The Danish SoL Project: Effects of a Multi-Component Community-Based Health Promotion Intervention on Prevention of Overweight among 3–8-Year-Old Children
Abstract
:1. Introduction
2. Materials and Methods
2.1. Intervention Design
2.2. Study Design
2.3. Subjects
2.4. Anthropometric Measurements
2.5. Socio-Economic and Family Status
2.6. Statistical Analysis
3. Results
4. Discussion
4.1. Implications
4.2. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
References
- World Health Organization. Ottawa Charter for Health Promotion; World Health Organization: Geneva, Switzerland, 1986. [Google Scholar]
- Sallis, J.F.; Cervero, R.B.; Ascher, W.; Henderson, K.A.; Kraft, M.K.; Kerr, J. An ecological approach to creating active living communities. Annu. Rev. Public Health 2006, 27, 297–322. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Madruga, S.W.; Araújo, C.L.P.; Bertoldi, A.D.; Neutzling, M.B. Tracking of dietary patterns from childhood to adolescence. Rev. Saude Publica 2012, 46, 376–386. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Brown, T.; Moore, T.H.; Hooper, L.; Gao, Y.; Zayegh, A.; Ijaz, S.; Elwenspoek, M.; Foxen, S.C.; Magee, L.; O’Malley, C.; et al. Interventions for preventing obesity in children. Cochrane Database Syst. Rev. 2019, 7, CD001871. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- World Health Organization. Report of the Commission on Ending Childhood Obesity. Implementation Plan: Executive Summary; World Health Organization: Geneva, Switzerland, 2017. [Google Scholar]
- Bleich, S.N.; Segal, J.; Wu, Y.; Wilson, R.; Wang, Y. Systematic review of community-based childhood obesity prevention studies. Pediatrics 2013, 132, 210. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wolfenden, L.; Wyse, R.; Nichols, M.; Allender, S.; Millar, L.; McElduff, P. A systematic review and meta-analysis of whole of community interventions to prevent excessive population weight gain. Prev. Med. 2014, 62, 193–200. [Google Scholar] [CrossRef]
- Bloch, P.; Toft, U.; Reinbach, H.; Clausen, L.; Mikkelsen, B.; Poulsen, K.; Jensen, B. Revitalizing the setting approach–Supersettings for sustainable impact in community health promotion. Int. J. Behav. Nutr. Phys. Act. 2014, 11, 118. [Google Scholar] [CrossRef] [Green Version]
- Toft, U.; Bloch, P.; Reinbach, H.C.; Winkler, L.L.; Buch-Andersen, T.; Aagaard-Hansen, J.; Mikkelsen, B.E.; Jensen, B.B.; Glumer, C. Project SoL-A Community-Based, Multi-Component Health Promotion Intervention to Improve Eating Habits and Physical Activity among Danish Families with Young Children. Part 1: Intervention Development and Implementation. Int. J. Environ. Res. Public Health 2018, 15, 1097. [Google Scholar] [CrossRef] [Green Version]
- Mikkelsen, B.E.; Bloch, P.; Reinbach, H.C.; Buch-Andersen, T.; Lawaetz Winkler, L.; Toft, U.; Glümer, C.; Jensen, B.B.; Aagaard-Hansen, J. Project SoL—A Community-Based, Multi-Component Health Promotion Intervention to Improve Healthy Eating and Physical Activity Practices among Danish Families with Young Children Part 2: Evaluation. Int. J. Environ. Res. Public Health 2018, 15, 1513. [Google Scholar] [CrossRef] [Green Version]
- Toft, U.; Buch-Andersen, T.; Bloch, P.; Winkler, L.L.; Glumer, C. The quantitative evaluation of the Health and Local Community Project (SoL). Eur. J. Public Health 2018, 26, 245. [Google Scholar] [CrossRef] [Green Version]
- Poulsen, I.H. Hvordan har du det? 2010. Sundhedsprofil for Region. Sjælland og kommuner (In English: How Are You? 2010. Health Profiles of Region. Zealand and Municipalities); Region Sjælland: Sorø, Denmark, 2011. [Google Scholar]
- Cole, T.J.; Green, P.J. Smoothing reference centile curves: The LMS method and penalized likelihood. Stat. Med. 1992, 11, 1305–1319. [Google Scholar] [CrossRef]
- Tinggaard, J.; Aksglaede, L.; Sorensen, K.; Mouritsen, A.; Wohlfahrt-Veje, C.; Hagen, C.P.; Mieritz, M.G.; Jorgensen, N.; Wolthers, O.D.; Heuck, C.; et al. The 2014 Danish references from birth to 20 years for height, weight and body mass index. Acta Paediatr. 2014, 103, 214–224. [Google Scholar] [CrossRef]
- Cole, T.J.; Bellizzi, M.C.; Flegal, K.M.; Dietz, W.H. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ 2000, 320, 1240–1243. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cole, T.J.; Flegal, K.M.; Nicholls, D.; Jackson, A.A. Body mass index cut offs to define thinness in children and adolescents: International survey. BMJ 2007, 335, 194. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pedersen, C.B.; Gøtzsche, H.; Møller, J.O.; Mortensen, P.B. The Danish Civil Registration System. A cohort of eight million persons. Dan. Med. Bull. 2006, 53, 441–449. [Google Scholar] [PubMed]
- de Vos, K.; Zaidi, M.A. Equivalence scale sensitivity of poverty statistics for the member states of the European community. Rev. Income Wealth 1997, 43, 319–333. [Google Scholar] [CrossRef]
- Baadsgaard, M.; Quitzau, J. Danish registers on personal income and transfer payments. Scand. J. Public Health 2011, 39, 103–105. [Google Scholar] [CrossRef]
- Jensen, V.M.; Rasmussen, A.W. Danish Education Registers. Scand. J. Public Health 2011, 39, 91–94. [Google Scholar] [CrossRef] [Green Version]
- Koepsell, T.D.; Martin, D.C.; Diehr, P.H.; Psaty, B.M.; Wagner, E.H.; Perrin, E.B.; Cheadle, A. Data analysis and sample size issues in evaluations of community-based health promotion and disease prevention programs: A mixed-model analysis of variance approach. J. Clin. Epidemiol. 1991, 44, 701–713. [Google Scholar] [CrossRef]
- Fitzmaurice, G.M.; Laird, N.M.; Ware, J.H. Hypotheses concerning response profiles. In Applied Longitudinal Analysis; John Wiley & Sons: Hoboken, NJ, USA, 2011; Volume 998, pp. 107–112. [Google Scholar]
- Fitzmaurice, G.M.; Laird, N.M.; Ware, J.H. Missing Data issues. In Applied Longitudinal Analysis; John Wiley & Sons: Hoboken, NJ, USA, 2011; pp. 94–96. [Google Scholar]
- Vinck, J.; Brohet, C.; Roillet, M.; Dramaix, M.; Borys, J.M.; Beysens, J.; Jacobs, N.; Jebb, S.; De Laet, C.; Nève, J. Downward trends in the prevalence of childhood overweight in two pilot towns taking part in the VIASANO community-based programme in Belgium: Data from a national school health monitoring system. Pediatr. Obes. 2016, 11, 61–67. [Google Scholar] [CrossRef]
- Borys, J.-M.; Valdeyron, L.; Levy, E.; Vinck, J.; Edell, D.; Walter, L.; Ruault du Plessis, H.; Harper, P.; Richard, P.; Barriguette, A. EPODE-A Model for Reducing the Incidence of Obesity and Weight-related Comorbidities. Eur. Endocrinol. 2013, 9, 116–120. [Google Scholar] [CrossRef] [Green Version]
- De Coen, V.; De Bourdeaudhuij, I.; Vereecken, C.; Verbestel, V.; Haerens, L.; Huybrechts, I.; Van Lippevelde, W.; Maes, L. Effects of a 2-year healthy eating and physical activity intervention for 3–6-year-olds in communities of high and low socio-economic status: The POP (Prevention of Overweight among Pre-school and school children) project. Public Health Nutr. 2012, 15, 1737–1745. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Folta, S.C.; Kuder, J.F.; Goldberg, J.P.; Hyatt, R.R.; Must, A.; Naumova, E.N.; Nelson, M.E.; Economos, C.D. Changes in diet and physical activity resulting from the Shape Up Somerville community intervention. BMC Pediatr. 2013, 13, 157. [Google Scholar] [CrossRef] [Green Version]
- Bolton, K.A.; Kremer, P.; Gibbs, L.; Waters, E.; Swinburn, B.; de Silva, A. The outcomes of health-promoting communities: Being active eating well initiative—A community-based obesity prevention intervention in Victoria, Australia. Int. J. Obes. 2017, 41, 1080–1090. [Google Scholar] [CrossRef] [PubMed]
- Romon, M.; Lommez, A.; Tafflet, M.; Basdevant, A.; Oppert, J.M.; Bresson, J.L.; Ducimetière, P.; Charles, M.A.; Borys, J.M. Downward trends in the prevalence of childhood overweight in the setting of 12-year school- and community-based programmes. Public Health Nutr. 2009, 12, 1735–1742. [Google Scholar] [CrossRef] [PubMed]
- Sundhedsdatastyrelsen Den Nationale Børnedatabase (In English: The Children’s Database). Available online: https://sundhedsdatastyrelsen.dk/da/registre-og-services/om-de-nationale-sundhedsregistre/graviditet-foedsler-og-boern/boernedatabasen (accessed on 1 June 2018).
- Shrewsbury, V.; Wardle, J. Socioeconomic Status and Adiposity in Childhood: A Systematic Review of Cross-sectional Studies 1990–2005. Obesity 2008, 16, 275–284. [Google Scholar] [CrossRef] [PubMed]
- Freedman, D.S.; Sherry, B. The validity of BMI as an indicator of body fatness and risk among children. Pediatrics 2009, 124, S23–S24. [Google Scholar] [CrossRef] [PubMed] [Green Version]
Intervention Group (n = 201) | Control Group (n = 166) | |
---|---|---|
Mean or Frequency | Mean or Frequency | |
Age, years (SD) | 6.51 (1.49) | 6.21 (1.80) |
Female (%) | 105 (52) | 90 (54) |
Height, cm (SD) a | 120.76 (10.84) | 118.58 (11.92) |
Weight, kg (SD) | 23.72 (5.44) | 23.04 (5.33) |
Parental education *** | ||
Primary/secondary school (%) | 23 (11) | 44 (27) |
Vocational education (%) | 100 (50) | 65 (39) |
Academy or bachelor (%) | 71 (35) | 45 (27) |
Master or PhD (%) | 7 (4) | 12 (7) |
Household income | ||
Lower quartile (%) | 38 (19) | 42 (25) |
Lower middle quartile (%) | 86 (43) | 57 (34) |
Upper middle quartile (%) | 49 (24) | 44 (27) |
Upper quartile (%) | 28 (14) | 23 (14) |
Family status | ||
Married couples (%) | 125 (62) | 111 (66) |
Registered partnership (%) | 1 (1) | 0 (0) |
Couple living in consensual union (%) | 43 (21) | 26 (16) |
Cohabiting couples (%) | 13 (7) | 11 (7) |
Single parent (%) | 19 (10) | 19 (12) |
Intervention Group | Control Group | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Baseline | Follow-Up | Baseline | Follow-Up | |||||||||
n | Median | P25, P75 | n | Median | P25, P75 | n | Median | P25, P75 | n | Median | P25, P75 | |
BMI z-score a | 200 | 0.15 | −0.58, 0.84 | 151 | 0.04 | −0.61, 0.91 | 166 | 0.32 | −0.32, 0.77 | 130 | 0.15 | −0.35, 0.85 |
Waist circumference, cm | 201 | 54.67 | 51.33, 57.17 | 150 | 56.58 | 53.17, 60.33 | 165 | 53.33 | 51.00, 56.33 | 129 | 56.17 | 52.83, 59.00 |
Weight class b | n | % | n | % | n | % | n | % | ||||
Underweight | 12 | 6 | 10 | 7 | 8 | 5 | 9 | 7 | ||||
Healthy weight | 160 | 80 | 120 | 80 | 138 | 83 | 110 | 85 | ||||
Overweight | 25 | 13 | 17 | 11 | 20 | 12 | 11 | 9 | ||||
Obese | 3 | 2 | 4 | 3 | 0 | 0 | 0 | 0 |
Intervention Group | Control Group | Group Difference a | |||
---|---|---|---|---|---|
Adjusted Change (CI) b | Adjusted Change (CI) b | n (Child/Obs) | Adjusted Change (CI) c | p | |
BMI z-score d | 0.09 (0.01, 0.17) | −0.10 (−0.18, −0.02) | 367/646 | 0.19 (0.08, 0.30) | 0.0013 |
Waist circumference, cm | 0.29 (−0.31, 0.90) | −0.09 (−0.71, 0.53) | 367/644 | 0.38 (−0.26, 1.02) | 0.2374 |
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Buch-Andersen, T.; Eriksson, F.; Bloch, P.; Glümer, C.; Mikkelsen, B.E.; Toft, U. The Danish SoL Project: Effects of a Multi-Component Community-Based Health Promotion Intervention on Prevention of Overweight among 3–8-Year-Old Children. Int. J. Environ. Res. Public Health 2021, 18, 8419. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168419
Buch-Andersen T, Eriksson F, Bloch P, Glümer C, Mikkelsen BE, Toft U. The Danish SoL Project: Effects of a Multi-Component Community-Based Health Promotion Intervention on Prevention of Overweight among 3–8-Year-Old Children. International Journal of Environmental Research and Public Health. 2021; 18(16):8419. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168419
Chicago/Turabian StyleBuch-Andersen, Tine, Frank Eriksson, Paul Bloch, Charlotte Glümer, Bent Egberg Mikkelsen, and Ulla Toft. 2021. "The Danish SoL Project: Effects of a Multi-Component Community-Based Health Promotion Intervention on Prevention of Overweight among 3–8-Year-Old Children" International Journal of Environmental Research and Public Health 18, no. 16: 8419. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168419