A set of pedagogical recommendations for improving the integrated approach to childhood overweight and obesity: A Delphi study

Background: Tackling the increasing global problem of childhood overweight and obesity requires an integrated approach. Studies increasingly emphasize the importance of the parents' role in interventions designed to prevent overweight in children. The aim of this study was to develop a unified set of recommendations for healthy parenting practices that can be applied by all professionals who work with children age 4-13 years and can contribute to strengthening the integrated approach to childhood overweight. Methods: A modified Delphi procedure was used to reach consensus regarding what these pedagogical recommendations should encompass. The 30 panelists were professionals and researchers who work with children age 4-13 in the domains of health care, overweight, parenting, education, nutrition, and/or sports. The procedure consisted of: i) extracting existing pedagogical recommendations from national guidelines and professional protocols, ii) appraising and prioritizing these recommendations in terms of relevance through two rounds of questionnaires, and iii) meeting to discuss and approve the set of recommendations. Results: Consensus was reached for one set of eleven pedagogical theme-based recommendations designed to support and instruct parents how to stimulate healthy energy balance-related behaviors in their child. Each recommendation contained information regarding: i) which behaviors in the child and/or parent are important, ii) why this is important, and iii) how parents can stimulate this behavior by applying parenting skills in daily life. The eleven themes were: modeling, positive parenting, breakfast, varied diet, sugar-sweetened beverages, snacks, physical activity, playing sports, quantity of screen time, screen time during meals, and sleep. Conclusion We developed a set of recommendations for healthy parenting that can be used by various professionals working with children age 4-13 and can contribute to creating an integrated approach to childhood overweight. We also developed a web-based app called “Recommendations for Healthy Parenting” as a convenient tool for following these recommendations

The effectiveness of a web-based Dutch parenting program to prevent overweight in children 9–13 years of age:Results of a two-armed cluster randomized controlled trial

INTRODUCTION: Although parental support is an important component in programs designed to prevent overweight in children, current programs pay remarkably little attention to the role of parenting. We therefore developed a web-based parenting program entitled “Making a healthy deal with your child”. This e-learning program can be incorporated into existing overweight prevention programs. The aim of this study was to determine the effectiveness of this e-learning program. MATERIALS AND METHODS: The effectiveness was examined in a two-armed cluster randomized controlled trial. The participants were 475 parent-child dyads of children 9–13 years of age in the Netherlands who participated in an existing schoolclass-based overweight prevention program. At the school grade level, parents were randomly assigned to either the intervention or the control condition. Measurements were taken from both parents and children at baseline, and 5 and 12 months after baseline. Primary outcomes included the child’s dietary and sedentary behavior, and level of physical activity. Secondary outcomes included general parenting style, specific parenting practices, and parental self-efficacy. Linear mixed effects models and generalized linear mixed effects models were conducted in R. RESULTS: Intention-to-treat analyses and completers only revealed no significant effects between the intervention and control condition on energy balance-related behaviors of the child and parenting skills after correction for multiple testing. The parents’ mean satisfaction with the e-learning program (on a 10-point scale) was 7.0±1.1. CONCLUSIONS: Although parents were generally satisfied with the parenting program, following this program had no significant beneficial effects regarding the children’s energy balance-related behaviors or the parenting skills compared to the control condition. This program may be more beneficial if used by high-risk groups (e.g. parents of children with unhealthy energy balance-related behaviors and/or with overweight) compared to the general population, warranting further study

Buurtsportcoaches slaan brug tussen zorg en sport

Om het effect te onderzoeken van buurtsportcoaches, volgden onderzoekers van Wageningen University & Research en Radboudumc drie jaar lang de activiteiten van coaches in negen gemeenten. De buurtsportcoaches hebben de verbinding weten te leggen tussen zorg, sport en bewegen

Exploring the impact of the care sport connector in the Netherlands

Background: Regular physical activity (PA) is deemed to contribute to the primary and secondary prevention of several chronic diseases, like diabetes mellitus, cancer, cardiovascular diseases, and osteoporosis. In 2012, Care Sport Connectors (CSC), to whom a broker has been ascribed, were introduced in the Netherlands to stimulate PA and guide primary care patients towards local sport facilities. The aim of this study was to explore which structural embedding is the most promising for CSCs’ work.Methods: In three rounds of interviews, 13 CSCs were followed for 2 years in their work. In these interviews, a network survey was used to identify organisations in the CSCs’ network, whether they collaborated with these organisations, and the role of the organisations in the connection. Data from the network survey were analysed using the RE-AIM framework and disaggregated into how CSCs were structurally embedded (Type A: only PA sector; Type B: different sectors; Type C: partnership). A related samples Wilcoxon signed rank test was performed to study how the CSCs’ network developed between 2014 and 2016.Results: All CSCs established a connection between the primary care and the PA sector in which the average number of organisations with which CSCs collaborated increased significantly between 2014 (8.3) and 2016 (19.8) (p = 0.002). However, differences were identified in the way CSCs were structurally embedded and in the way they established the connection. Type A CSCs established the connection mostly around their own activities, supported PA organisations with their activities, and collaborated with primary care and welfare professionals around their own activities. Type B and Type C CSCs established the connection by organising, supporting, and implementing different kinds of activities targeting different kinds of audiences, and collaborated mostly with primary care professionals around the referral of professionals’ patients.Conclusions: The results of this study suggest that adopting an integral approach (Type B and C) for the structural embedding of the CSC is more promising for reaching the desired outcomes. Whether CSCs really improve the target groups’ PA level and health needs to be further studied.<br/

Onderzoeksopzet evaluatie Gezonde School: onder welke condities doet het ertoe?

Hoewel steeds meer scholen het vignet Gezonde School hebben behaald, is weinig bekend over de factoren, kenmerken en processen, ofwel condities, die de effectiviteit van het programma Gezonde School beïnvloeden. Daarom wordt een evaluatieonderzoek uitgevoerd op drie niveaus: de leerling, de school en de regio. De drie centrale onderzoeksvragen zijn gericht op: 1) condities voor leerlinguitkomsten, 2) condities voor implementatie op school, en 3) condities voor regionale ondersteuning. Daarbij worden de school en de regio beschouwd als complexe adaptieve systemen. Condities voor beoogde uitkomsten op leefstijl, gezondheid en schoolprestaties van leerlingen worden onderzocht met een combinatie van bestaande databronnen waaraan schoolcodes kunnen worden toegevoegd. Goed en minder goed presterende scholen worden geselecteerd voor een overwegend kwalitatieve vervolganalyse om verschillen in uitkomsten verder te verklaren. Om inzicht te krijgen in condities voor implementatie op school en de regionale ondersteuning in negen GGD-regio’s wordt met een vragenlijst de implementatiegraad bepaald, om daarna scholen te selecteren voor overwegend kwalitatief vervolgonderzoek. Dit onderzoek biedt niet alleen inzicht in de huidige stand van zaken op de drie niveaus, maar kan ook verschillen in uitkomsten tussen leerlingen, scholen en regio’s verklaren. Zo kunnen concrete aangrijpingspunten worden gegeven om de implementatie van Gezonde School verder te versterken.An increasing number of schools obtained a Healthy School certificate, yet little is known about factors, characteristics, and processes, i.e. conditions, influencing the effectiveness of the Healthy School program. Therefore, a mixed methods evaluation study will be conducted on three levels: the student, the school, and the region. The research questions are focused on: 1) conditions for student outcomes, 2) conditions for implementation in schools, and 3) conditions for regional support. For the evaluation, the school and region are considered complex adaptive systems. Conditions for intended outcomes on student lifestyle, health, and academic achievement will be examined using a combination of existing datasets including school codes. Based on student outcomes, best and worst performing schools will be selected for predominantly qualitative analysis to further explain differences. To get insight into conditions for implementation in schools and regional support in nine regions, the degree of implementation will be determined with a questionnaire to select schools for predominantly qualitative analysis. Combined, this study will not only provide insight into the current situation on the three levels, but also explain differences between regions, schools, and students. Consequently, it will be possible to provide concrete advice to strengthen implementation of the Healthy School program