Combining Effect and Process Evaluation on European Preschool Children's Snacking Behavior in a Kindergarten-Based,...

Area of Science:

• Child Nutrition
• Public Health Interventions
• Behavioral Science

Background:

• Preschoolers' dietary habits are crucial for long-term health.
• Effective interventions are needed to improve children's snack intake.
• The ToyBox intervention aimed to promote healthy eating in European preschoolers.

Purpose of the Study:

• To evaluate the impact of the standardized ToyBox intervention on preschoolers' snacking behavior.
• To determine if higher process evaluation scores correlate with better intervention outcomes.
• To analyze intervention effects across six European countries.

Main Methods:

• A large sample of 4970 preschoolers (aged 4.74 ± 0.44 years) from six European countries participated.
• Snack intake was assessed using a Food Frequency Questionnaire.
• Multilevel repeated measures analyses and process evaluation questionnaires were employed.

Main Results:

• No statistically significant intervention effects on preschoolers' snack intake were observed (p > 0.003).
• Process evaluation scores from teachers and parents did not correlate with improved snack intake.
• Intervention effects did not differ based on evaluation scores.

Conclusions:

• The standardized ToyBox intervention, as implemented, did not significantly change preschoolers' snack intake.
• Limited intervention duration and dose may have contributed to the lack of effect.
• Future interventions may require greater standardization and local tailoring for enhanced impact.