Are associations between home environment and preschool children’s sedentary time influenced by parental educational level in a cross-sectional survey?

Background: Childhood obesity is a major public health concern, especially in low socioeconomic groups. Sedentary time (SED) is an important predictor of obesity. To be able to diminish SED it is important to find modifiable predictors of sedentary behavior. The home environment associated with children's SED may vary by parental socioeconomic status. This study aims to clarify the association between parental educational level (PEL) and the home environment of 3-6-year-old children, and to examine how home environment associates with children's SED, and whether PEL modifies these associations. Methods: A cross-sectional Increased health and wellbeing in preschools (DAGIS) study was conducted in 2015-2016 in Finland. The parents (n = 809) filled in questionnaires assessing PEL, and the home physical and social environment related to children's SED. Children's SED was measured with accelerometers, which the children (n = 745) wore for 1 week. Results: High PEL was associated with a home environment restraining sedentary behaviour compared with low PEL. Stricter descriptive norms about screen time, considering it important to limit the child's screen time, and satisfaction about the child's screen time associated with children's lower SED. The association with parental psychological control and SED was influenced by PEL. In the PEL stratified analyses, however, the associations between psychological control and SED did not reach statistical significance. Conclusions: Future interventions aiming to decrease SED should pay attention to relevant factors in children's sedentary behaviour home environment. It is important to acknowledge the possible PEL differences in these factors.Peer reviewe

Effects of the Preschool-Based Family-Involving DAGIS Intervention on Family Environment: A Cluster Randomised Trial

Interventions promoting young children’s healthy energy balance-related behaviours (EBRBs) should also examine changes in the family environment as this is an important determinant that may affect the effectiveness of the intervention. This study examines family environmental effects of the Increased Health and Wellbeing in Preschools (DAGIS) intervention study, and whether these effects differed when considering three parental educational level (PEL) groups. The DAGIS intervention was conducted in preschools and involving parents in Southern Finland from September 2017 to May 2018. It was designed as a randomised trial, clustered at preschool-level. Parents of 3–6-year-olds answered questionnaires recording PEL, parental role modelling for EBRBs, and the family environment measured as EBRBs availability and accessibility. Linear Mixed Models with Repeated Measures were used in order to detect intervention effects. Models included group by time interactions. When examining intervention effects separated by PEL groups, models with three-level interactions (group × time-points × PEL) were evaluated. There was an interaction effect for the availability of sugary everyday foods and drinks (p = 0.002). The analyses showed that the control group increased availability (p = 0.003), whereas in the intervention group no changes were detected (p = 0.150). In the analysis separated by PEL groups, changes were found only for the accessibility of sugary treats at home; the high PEL control group increased the accessibility of sugary treats (p = 0.022) (interaction effect: p = 0.027). Hence, results suggest that the DAGIS multicomponent intervention had a limited impact on determinants for children’s healthy EBRBs, and no impact was found in the low PEL group

Effects of the Preschool-Based Family-Involving DAGIS Intervention on Family Environment: A Cluster Randomised Trial

Interventions promoting young children’s healthy energy balance-related behaviours (EBRBs) should also examine changes in the family environment as this is an important determinant that may affect the effectiveness of the intervention. This study examines family environmental effects of the Increased Health and Wellbeing in Preschools (DAGIS) intervention study, and whether these effects differed when considering three parental educational level (PEL) groups. The DAGIS intervention was conducted in preschools and involving parents in Southern Finland from September 2017 to May 2018. It was designed as a randomised trial, clustered at preschool-level. Parents of 3–6-year-olds answered questionnaires recording PEL, parental role modelling for EBRBs, and the family environment measured as EBRBs availability and accessibility. Linear Mixed Models with Repeated Measures were used in order to detect intervention effects. Models included group by time interactions. When examining intervention effects separated by PEL groups, models with three-level interactions (group × time-points × PEL) were evaluated. There was an interaction effect for the availability of sugary everyday foods and drinks (p = 0.002). The analyses showed that the control group increased availability (p = 0.003), whereas in the intervention group no changes were detected (p = 0.150). In the analysis separated by PEL groups, changes were found only for the accessibility of sugary treats at home; the high PEL control group increased the accessibility of sugary treats (p = 0.022) (interaction effect: p = 0.027). Hence, results suggest that the DAGIS multicomponent intervention had a limited impact on determinants for children’s healthy EBRBs, and no impact was found in the low PEL group

Development of the DAGIS intervention study : a preschool-based family-involving study promoting preschoolers’ energy balance-related behaviours and self-regulation skills

Background: Preschoolers' energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers' EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children's socio-economic status (SES) background, have been conducted. This study will present the Increased Health and Wellbeing in Preschools (DAGIS) intervention development process applying the Intervention Mapping (IM) framework. Methods: The development of the DAGIS intervention study, a preschool level clustered randomized controlled trial (RCT), was based on the IM framework. The protocol in IM guides the development process of an intervention through six steps: needs assessment and logic model of the problem, programme outcomes and objectives, design of the programme, production, implementation plan, and evaluation plan. Results: The needs assessment, part of the step 1 in IM, yielded the base for the DAGIS logic model of change. The model includes objectives related to changes in children's EBRBs, self-regulation skills, and in psychosocial and physical environment that is determined by parents and early educators. A 22-week programme was developed, and materials for preschools and families were produced. A feasibility study of the recruitment processes, acceptability of the materials and methods, and implementation was conducted. The DAGIS intervention study was conducted September 2017-May 2018 as a clustered RCT including a comprehensive effectiveness and process evaluation. The process evaluation was run throughout the intervention targeting preschools and families. Conclusion: A preschool-based family-involving programme was developed in the DAGIS intervention study by applying the IM protocol. It was a time- and resource-consuming process. However, the systematic planning, development, and running of the programme have reinforced a comprehensive evaluation, which is a strength in the intervention. The results from the evaluation will enhance the knowledge of how to promote EBRBs and self-regulation skills among preschoolers, and diminish SES differences in them.Peer reviewe

Development of the DAGIS intervention study : a preschool-based family-involving study promoting preschoolers’ energy balance-related behaviours and self-regulation skills

Background: Preschoolers' energy balance-related behaviours (EBRBs) and self-regulation skills are important for their later health. Few preschool-based interventions aiming to promote preschoolers' EBRBs and self-regulation skills, simultaneously reducing differences in EBRBs, due to children's socio-economic status (SES) background, have been conducted. This study will present the Increased Health and Wellbeing in Preschools (DAGIS) intervention development process applying the Intervention Mapping (IM) framework. Methods: The development of the DAGIS intervention study, a preschool level clustered randomized controlled trial (RCT), was based on the IM framework. The protocol in IM guides the development process of an intervention through six steps: needs assessment and logic model of the problem, programme outcomes and objectives, design of the programme, production, implementation plan, and evaluation plan. Results: The needs assessment, part of the step 1 in IM, yielded the base for the DAGIS logic model of change. The model includes objectives related to changes in children's EBRBs, self-regulation skills, and in psychosocial and physical environment that is determined by parents and early educators. A 22-week programme was developed, and materials for preschools and families were produced. A feasibility study of the recruitment processes, acceptability of the materials and methods, and implementation was conducted. The DAGIS intervention study was conducted September 2017-May 2018 as a clustered RCT including a comprehensive effectiveness and process evaluation. The process evaluation was run throughout the intervention targeting preschools and families. Conclusion: A preschool-based family-involving programme was developed in the DAGIS intervention study by applying the IM protocol. It was a time- and resource-consuming process. However, the systematic planning, development, and running of the programme have reinforced a comprehensive evaluation, which is a strength in the intervention. The results from the evaluation will enhance the knowledge of how to promote EBRBs and self-regulation skills among preschoolers, and diminish SES differences in them.Peer reviewe

Parental Happiness Associates With the Co-occurrence of Preschool-Aged Children’s Healthy Energy Balance-Related Behaviors

Publisher Copyright: © 2021, The Author(s).We examined whether parental happiness associate with preschoolers’ healthy energy balance-related behaviors (EBRBs) and with the co-occurrence of multiple healthy EBRBs. This cross-sectional study included 647 pairs of parents (88% mothers) and children (mean age 4.7, SD 0.9 years). Parents completed the Subjective Happiness Scale. In addition, ActiGraph accelerometers measured children’s physical activity, and parents reported screen time and food consumption on behalf of their children. We defined four healthy EBRBs: meeting physical activity guidelines; meeting screen time guidelines; a higher consumption of vegetables, fruits and berries; and a lower consumption of sugary foods, treats and drinks. Parental happiness scores did not associate with children’s healthy EBRBs when each behavior was analyzed separately. However, parents with higher happiness scores were more likely to have a child with 2 or 3–4 healthy EBRBs than a child with 0–1 healthy EBRBs. To conclude, parents who are happier have children with multiple healthy EBRBs. Targeting parental wellbeing should be considered when promoting children’s healthy EBRBs.Peer reviewe

Effects of the Preschool-Based Family-Involving DAGIS Intervention Program on Children’s Energy Balance-Related Behaviors and Self-Regulation Skills: A Clustered Randomized Controlled Trial

The study examines the effects of a preschool-based family-involving multicomponent intervention on children’s energy balance-related behaviors (EBRBs) such as food consumption, screen time and physical activity (PA), and self-regulation (SR) skills, and whether the intervention effects differed among children with low or high parental educational level (PEL) backgrounds. The Increased Health and Wellbeing in Preschools (DAGIS) intervention was conducted as a clustered randomized controlled trial, clustered at preschool level, over five months in 2017–2018. Altogether, 802 children aged 3–6 years in age participated. Parents reported children’s consumption of sugary everyday foods and beverages, sugary treats, fruits, and vegetables by a food frequency questionnaire, and screen time by a 7-day diary. Physical activity was assessed by a hip-worn accelerometer. Cognitive and emotional SR was reported in a questionnaire by parents. General linear mixed models with and without repeated measures were used as statistical methods. At follow-up, no differences were detected in EBRBs or SR skills between the intervention and control group, nor did differences emerge in children’s EBRBs between the intervention and the control groups when stratified by PEL. The improvement in cognitive SR skills among low PEL intervention children differed from low PEL control children, the significance being borderline. The DAGIS multicomponent intervention did not significantly affect children’s EBRBs or SR. Further sub-analyses and a comprehensive process evaluation may shed light on the non-significant findings

Parental happiness associates with the co-occurrence of preschool-aged children’s healthy energy balance-related behaviors

We examined whether parental happiness associate with preschoolers’ healthy energy balance-related behaviors (EBRBs) and with the co-occurrence of multiple healthy EBRBs. This cross-sectional study included 647 pairs of parents (88% mothers) and children (mean age 4.7, SD 0.9 years). Parents completed the Subjective Happiness Scale. In addition, ActiGraph accelerometers measured children’s physical activity, and parents reported screen time and food consumption on behalf of their children. We defined four healthy EBRBs: meeting physical activity guidelines; meeting screen time guidelines; a higher consumption of vegetables, fruits and berries; and a lower consumption of sugary foods, treats and drinks. Parental happiness scores did not associate with children’s healthy EBRBs when each behavior was analyzed separately. However, parents with higher happiness scores were more likely to have a child with 2 or 3–4 healthy EBRBs than a child with 0–1 healthy EBRBs. To conclude, parents who are happier have children with multiple healthy EBRBs. Targeting parental wellbeing should be considered when promoting children’s healthy EBRBs.</p

Yksilöllisyys ruoan maailmassa - tutkimuksia lasten temperamentin, ruokaympäristön ja ruokavalion yhteyksistä

Many factors relate to children’s eating; among the factors extensively studied is the home food environment, which encompasses parenting behaviors around food and eating as well as the physical aspects: food availability and accessibility in the home. In addition to the food environment’s vital role in a child’s developing eating habits, relevant are also the child’s individual characteristics, such as temperament. Developmental theories suggest that children are not merely passive recipients in their environments but may actively shape their environment through their behavior. Furthermore, depending on their temperament, the same environment may have varying effects on a child’s development. To date existing literature has mainly focused on coercive food parenting practices, such as restriction and pressure to eat, while less attention has received structure- and autonomy-promoting food parenting practices. Moreover, children’s dietary intake in early childhood education and care (ECEC) centers – another essential everyday life environment – has been understudied. Little is also known about the interplay between a child’s temperament and structure- and autonomy-promoting food parenting practices or temperament in relation to dietary factors specifically in the ECEC environment. The aim of this thesis was to examine how a child’s temperament is associated with dietary factors together with different factors of the home food environment. Furthermore, this thesis examined the association between temperament and dietary factors in the ECEC environment. The most central dietary factors investigated were the frequency of consuming fruits, vegetables, and sugar-rich foods and drinks, as well as total energy intake. This thesis utilized data from the Increased Health and Wellbeing in Preschools (DAGIS) project. In Study I, data was used from 505 children; Study II used the data from 728 children participating in the cross-sectional DAGIS survey conducted in 2015 and 2016 in Southern and Western Finland. Study III combined data from the cross-sectional survey with data from the DAGIS intervention baseline collected in 2017 and 2018 in two municipalities in Southern Finland, including information from 1216 children. The very short form of Children’s Behavior Questionnaire (CBQ) measured children’s three broad temperament dimensions: surgency, effortful control, and negative affectivity. Dietary factors in Study I were measured with a three-day food record, and in Studies II and III, with a parent-reported food frequency questionnaire (FFQ). The environmental factors investigated were structure- and autonomy-promoting food parenting practices, home food availability and accessibility, and general home and ECEC environments. Parents also reported about food parenting practices and the availability and accessibility of foods in the home. The results showed associations between a child’s higher temperamental surgency and higher mean daily energy intake, particularly in the ECEC environment. Children with higher negative affectivity had greater day-to-day variability in their daily energy intake. Children with higher temperamental surgency and effortful control were more likely to consume vegetables daily. Moreover, this association was indirect through parents’ structure- and autonomy-promoting practices. Furthermore, the association between home accessibility of sugar-rich foods and drinks and the consumption frequency of those foods was stronger for children with higher scores on negative affectivity. Overall, a child’s temperamental dispositions were associated with dietary factors, and food environment played a role in those associations. A novel finding was that temperamental surgency was associated with a higher mean daily energy intake, specifically in the ECEC environment. Thus, the role of a child’s temperament in dietary factors and eating, particularly in the ECEC environment, should be studied further. Furthermore, a paucity of research exists on associations between a child’s temperament and structure- and autonomy-promoting food parenting practices, which should be investigated in the future. Acknowledging and understanding the interplay between temperament and the food environment could help families and early educators in promoting healthy eating and food-related behavior among children.Lapsen syömistä muovaavat monet tekijät, kuten kodin ruokaympäristö ja lapsen yksilölliset piirteet, esimerkiksi temperamentti. Temperamentin ja kodin ruokaympäristön välisiä yhteyksiä ja sitä, miten ne yhdessä ovat yhteydessä lasten ruoankäyttöön on kuitenkin tutkittu vain vähän, kuten on myös lapsen temperamentin yhteyttä päiväkotiaikaiseen syömiseen. Tämä väitöstutkimus tarkasteli lapsen temperamenttipiirteiden yhteyttä ruoankäyttöön yhdessä erilaisten kodin ruokaympäristön tekijöiden – ruokien saatavuuden ja vanhempien ruokakäytäntöjen – kanssa. Lisäksi tutkittiin temperamentin yhteyttä syömiseen erikseen kotona ja päiväkodissa. Keskeisimmät tutkitut ravintotekijät olivat kasvisten, hedelmien ja sokeripitoisten ruokien ja juomien kulutus sekä energiansaanti. Tutkimuksessa käytettiin kahta aineistoa, jotka kerättiin osana Increased Health and Wellbeing in Preschools (DAGIS) -hankketta vuosina 2015–2018. Tutkittavien lasten määrä vaihteli väitöskirjan osatöissä (n=505–1216). Vanhemmat raportoivat lapsen temperamentin lomakkeella, joka kartoitti kolmea temperamenttipiirrettä: ulospäinsuuntautuneisuutta, tahdonalaista hallintaa ja kielteistä virittyneisyyttä. Lisäksi vanhemmat vastasivat lomakkeella ruokakäytännöistään ja kodin fyysisestä ruokaympäristöstä. Lasten ruoankäyttöä tutkittiin vanhempien ja varhaiskasvattajien pitämällä ruokapäiväkirjalla sekä vanhempien täyttämällä kyselylomakkeella eri ruokien käyttötiheyksistä. Ulospäinsuuntautuneisuus oli yhteydessä suurempaan päivittäiseen energiansaantiin, erityisesti päiväkotiympäristössä. Lapsilla, joilla oli enemmän kielteistä virittyneisyyttä, päivittäinen energiansaanti vaihteli enemmän päivästä toiseen. Lisäksi ulospäinsuuntautuneisuus ja tahdonalainen hallinta olivat yhteydessä suurempaan todennäköisyyteen syödä kasviksia päivittäin. Vanhempien ruokakäytännöt selittivät ulospäinsuuntautuneisuuden ja tahdonalaisen hallinnan yhteyttä kasvisten päivittäiseen kulutukseen. Lisäksi havaittiin, että yhteys sokeripitoisten ruokien ja juomien helpon saatavuuden ja niiden kulutuksen välillä oli vahvempi lapsilla, joilla oli enemmän kielteistä virittyneisyyttä. Lapsen temperamenttipiirteiden ja ruokavaliotekijöiden välillä löydettiin yhteyksiä, ja temperamentin ja ruokaympäristön välinen vuorovaikutus oli merkityksellistä näissä yhteyksissä. Jatkossa lapsen temperamentin yhteyttä syömiseen päiväkotiympäristössä tulisi tutkia kattavammin

Does temperament make children differently susceptible to their home physical food environment? A cross-sectional DAGIS study on 3-6 year old Finnish children's food consumption

Consistently linked with children?s food consumption are food availability and accessibility. However, less is known about potential individual differences among young children in their susceptibility to home food environments. The purpose of the study was to examine whether the association between home food availability and accessibility of sugar-rich foods and drinks (SFD) or fruits and vegetables (FV) and children?s consumption of these foods differ according to their temperament. The study used two cross-sectional datasets collected as part of the Increased Health and Wellbeing in Preschools (DAGIS) study: 1) a cross-sectional data of 864 children aged 3?6 years old collected between fall 2015 and spring 2016, and 2) an intervention baseline data of 802 children aged 3?6 collected in fall 2017. Parents reported their children?s temperament, consumption of FV and SFD, and home availability and accessibility of SFD and FV. Examination of whether associations between home availability and accessibility of FV and their consumption differ according to children?s temperament involved using linear regression models. Similar models were used to examine association between home availability and accessibility of SFD and their consumption, and the moderating role of temperament. The association between home accessibility of SFD and their consumption frequency was dependent on the level of children?s negative affectivity. More frequent consumption of SFD was observed with higher home accessibility of SFD. The association was stronger in children with higher scores in negative affectivity. No other interactions were found. Children with higher negative affectivity are possibly more vulnerable to food cues in the home environment than children with lower negative affectivity. Consideration of children?s individual characteristics is necessary in supporting their healthy eating.Peer reviewe