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Increased health and well-being in preschools (DAGIS): rationale and design for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature268238
Source
BMC Public Health. 2015;15:402
Publication Type
Article
Date
2015
Author
Suvi Määttä
Reetta Lehto
Mari Nislin
Carola Ray
Maijaliisa Erkkola
Nina Sajaniemi
Eva Roos
Source
BMC Public Health. 2015;15:402
Date
2015
Language
English
Publication Type
Article
Keywords
Child
Child Behavior
Child, Preschool
Cross-Sectional Studies
Female
Finland
Health Promotion - methods
Humans
Male
Physical Education and Training - organization & administration
Randomized Controlled Trials as Topic
Research Design
School Health Services - organization & administration
Surveys and Questionnaires
Abstract
Effective interventions that target socioeconomic status (SES) differences to avoid the potential widening of inequalities in health are needed. Children at preschool age is a valuable intervention target since sedentary behaviors, physical activity (PA), dietary behaviors, and sleep habits, jointly called the energy balance-related behaviors (EBRBs), are established in early childhood and tend to persist later in life. The interventions are most effective, when they focus on evidence-based factors. One potential factor associated with EBRBs and SES is children's stress regulation, which receives special attention in this study. Based on the socioecological approach, the combinations of multiple levels (e.g. individual, environmental, societal) of analysis and diverse methodologies (e.g. surveys, observations, biological measurements) are used to assess the healthfulness of environments (e.g. social, physical, learning, policy) in preschool and family settings. The intervention aimed to diminish SES differences in EBRBs is then conducted in the preschool setting.
The DAGIS study is divided into two phases. The first phase comprises focus group interviews and a cross-sectional survey. Parents and preschool personnel in low SES neighborhoods participated in interviews about children's sedentary behaviors, dietary behaviors, and PA in 2014. In the cross-sectional survey beginning in autumn 2015, preschools will be recruited from a random sample of preschools in 3-5 municipalities in Southern Finland. A total of 800 children will wear an accelerometer for seven days. Children's hair and saliva samples will be taken. Parents and preschool personnel will complete questionnaires on EBRBs, social and physical environments and SES factors. The quality of preschool environment is also observed. In the second phase, an intervention targeting to narrowing SES differences in EBRBs is conducted. The effects of the intervention will be evaluated in randomised controlled trial. The implementation of the intervention will also be evaluated.
If effective, this unique preschool-based study will be able to narrow the SES differences in preschool children's EBRBs. This study is anticipated to identify the most important modifiable factors in preschool and family environmental settings associated with children's EBRBs, especially in children from low SES backgrounds.
ISRCTN57165350 (January, 8th, 2015).
Notes
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PubMed ID
25927298 View in PubMed
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Increased Health and Wellbeing in Preschools (DAGIS) Study-Differences in Children's Energy Balance-Related Behaviors (EBRBs) and in Long-Term Stress by Parental Educational Level.

https://arctichealth.org/en/permalink/ahliterature297859
Source
Int J Environ Res Public Health. 2018 10 21; 15(10):
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-21-2018
Author
Elviira Lehto
Carola Ray
Henna Vepsäläinen
Liisa Korkalo
Reetta Lehto
Riikka Kaukonen
Eira Suhonen
Mari Nislin
Kaija Nissinen
Essi Skaffari
Leena Koivusilta
Nina Sajaniemi
Maijaliisa Erkkola
Eva Roos
Author Affiliation
Folkhälsan Research Center, Topeliuksenkatu 20, 00250 Helsinki, Finland. elviira.lehto@helsinki.fi.
Source
Int J Environ Res Public Health. 2018 10 21; 15(10):
Date
10-21-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Child
Child Behavior
Child, Preschool
Cross-Sectional Studies
Diet
Educational Status
Exercise
Female
Finland - epidemiology
Health Status Disparities
Health Surveys
Humans
Male
Parents
Screen Time
Sedentary Behavior
Social Determinants of Health - statistics & numerical data
Stress, Psychological - epidemiology - etiology
Abstract
This paper describes the Increased Health and Wellbeing in Preschools (DAGIS) survey process and socioeconomic status (SES) differences in children's energy balance-related behaviors (EBRBs), meaning physical activity, sedentary and dietary behaviors, and long-term stress that serve as the basis for the intervention development. A cross-sectional survey was conducted during 2015?2016 in 66 Finnish preschools in eight municipalities involving 864 children (3?6 years old). Parents, preschool personnel, and principals assessed environmental factors at home and preschool with questionnaires. Measurement of children's EBRBs involved three-day food records, food frequency questionnaires (FFQ), seven-day accelerometer data, and seven-day sedentary behavior diaries. Children's long-term stress was measured by hair cortisol concentration. Parental educational level (PEL) served as an indicator of SES. Children with low PEL had more screen time, more frequent consumption of sugary beverages and lower consumption of vegetables, fruit, and berries (VFB) than those with high PEL. Children with middle PEL had a higher risk of consuming sugary everyday foods than children with high PEL. No PEL differences were found in children's physical activity, sedentary time, or long-term stress. The DAGIS intervention, aiming to diminish SES differences in preschool children's EBRBs, needs to have a special focus on screen time and consumption of sugary foods and beverages, and VFB.
PubMed ID
30347875 View in PubMed
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