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Open AccessArticle

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

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Department of Rehabilitation Sciences, Ghent University, 9000 Ghent, Belgium
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Research Foundation Flanders, 1000 Brussels, Belgium
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Department of Public Health and Primary Care, Ghent University, 9000 Ghent, Belgium
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Department of Nutrition and Dietetics, School of Physical Education, University of Thessaly, Sport Science and Dietetics, 421 00 Trikala, Greece
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Department of Physiatry and Nursing, GENUD (Growth, Exercise, Drinking Behaviour and Development), University of Zaragoza, 50001 Zaragoza, Spain
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Department of Pediatrics, Medical University Varna, 9002 Varna, Bulgaria
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Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, 80337 Munich, Germany
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Children’s Memorial Institute, 04-730 Warsaw, Poland
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Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University, 17778 Athens, Greece
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Department of Movement and Sports Sciences, Ghent University, 9000 Ghent, Belgium
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(19), 7312; https://doi.org/10.3390/ijerph17197312
Received: 11 August 2020 / Revised: 14 September 2020 / Accepted: 1 October 2020 / Published: 7 October 2020
(This article belongs to the Collection Feature Papers in Children's Health)
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. View Full-Text
Keywords: intervention; effect evaluation; process evaluation; snacking behavior; preschoolers intervention; effect evaluation; process evaluation; snacking behavior; preschoolers
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MDPI and ACS Style

De Craemer, M.; Verbestel, V.; Verloigne, M.; Androutsos, O.; Moreno, L.; Iotova, V.; Koletzko, B.; Socha, P.; Manios, Y.; Cardon, G. 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. Int. J. Environ. Res. Public Health 2020, 17, 7312. https://doi.org/10.3390/ijerph17197312

AMA Style

De Craemer M, Verbestel V, Verloigne M, Androutsos O, Moreno L, Iotova V, Koletzko B, Socha P, Manios Y, Cardon G. 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. International Journal of Environmental Research and Public Health. 2020; 17(19):7312. https://doi.org/10.3390/ijerph17197312

Chicago/Turabian Style

De Craemer, Marieke; Verbestel, Vera; Verloigne, Maïté; Androutsos, Odysseas; Moreno, Luis; Iotova, Violeta; Koletzko, Berthold; Socha, Piotr; Manios, Yannis; Cardon, Greet. 2020. "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" Int. J. Environ. Res. Public Health 17, no. 19: 7312. https://doi.org/10.3390/ijerph17197312

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