title: The Program SI! intervention for enhancing a healthy lifestyle in preschoolers: first results from a cluster randomized trial.
abstract: BACKGROUND
  Unhealthy lifestyles contribute to the development of cardiovascular risk factors, whose incidence is increasing among children and adolescents. The Program SI! is a long-term, multi-target behavioral intervention to promote healthy lifestyle habits in children through the school environment. The objective of the study is to evaluate the efficacy of this intervention in its first phase, preschoolers.
  
  
  METHODS
  Cluster-randomized controlled trial in public schools in the city of Madrid, Spain. A total 24 schools, including 2062 children (3-5 years), 1949 families, and 125 teachers participated in the study. Schools were assigned to their usual school curriculum or to engage in an additional multi-component intervention (Program SI!). The primary outcome of this trial is 1-school year changes from baseline in scores for children's knowledge, attitudes and habits (KAH). Secondary outcomes are 1-school year changes from baseline in scores for knowledge, attitudes, and habits among parents, teachers, and the school environment.
  
  
  RESULTS
  After 1-school year, our results indicate that the Program SI! intervention increases children's KAH scores, both overall (3.45, 95% CI, 1.84-5.05) and component-specific (Diet: 0.93, 95% CI, 0.12-1.75; Physical activity: 1.93, 95% CI, 1.17-2.69; Human body: 0.65, 95% CI, 0.07-1.24) score.
  
  
  CONCLUSIONS
  The Program SI! is demonstrated as an effective and feasible strategy for increasing knowledge and improving lifestyle attitudes and habits among very young children.
  
  
  BACKGROUND
  NCT01579708, Evaluation of the Program SI! for Preschool Education: A School-Based Randomized Controlled Trial (Preschool-SI!).
authors.affiliation: Area of Epidemiology and Populations Genetics, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Calle Melchor Fdez Almagro 3, Madrid 28029, Spain. jlpenalvo@cnic.es.
authors.forename: José L
authors.initials: JL
authors.lastname: Peñalvo
authors.forename: Mercedes
authors.initials: M
authors.lastname: Sotos-Prieto
authors.forename: Gloria
authors.initials: G
authors.lastname: Santos-Beneit
authors.forename: Stuart
authors.initials: S
authors.lastname: Pocock
authors.forename: Juliana
authors.initials: J
authors.lastname: Redondo
authors.forename: Valentín
authors.initials: V
authors.lastname: Fuster
mesh_terms: D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D016000:Cluster Analysis; D005240:Feasibility Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D015397:Program Evaluation; D012572:School Health Services / Q000458:organization & administration*; D012931:Social Environment; D013030:Spain