kugelberg, S
    Department for Health, Nutrition and Management, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
    van Aasche, J
    Department of Political Science, Ghent University, Ghent, Belgium.
    Buijs, Goof
    Netherlands Institute for Health Promotion NIGZ, Woerden, Netherlands.
    Yngve, Agneta
    Department for Health, Nutrition and Management, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
    de Henauw, Stefan
    Department for Public Health, Ghent University, Ghent, Belgium.
    Boskou, G
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Existing policies, regulation, legislation and ongoing health promotion activities related to physical activity and nutrition in pre-primary education settings: an overview2012In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 13, no suppl 1, p. 118-128Article in journal (Refereed)
    Abstract [en]

    Obesity prevention efforts for school-aged children and adolescents are increasing in number. However, little has been done to address the problem in the preschool age. To address this age group, an evidence-based preschool programme on physical activity (PA) and nutrition is developed within the ToyBox project. Environmental influencing factors such as policies and competitive health promotion activities could inhibit or induce a successful health promotion programme. This paper describes an overview of existing policies, legislation and/or regulations and health promotion activities in the preschool setting. Method: data were gathered on policies and activities aiming to improve healthy eating and PA of young children (age group 4-6 years) in Belgium-Flanders, Bulgaria, Germany, Greece, Poland and Spain. A limited number of influencing policies, regulations and/or legislation exists; agenda setting of health promotion and policy evaluations in all relevant policy areas was lacking. Also, health promotion activities in preschool the setting did not exist in all six European countries and high-quality preschool-based health interventions existed in three of the six ToyBox countries.

  • 13.
    Payr, A
    et al.
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Wildgruber, A
    State Institute of Early Childhood Research, Munich, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Lateva, M
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    De Decker, E
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    De Craemer, M
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Koletzko, B
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Concepts and strategies on how to train and motivate teachers to implement a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 40-47Article in journal (Refereed)
    Abstract [en]

    The key person for the implementation of kindergarten-based behavioural interventions is the kindergarten teacher. When conducting intervention studies in kindergartens, training sessions are needed to train and motivate kindergarten teachers for programme implementation. This paper presents the systematic development of the teachers' trainings executed in the ToyBox-intervention - a kindergarten-based and family-involved obesity prevention programme for children aged 4-6. Based on concepts for the education of kindergarten teachers, on general strategies for successful programme implementation and on the ToyBox programme-specific requirements, the aims of the teachers' trainings were defined and an overall concept was deduced. Regarding the concept for the ToyBox teachers' training sessions, it is concluded that the training modules should focus on presenting information on the practical implementation of the intervention. Furthermore, these modules should also include self-efficacy enhancing components and should give kindergarten teachers opportunities to share experiences. Regarding the didactic methods applied in the ToyBox teachers' training sessions, constructivist learning approaches that facilitate active participation, reflective thinking and personal involvement were implemented. Emphasis was put not only on the content but especially on the didactic methods of teachers' trainings in order to enhance devotion to, and quality and sustainability of the ToyBox-intervention.

  • 14.
    Pil, L
    et al.
    Department of Public Health, Ghent University, Ghent, Belgium.
    Putman, K
    Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
    Cardon, G
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    De Bourdeaudhuij, I
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Androutsos, O
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Lateva, M
    Clinic of Paediatric Endocrinology, Medical University of Varna, Varna, Bulgaria.
    Iotova, V
    Clinic of Paediatric Endocrinology, Medical University of Varna, Varna, Bulgaria.
    Zych, K
    Public Health Division, The Children’s Memorial Health Institute, Warsaw, Poland.
    Góźdź, M
    Public Health Division, The Children’s Memorial Health Institute, Warsaw, Poland.
    González-Gil, E M
    Growth, Exercise, Nutrition and Development (GENUD) Reseach Group, University of Zaragoza, Zaragoza, Spain.
    De Miguel-Etayo, P
    Growth, Exercise, Nutrition and Development (GENUD), University of Zaragoza, Zaragoza, Spain.
    Geyer, C
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Birnbaum, J
    Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University of Munich, München, Germany.
    Annemans, L
    Department of Public Health, Ghent University, Ghent, Belgium; Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussels, Belgium.
    Nilsen, Bente (Contributor)
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Establishing a method to estimate the cost-effectiveness of a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 81-89Article in journal (Refereed)
    Abstract [en]

    Overweight and obesity in children are recognized as a major health problem. The ToyBox-intervention was developed with the aim of preventing obesity in pre-schoolers. Because it is increasingly important to inform policy makers not only on the effects of prevention interventions, but also on their costs and cost-effectiveness, our purpose was to establish a method to estimate the cost-effectiveness of the ToyBox-intervention. In order to estimate the long-term impact of the ToyBox-intervention on health and societal costs, extrapolations of the intervention effect will be conducted to predict children's weight status (based on the body mass index) at adult age. Effects of the adult weight status on the prevalence of obesity-related complications will be modelled through a Markov model, with a total time horizon of 70 years and a cycle length of 1 year. The model will be conducted in six European countries participating in the ToyBox-intervention, based on country-specific economic and epidemiological data. This study describes the methodological rationale and implementation of an analytic model to examine the cost-effectiveness of the ToyBox-intervention for six European countries, in order to inform decision-makers on the value for money of this intervention in the prevention of obesity in pre-schoolers.

  • 15.
    Sundbom, Magnus
    et al.
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Näslund, Ingmar
    Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Ottosson, Johan
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Stenberg, Erik
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Näslund, Erik
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Results from the Scandinavian Obesity Surgery Registry: A narrative review2024In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 25, no 2, article id e13662Article, review/survey (Refereed)
    Abstract [en]

    In 2007, the Scandinavian Obesity Surgery Registry (SOReg) was started by the profession to monitor the results of bariatric surgery and to provide a high-quality database for research. In the end of August 2023, SOReg contains 88,379 patients (body mass index [BMI] 41.7 kg/m2 , 41.2 years, 77.1% females, gastric bypass 76.8%). In this narrative review, we demonstrate that preoperative weight loss is of value and that the laparoscopic double omega-loop technique is highly suitable for gastric bypass. Closing the mesenteric openings is, however, important. Swedish bariatric surgery has low mortality, and our results are comparative to those of other countries. Significant long-term improvements are found in common obesity-related diseases such as diabetes, hypertension, and sleep apnea. Furthermore, the risk for cardiac failure and major adverse cardiovascular events is significantly reduced. Pregnancy-related outcomes are also improved. Gastric bypass results in significant improvements in quality of life and seems to be cost saving. We have revealed that low socioeconomic status is associated with reduced chance of undergoing bariatric surgery and inferior outcomes. Of note, we have performed several randomized clinical trials within the registry database. In conclusion, high-quality national registry databases, such as SOReg, are important for maintaining high-quality care and present a platform for extensive research.

  • 16.
    Taxová Braunerová, Radka
    et al.
    Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
    Kunešová, Marie
    Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
    Heinen, Mirjam M.
    National Nutrition Surveillance Centre, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
    Rutter, Harry
    Department of Social and Policy Sciences, University of Bath, Bath, UK.
    Hassapidou, Maria
    Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece.
    Duleva, Vesselka
    Department of Food and Nutrition, National Centre of Public Health and Analyses, Sofia, Bulgaria.
    Pudule, Iveta
    Department of Research and Health Statistics, Centre for Disease and Prevention Control, Riga, Latvia.
    Petrauskienė, Aušra
    Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Sjöberg, Agneta
    Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Lissner, Lauren
    School of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Spiroski, Igor
    Institute of Public Health, Skopje, North Macedonia; Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia.
    Gutiérrez-González, Enrique
    Spanish Agency for Food Safety and Nutrition, Ministry of Consumer Affairs, Madrid, Spain.
    Kelleher, Cecily C.
    College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland.
    Bergh, Ingunn Holden
    Department of Health and Inequality, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
    Metelcová, Tereza
    Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic; 1st Faculty of Medicine, Charles University, Prague, Czech Republic.
    Vignerová, Jana
    Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
    Brabec, Marek
    Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic.
    Buoncristiano, Marta
    World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
    Williams, Julianne
    World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
    Simmonds, Philippa
    World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
    Zamrazilová, Hana
    Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
    Hainer, Vojtěch
    Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic.
    Yngve, Agneta
    Örebro University, School of Health Sciences. Department of Nutrition, Dietetics and Food Studies, Uppsala University, Sweden.
    Rakovac, Ivo
    World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
    Breda, João
    World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation.
    Waist circumference and waist-to-height ratio in 7-year-old children: WHO Childhood Obesity Surveillance Initiative2021In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 22, no S6, article id e13208Article in journal (Refereed)
    Abstract [en]

    Childhood obesity is a serious global health problem. Waist circumference (WC) and waist-to-height ratio (WHtR) reflect body fat distribution in children. The objectives of this study were to assess WC and WHtR in 7-year-old children and to determine body mass index (BMI), WC, and WHtR differences in children from 10 selected countries across Europe (Bulgaria, Czechia, Greece, Ireland, Latvia, Lithuania, North Macedonia, Norway, Spain, and Sweden) participating in the World Health Organization (WHO) Europe Childhood Obesity Surveillance Initiative (COSI). The 50th and 90th percentile of WC (according to COSI and "Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS" (IDEFICS) cutoff values) and WHtR above 0.5 were used as measures of abdominal obesity in a unique sample of 38,975 children aged 7.00-7.99 years. Southern European countries, including Greece and Spain, showed significantly higher BMI, WC, and WHtRin both genders (p < 0.0001) than Eastern and Northern Europe. The highest values for WC were observed in Greece (60.8 ± 7.36 cm boys; 60.3 ± 7.48 cm girls), North Macedonia (60.4 ± 7.91 cm boys; 59.0 ± 8.01 cm girls), and Spain (59.7 ± 6.96 cm boys; 58.9 ± 6.77 cm girls). WC and WHtRin may add an information about the occurrence of central obesity in children.

  • 17.
    Wang, Jian
    et al.
    Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
    Chang, Yan-Shing
    Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
    Wei, Xiaoxue
    School of Nursing, Shanghai Jiao Tong University, Shanghai, China.
    Cao, Yang
    Örebro University, School of Medical Sciences. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Winkley, Kirsty
    Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
    The effectiveness of interventions on changing caregivers' feeding practices with preschool children: A systematic review and meta-analysis2024In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, article id e13688Article, review/survey (Refereed)
    Abstract [en]

    Caregivers' feeding practices are critical in shaping preschool children's eating habits and preventing childhood obesity. We conducted a systematic review and meta-analysis to evaluate the effectiveness of existing interventions targeting caregivers of preschool children, which aimed to promote child healthy eating and/or manage child weight and/or prevent child nutrition-related problems and included feeding practices as one of the outcomes. Eighteen studies with 18 intervention programs and 3887 respondents that completed baseline evaluations were eligible for data synthesis. Behavior change techniques (BCTs) frequently used included the following: instruction on how to perform the behavior and demonstration of the behavior. The pooled effects of randomized controlled trials (RCTs) on pressure to eat (pooled standardized mean difference [SMD] = 0.61; 95%CI: -1.16, -0.06), use of food as a reward (pooled SMD = -0.31; 95%CI: -0.61, -0.01), and emotional feeding (pooled SMD = -0.36; 95%CI: -0.66, -0.06) were found statistically significant compared with control groups at post-intervention. However, there were no pooled effects on restrictive feeding and pressure to eat at other follow-ups or on other feeding practices at post-intervention. Interventions may have short-term effects on decreasing the adoption of coercive control. Future interventions should directly and adequately optimize feeding practices, include components of individual support, and contribute to the maintenance of the effects over the long term.

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