Related Experiment Video
Updated: Apr 1, 2026
Measuring Cardiac Autonomic Nervous System ANS Activity in Toddlers - Resting and Developmental Challenges
Published on: February 25, 2016
The SI! Program for Cardiovascular Health Promotion in Early Childhood: A Cluster-Randomized Trial
José L Peñalvo1, Gloria Santos-Beneit2, Mercedes Sotos-Prieto3
1Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
Background:
The preschool years offer a unique window of opportunity to instill healthy life-style behaviors and promote cardiovascular health.
Objectives:
This study sought to evaluate the effect of a 3-year multidimensional school-based intervention to improve life-style-related behaviors.
Methods:
We performed a cluster-randomized controlled intervention trial involving 24 public schools in Madrid, Spain, that were assigned to either the SI! Program intervention or the usual curriculum and followed for 3 years. The SI! Program aimed to instill and develop healthy behaviors in relation to diet, physical activity, and understanding how the human body and heart work. The primary outcome was change in the overall knowledge, attitudes, and habits (KAH) score (range 0 to 80). The intervention's effect on adiposity markers was also evaluated.
Results:
A total of 2,062 children from 3 to 5 years of age were randomized. After 3 years of follow-up, the overall KAH score was 4.9% higher in children in the intervention group compared with the control group (21.7 vs. 16.4; p < 0.001). A peak effect was observed at the second year (improvement 7.1% higher than in the control group; p < 0.001). Physical activity was the main driver of the change in KAH at all evaluation times. Children in the intervention group for 2 years and 1 year showed greater improvement than control subjects (5.9%; p < 0.001 and 2.9%; p = 0.002, respectively). After 3 years, the intervention group showed a higher probability than the control group of reducing the triceps skinfold z-score by at least 0.1 (hazard ratio: 1.40, 95% confidence interval: 1.04 to 1.89; p = 0.027).
Conclusions:
The SI! Program is an effective strategy for instilling healthy habits among preschoolers, translating into a beneficial effect on adiposity, with maximal effect when started at the earliest age and maintained over 3 years. Wider adoption may have a meaningful effect on cardiovascular health promotion. (Evaluation of the Program SI! for Preschool Education: A School-Based Randomized Controlled Trial [Preschool_PSI!]; NCT01579708).
Related Concept Videos
01:26Coronary Artery Disease IV: Preventive Measures
01:26Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
01:25Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:18Models of Health Promotion and Illness Prevention II
The agent-host-environment model states that disease results...
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...