The need for excess weight gain prevention in disadvantaged young children is widely recognised. Early Childhood Education and Care teachers are potential key actors in early interventions to prevent overweight and obesity. This study examines the effects of a preschool-based intervention for teachers in promoting healthy eating and physical activity in young children. A cluster randomised controlled trial was conducted at 41 preschools in a deprived area of Amsterdam, The Netherlands. The intervention consisted of 2 programmes that were applied in succession: A Healthy Start and PLAYgrounds for TODdlers. The study period was 9 months. Primary outcomes were assessed via questionnaires and included teachers’ knowledge, attitude, food/activity-related practices, and level of confidence in promoting healthy behaviours. Secondary outcomes in this study were teachers’ and children’s BMI (z-score), body composition, dietary intake and physical activity level. Intention-to-treat analyses were performed using linear mixed models. In total, 115 teachers and 249 children (mean age 3.0 (0.2) years) were included. A positive effect on teachers’ knowledge about the Dutch dietary guidelines was found after the programme A Healthy Start (difference = 1.38; 1-sided 95% CL = 0.29; p = 0.02). This effect was not sustained at 9 months (difference = 0.34; 1-sided 95% CL = -0.76; p = 0.31). The overall intervention had a positive effect on 3 of the 5 attitude statements regarding a healthy lifestyle (difference ranged from 0.34 to 0.55) and on the practice scale Activity-related-Modelling (difference = 0.16; 1-sided 95% CL = 0.06; p = 0.01). No intervention effects were observed on food-related practice scales and the level of confidence in promoting healthy behaviours. At this stage, no effects were seen on teachers’ and children’s BMI (z-score). This study contributes to the professional development of Early Childhood Education and Care teachers and addresses the call for interventions to prevent overweight/obesity and to minimise health inequalities in young children.
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Preschool children's vocabulary mainly develops verbal through interaction. Therefore, the technology-enhanced storytelling (TES) activity Jeffy's Journey is developed to support parent–child interaction and vocabulary in preschool children. TES entails shared verbal storytelling supported by a story structure and real-time visual, auditory and textual prompts on a tablet computer. In this exploratory study, we investigated how TES influenced parent–child interaction and vocabulary. An experimental pretest-intervention-posttest design was followed with 44 3-year-old children and their parents in the experimental group and 27 peers in the control group. Results revealed that TES stimulated active child involvement and generated parent–child interaction, yet a great variety in TES characteristics both in time spent and usage of prompts was found among participants. Dyads that spent more time on story phases showed more and higher quality parent–child interaction. The usage of prompts was associated with improved parent–child interaction quality. Finally, an effect of TES was evidenced on children's productive vocabulary knowledge. To conclude, this study demonstrates that TES can be considered as a promising context for fostering parent–child interaction and children's vocabulary development.
A common early intervention approach for preschool children with language problems is parent–child interaction therapy (PCIT). PCIT has positive effects for children with expressive language problems. It appears that speech and language therapists (SLTs) conduct this therapy in many different ways. This might be because of the variety of approaches available, the diverse set of families SLTs work with or the different organizational structures. Understanding the critical components of PCIT would enable SLTs to map the variations that are implemented and researchers to evaluate the effects of such variation. This study aimed to identify the potentially critical components of PCIT based on the practical experience of SLTs and to identify SLTs’ rationales for the way they structure PCIT. Both parameters are important for the long term goal, that is, to develop a framework that can be used to support practice. Semi-structured interviews were conducted with 10 SLTs who had at least one year experience in delivering PCIT with preschool children with language impairment. The interviews were transcribed and analysed, using thematic analysis. Analysis of the SLT interview data identified four potentially critical components that underpin the teaching of strategies to parents: parents’ engagement, parents’ understanding, parents’ reflection and therapists’ skills. SLTs suggested that all four components are needed for the successful delivery of PCIT. The reasons that SLTs give for the way in which they structure PCIT are mainly based on organizational constraints, family needs and practicalities. SLTs consider PCIT to be valuable but challenging to implement. A framework that makes explicit these components may be beneficial to support practice.
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In de voorschool worden pedagogisch medewerkers (PMers) steeds vaker geconfronteerd met overgewicht bij kinderen van 2,5 tot 4 jaar. De PMer is getraind in het ondersteunen van de ontwikkeling en opvoeding van het kind. PMers zijn niet opgeleid voor leefstijladvisering. Ongezonde voeding en inactiviteit zijn de belangrijkste oorzaken van overgewicht. Overgewicht komt op jonge leeftijd al meer voor bij lagere sociaaleconomische en etnische groepen. De gezondheidsverschillen nemen hierdoor toe. PMers geven aan dat zij zich niet bekwaam voelen om verantwoordelijk te zijn voor de gezonde keuzes op de voorschool als ook in de advisering naar ouders toe. De centrale vragen in dit project zijn: Wat heeft de PMer in de voorschool nodig in kennis, vaardigheden en attitude om het handelingsrepertoire tav leefstijladvisering aan alle kinderen van 2,5 tot 4 jaar en ouders met diverse sociaaleconomische en cultureel-etnische achtergronden te professionaliseren. Wat is het effect van het handelen van de PMer op de gezonde (gewichts)ontwikkeling van het kind? Het onderzoek is een gerichte interventiestudie met voor- en nametingen bij PMers, kinderen en ouders. De interventie wordt bij een deel van de PMers uitgevoerd en vergeleken met een controlegroep. Bij kinderen worden fysieke- en gedragsmetingen uitgevoerd. Eindpunten zijn het vertrouwen in leefstijladvisering door PMers en ontwikkelingstrends in gewicht bij kinderen. Fases van het projectplan: I. nulmeting en interventie bij PMers; II. nulmeting bij kinderen en interventie door PMers; III. effectmeting interventie bij PMers en kinderen; IV. ontwikkeling competentieprofiel leefstijladvisering voor PMers. Het PS@HW consortium olv de Hogeschool van Amsterdam, Impuls Kinderopvang, Brancheorganisatie Kinderopvang Amsterdam, Nederlands Jeugdinstituut, RIVM Centrum voor Gezond Leven, VU medisch centrum, HvA-Speerpunt Urban Vitality en Sarphati Amsterdam pakt dit op. Dit project beoogt het ontwikkelen van de HBO competentie leefstijladvisering voor PMers van de voorscholen die kinderen bereiken met een achterstand, voor een gezonde (gewichts)ontwikkeling en het terugdringen van gezondheidsverschillen.
