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Mouratidou T, Mesana Graffe MI, Huybrechts I, De Decker E, De Craemer M, Androutsos O, Manios Y, Galcheva S, Lateva M, Gurzkowska B, Kułaga Z, Birnbaum J, Koletzko B, Moreno LA. Reproducibility and relative validity of a semiquantitative food frequency questionnaire in European preschoolers: The ToyBox study. Nutrition 2019; 65:60-67. [PMID: 31029924 DOI: 10.1016/j.nut.2019.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 02/09/2019] [Accepted: 03/13/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to examine the reproducibility and relative validity of a semiquantitative food frequency questionnaire (FFQ) in assessing food group estimates. METHODS Food group estimates were assessed via a 37-item FFQ and a 3-d food record (FR). Pearson's correlation coefficients for log-transformed values were calculated to assess the reproducibility and Spearman's rank correlation coefficients for log-transformed values were calculated to assess the validity. Kindergartens from six European countries participated in the preparatory substudies of the ToyBox intervention study; data from preschool children 4 to 6 y of age (n = 196, reproducibility study; n = 324, validation study) were obtained. RESULTS In the reproducibility study, positive Pearson's correlation coefficients for single and aggregated food groups ranged from 0.14 for pasta and rice to 0.90 for cooked vegetables. In the validation study, the FR gave higher estimates of 40 of the 50 food items (single and aggregated) examined compared with those obtained from the FFQ. Positive crude Spearman rank correlation coefficients ranged from 0.01 for total beverages (added sugar) and rice to 0.62 for tea. Corrections for the deattenuation effect did not improve observed correlations. Quartiles and tertiles were calculated for a small number of food groups (N = 14) owing to zero consumption in the rest of the groups. CONCLUSIONS Moderately good reproducibility and low-moderate relative validity of the FFQ used in preschool children was observed. Relative validity, however, varied by food and beverage group; for some of the "key" foods/drinks targeted in the ToyBox intervention (e.g., biscuits), the validity was good. The findings should be considered in future epidemiologic and intervention studies in preschool children.
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Affiliation(s)
- Theodora Mouratidou
- Instituto Agroalimentario de Aragón (IA2). University of Zaragoza, Zaragoza, Spain
| | - María Isabel Mesana Graffe
- Instituto Agroalimentario de Aragón (IA2). University of Zaragoza, Zaragoza, Spain; Instituto de Investigqación Sanitaria de Aragón, Centro de Investigación Biomédica de Aragón (CIBA) Avda. San Juan Bosco, 13. 50009. Zaragoza, Spain; Red de Salud Materno-infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain; Red de Salud Materno-infantil y del Desarrollo.
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium; International Agency for Research on Cancer, Lyon, France
| | - Ellen De Decker
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Marieke De Craemer
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Yanis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | | | | | | | | | - Julia Birnbaum
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Berthold Koletzko
- Dr. von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany
| | - Luis Alberto Moreno
- Instituto Agroalimentario de Aragón (IA2). University of Zaragoza, Zaragoza, Spain; Instituto de Investigqación Sanitaria de Aragón, Centro de Investigación Biomédica de Aragón (CIBA) Avda. San Juan Bosco, 13. 50009. Zaragoza, Spain; Red de Salud Materno-infantil y del Desarrollo (SAMID), Instituto de Salud Carlos III, Madrid, Spain; Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición
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De Craemer M, De Decker E, Verloigne M, De Bourdeaudhuij I, Manios Y, Cardon G. The effect of a cluster randomised control trial on objectively measured sedentary time and parental reports of time spent in sedentary activities in Belgian preschoolers: the ToyBox-study. Int J Behav Nutr Phys Act 2016; 13:1. [PMID: 26733186 PMCID: PMC4702324 DOI: 10.1186/s12966-015-0325-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/23/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In preschoolers, high levels of sedentary behaviour are associated with several adverse health outcomes. The purpose of this study is to report the effects of the ToyBox-intervention (a European 24-week cluster randomised controlled trial) on sedentary behaviour in preschoolers. METHODS In Belgium, 859 preschoolers from 27 kindergartens (15 intervention and 12 control) wore an accelerometer to objectively measure their sedentary time and 1715 parents/caregivers completed a questionnaire to assess sedentary activities in which preschoolers participate at home. Main outcomes were objectively measured sedentary time, time spent watching TV, using the computer and time spent in quiet play. Multilevel repeated measures analyses were conducted to take clustering into account. Intention to treat analysis was used to handle missing data. RESULTS A sample of 859 (29.5% of all contacted children) preschoolers (4.4 ± 0.6 years, 54.4% boys) provided valid accelerometer data at either baseline or follow-up and parents of 1715 (58.9% of all contacted children) preschoolers (4.4 ± 0.5 years, 52.5% boys) completed a questionnaire at either baseline or follow-up. No intervention effects were found on objectively and subjectively measured total sedentary time in the total sample. However, some effects on objectively and subjectively measured sedentary time were found in specific subgroups. Preschoolers from the intervention group from high SES kindergartens and preschoolers with high levels of sedentary time at baseline decreased their sedentary time, while preschoolers from the control group increased their sedentary time. Girls in the intervention group decreased their TV viewing time during weekend days (-5.83 min/day), while girls' &TV viewing in the control group increased (+4.15 min/day). In low SES kindergartens, a smaller increase for computer time during weekend days was found in preschoolers in intervention kindergartens (+6.06 min/day) than in control kindergartens (+12.49 min/day). CONCLUSION While some small positive effects were found in some sub-groups, the ToyBox-intervention had no effect on objectively and subjectively measured sedentary time in the total sample. A longer period to implement the intervention and a more active involvement of parents/caregivers might enhance intervention effects. The ToyBox-study is registered with the clinical trials registry clinicaltrials.gov, ID: NCT02116296.
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Affiliation(s)
- Marieke De Craemer
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, Ghent, 9000, Belgium.
| | - Ellen De Decker
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, Ghent, 9000, Belgium.
| | - Maïté Verloigne
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, Ghent, 9000, Belgium. .,Research Foundation Flanders, Brussels, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, Ghent, 9000, Belgium.
| | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, E. Venizelou 70, Athens, 17671, Greece.
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, Ghent, 9000, Belgium.
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De Craemer M, Lateva M, Iotova V, De Decker E, Verloigne M, De Bourdeaudhuij I, Androutsos O, Socha P, Kulaga Z, Moreno L, Koletzko B, Manios Y, Cardon G. Differences in energy balance-related behaviours in European preschool children: the ToyBox-study. PLoS One 2015; 10:e0118303. [PMID: 25785738 PMCID: PMC4364763 DOI: 10.1371/journal.pone.0118303] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 11/18/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of the current study was to compare levels of energy balance-related behaviours (physical activity, sedentary behaviour, and dietary behaviours (more specifically water consumption, sugar-sweetened beverage consumption and unhealthy snacking)) in four- to six-year-old preschoolers from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, and Spain) within the ToyBox cross-sectional study. METHODS A sample of 4,045 preschoolers (4.77 ± 0.43 years; 52.2% boys) had valid physical activity data (steps per day), parents of 8,117 preschoolers (4.78 ± 0.46 years; 53.0% boys) completed a parental questionnaire with questions on sedentary behaviours (television viewing, computer use, and quiet play), and parents of 7,244 preschoolers (4.77 ± 0.44 years; 52.0% boys) completed a food frequency questionnaire with questions on water consumption, sugar-sweetened beverage consumption and unhealthy snacking. RESULTS The highest levels of physical activity were found in Spain (12,669 steps/day on weekdays), while the lowest levels were found in Bulgaria and Greece (9,777 and 9,656 steps/day on weekdays, respectively). German preschoolers spent the least amount of time in television viewing (43.3 min/day on weekdays), while Greek preschoolers spent the most time in television viewing (88.5 min/day on weekdays). A considerable amount of time was spent in quiet play in all countries, with the highest levels in Poland (104.9 min/day on weekdays), and the lowest levels in Spain (60.4 min/day on weekdays). Belgian, German, and Polish preschoolers had the lowest intakes of water and the highest intakes of sugar-sweetened beverages. The intake of snacks was the highest in Belgian preschoolers (73.1 g/day) and the lowest in Greek preschoolers (53.3 g/day). CONCLUSIONS Across six European countries, differences in preschoolers' energy balance-related behaviours were found. Future interventions should target European preschoolers' energy balance-related behaviours simultaneously, but should apply country-specific adaptations.
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Affiliation(s)
| | | | | | | | - Maïté Verloigne
- Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | | | | | - Piotr Socha
- Children’s Memorial Health Institute, Warsaw, Poland
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De Craemer M, De Decker E, De Bourdeaudhuij I, Verloigne M, Manios Y, Cardon G. The translation of preschoolers' physical activity guidelines into a daily step count target. J Sports Sci 2014; 33:1051-7. [PMID: 25524541 DOI: 10.1080/02640414.2014.981850] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study aimed at translating the physical activity (PA) guideline (180 min of total PA per day) into a step count target in preschoolers. 535 Flemish preschoolers (mean age: 4.41 ± 0.58) wore an ActiGraph accelerometer (GT1M, GT3X and GT3X+) - with activated step count function - for four consecutive days. The step count target was calculated from the accelerometer output using a regression equation, applying four different cut-points for light-to-vigorous PA: Pate, Evenson, Reilly, and Van Cauwenberghe. The present analysis showed that 180 min of total PA per day is equivalent to the following step count targets: 5,274 steps/day using the Pate cut-point, 4,653 steps/day using the Evenson cut-point, 11,379 steps/day using the Reilly cut-point and 13,326 steps/day using the Van Cauwenberghe cut-point. Future studies should focus on achieving consensus on which cut-points to use in preschoolers before a definite step count target in preschoolers can be proposed. Until then, we propose to use a provisional step count target of 11,500 steps/day as this step count target is attainable, realistic and helpful in promoting preschoolers' PA.
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Affiliation(s)
- Marieke De Craemer
- a Department of Movement and Sport Sciences , Ghent University , Ghent , Belgium
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De Craemer M, De Decker E, Santos-Lozano A, Verloigne M, De Bourdeaudhuij I, Deforche B, Cardon G. Validity of the Omron pedometer and the actigraph step count function in preschoolers. J Sci Med Sport 2014; 18:289-93. [PMID: 24994695 DOI: 10.1016/j.jsams.2014.06.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 05/23/2014] [Accepted: 06/01/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To validate the GT1M actigraph accelerometer step count function, and the Omron Walking Style Pro pedometer against accelerometer-based activity counts, and to compare pedometer-based and accelerometer-based steps in preschoolers. DESIGN A sample of 41 preschoolers (21 boys, mean age 5.43±0.63 years) from one preschool in Flanders, Belgium, was included in data analysis. METHODS Accelerometer-based and pedometer-based steps were simultaneously collected in this Flemish sample of preschool children. Preschoolers wore two motion sensors (accelerometer and pedometer) for four consecutive days. Pearson correlations were calculated to compare accelerometer activity counts with accelerometer-based steps, accelerometer activity counts with pedometer-based steps and accelerometer-based steps with pedometer-based steps. Bland-Altman analysis was carried out to investigate the agreement between the pedometer-based and the accelerometer-based steps. RESULTS Accelerometer-based steps correlated moderately high with accelerometer activity counts per hour (r=0.77) and per day (r=0.82). Pedometer-based steps correlated moderately high with accelerometer activity counts per hour (r=0.65) and per day (r=0.64). High correlations were revealed between steps from both devices (hourly: r=0.92; daily: r=0.89). The Bland-Altman analysis showed a bias of 221.81 (±1679.78) and the limits of agreement ranged from -3070.57 to 3514.18 steps per day. CONCLUSIONS Both the accelerometer-based as pedometer-based step counts are valid estimates of preschoolers' physical activity levels during free-living activities based on group estimates. High agreement between both step counts justifies combining and comparing pedometer- and accelerometer-based step counts.
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Affiliation(s)
- Marieke De Craemer
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium.
| | - Ellen De Decker
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium
| | - Alejandro Santos-Lozano
- Department of Biomedical Sciences, University of Léon, Léon, Spain; Research Institute Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Maïté Verloigne
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium
| | | | - Benedicte Deforche
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium; Vrije Universiteit Brussel, Department of Human Biometry and Biomechanics, Brussels, Belgium
| | - Greet Cardon
- Ghent University, Department of Movement and Sport Sciences, Ghent, Belgium
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De Craemer M, De Decker E, Verloigne M, De Bourdeaudhuij I, Manios Y, Cardon G. The effect of a kindergarten-based, family-involved intervention on objectively measured physical activity in Belgian preschool boys and girls of high and low SES: the ToyBox-study. Int J Behav Nutr Phys Act 2014; 11:38. [PMID: 24628972 PMCID: PMC3995650 DOI: 10.1186/1479-5868-11-38] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/06/2014] [Indexed: 11/16/2022] Open
Abstract
Background The ToyBox-study developed an evidence- and theory-based intervention to improve preschoolers’ energy balance-related behaviours – including physical activity (PA) – by targeting the kindergarten environment and involving their parents/caregivers. The present study aimed to examine the effect of the ToyBox-intervention on increasing Belgian preschoolers’ objectively measured PA levels. Methods A sample of 472 preschoolers (4.43 ± 0.55 years; 55.1% boys) from 27 kindergartens (15 intervention, 12 control kindergartens) in Flanders, Belgium were included in the data analyses. Preschoolers wore an ActiGraph accelerometer for six consecutive days and were included in the data analyses if they had a minimum of two weekdays and one weekend day, both at baseline and follow-up (one year later). Preschoolers’ PA outcomes were estimated for an average day, weekday, weekend day, during school hours, and during after school hours. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample, and for sub-groups (according to sex, kindergarten levels of socio-economic status (SES) and risk groups (low levels of PA at baseline)) of preschoolers. Results Small intervention effects were found in the total sample. Most intervention effects were found in boys and in preschoolers from high SES kindergartens. Boys from the intervention group had an increase in vigorous PA (ß = 1.47, p = 0.03) and moderate-to-vigorous PA (ß = 1.27, p = 0.03) from baseline to follow-up, whereas PA levels in boys from the control group stagnated or decreased. In preschoolers from high SES kindergartens, the largest effects were found for PA outcomes during school hours and during after school hours. Conclusion The results from the Belgian sample demonstrate that effects of the PA-component of the ToyBox-intervention on objectively measured PA were found in preschool boys and in preschoolers from high SES kindergartens, which means that the ToyBox-intervention was mainly effective in those sub-groups. Future interventions should search for alternative strategies to increase preschoolers’ PA levels in preschool girls and preschoolers from low SES kindergartens, as these are the most important at-risk groups regarding PA.
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Affiliation(s)
- Marieke De Craemer
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
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De Decker E, De Craemer M, De Bourdeaudhuij I, Verbestel V, Duvinage K, Iotova V, Grammatikaki E, Wildgruber A, Mouratidou T, Manios Y, Cardon G. Using the intervention mapping protocol to reduce European preschoolers' sedentary behavior, an application to the ToyBox-Study. Int J Behav Nutr Phys Act 2014; 11:19. [PMID: 24552138 PMCID: PMC3936781 DOI: 10.1186/1479-5868-11-19] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 02/13/2014] [Indexed: 12/04/2022] Open
Abstract
Background High levels of sedentary behavior are often measured in preschoolers, but only a few interventions have been developed to counteract this. Furthermore, detailed descriptions of interventions in preschoolers targeting different forms of sedentary behavior could not be located in the literature. The aim of the present paper was to describe the different steps of the Intervention Mapping Protocol used towards the development of an intervention component of the ToyBox-study focusing on decreasing preschoolers’ sedentary behavior. The ToyBox-study focuses on the prevention of overweight in 4- to 6-year-old children by implementing a multi-component kindergarten-based intervention with family involvement in six different European countries. Methods Applying the Intervention Mapping Protocol, six different steps were systematically completed for the structured planning and development of the intervention. A literature search and results from focus groups with parents/caregivers and kindergarten teachers were used as a guide during the development of the intervention and the intervention materials. Results The application of the different steps in the Intervention Mapping Protocol resulted in the creation of matrices of change objectives, followed by the selection of practical applications for five different intervention tools that could be used at the individual level of the preschool child, at the interpersonal level (i.e., parents/caregivers) and at the organizational level (i.e., kindergarten teachers). No cultural differences regarding preschoolers’ sedentary behavior were identified between the participating countries during the focus groups, so cultural and local adaptations of the intervention materials were not necessary to improve the adoption and implementation of the intervention. Conclusions A systematic and evidence-based approach was used for the development of this kindergarten-based family-involved intervention targeting preschoolers, with the inclusion of parental involvement. The application of the Intervention Mapping Protocol may lead to the development of more effective interventions. The detailed intervention matrices that were developed as part of the ToyBox-study can be used by other researchers as an aid in order to avoid repetitive work for the design of similar interventions.
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Affiliation(s)
- Ellen De Decker
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
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Van Cauwenberghe E, De Craemer M, De Decker E, De Bourdeaudhuij I, Cardon G. The impact of a teacher-led structured physical activity session on preschoolers’ sedentary and physical activity levels. J Sci Med Sport 2013; 16:422-6. [DOI: 10.1016/j.jsams.2012.11.883] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 09/10/2012] [Accepted: 11/16/2012] [Indexed: 01/02/2023]
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De Decker E, De Craemer M, De Bourdeaudhuij I, Wijndaele K, Duvinage K, Androutsos O, Iotova V, Lateva M, Alvira JMF, Zych K, Manios Y, Cardon G. Influencing factors of sedentary behavior in European preschool settings: an exploration through focus groups with teachers. J Sch Health 2013; 83:654-661. [PMID: 23879785 DOI: 10.1111/josh.12078] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Revised: 08/06/2012] [Accepted: 08/09/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND Sedentary behavior refers to activities involving sitting down and reclining (eg, watching TV, using the computer) and has been associated with different health outcomes. In preschool, children are sedentary for 50% to 80% of the time, in the classroom as well as during recess. Because of the absence of qualitative studies examining influencing factors of preschoolers' sedentary behavior in preschool settings, this study explored teachers' opinions on potentially influencing factors of this behavior. METHODS Eighty-seven teachers of 4- to 6-year-old preschoolers from 6 European countries participated in a total of 18 focus groups between October 2010 and January 2011. Key findings were reported separately by country, and were independently analyzed by 2 researchers using qualitative content analysis. RESULTS Teachers perceive the lack of play space and small classroom size as being influential factors on preschoolers' sedentary behavior; increasing play equipment and using teachers' prompts are mentioned as ways to stimulate children to be less sedentary on the playground. Computer use is reported to be more common in preschool than watching TV. CONCLUSION Interventions should focus on increasing teachers' awareness of how sedentary preschoolers are during the preschool day. Teachers also should be informed about strategies to decrease sedentariness in the classroom and on the playground.
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Affiliation(s)
- Ellen De Decker
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Gent, Belgium.
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De Craemer M, De Decker E, De Bourdeaudhuij I, Deforche B, Vereecken C, Duvinage K, Grammatikaki E, Iotova V, Fernández-Alvira JM, Zych K, Manios Y, Cardon G. Physical activity and beverage consumption in preschoolers: focus groups with parents and teachers. BMC Public Health 2013; 13:278. [PMID: 23537117 PMCID: PMC3627633 DOI: 10.1186/1471-2458-13-278] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 03/13/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Qualitative research is a method in which new ideas and strategies can be discovered. This qualitative study aimed to investigate parents' and teachers' opinions on physical activity and beverage consumption of preschool children. Through separate, independent focus groups, they expressed their perceptions on children's current physical activity and beverage consumption levels, factors that influence and enhance these behaviours, and anticipated barriers to making changes. METHODS Multi-cultural and multi-geographical focus groups were carried out in six European countries (Belgium, Bulgaria, Germany, Greece, Poland and Spain). In total, twenty-four focus groups with 122 parents and eighteen focus groups with 87 teachers were conducted between October 2010 and January 2011. Based on a semi-structured interview guide, questions on preschoolers' physical activity (opinions on preschoolers' physical activity, how to increase physical activity, facilitators and barriers of physical activity) and beverage consumption (rules and policies, factors influencing promotion of healthy drinking, recommendations for future intervention development) were asked. The information was analyzed using qualitative data analysis software (NVivo8). RESULTS The focus group results indicated misperceptions of caregivers on preschoolers' physical activity and beverage consumption levels. Caregivers perceived preschoolers as sufficiently active; they argue that children need to learn to sit still in preparation for primary school. At most preschools, children can drink only water. In some preschools sugar-sweetened beverages like chocolate milk or fruit juices, are also allowed. It was mentioned that sugar-sweetened beverages can be healthy due to mineral and vitamin content, although according to parents their daily intake is limited. These opinions resulted in low perceived needs to change behaviours. CONCLUSIONS Although previous research shows need of change in obesity-related behaviours, the participants in the current study didn't perceive such. The awareness of parents and teachers needs to be raised concerning their shared responsibility about healthy behaviours in preschoolers. Providing preschool teachers with ready-to-use classroom material will encourage them to change physical activity and beverage consumption, and to implement related activities in the classroom. Involvement in activities that their children perform at preschool will motivate parents to extend these behaviours to the home environment.
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Affiliation(s)
- Marieke De Craemer
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, Ghent 9000, Belgium.
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