title: Effectiveness of the IDEFICS intervention on objectively measured physical activity and sedentary time in European children.
abstract: BACKGROUND
  This paper reports on the effectiveness of the prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) intervention on objectively measured physical activity (PA) and sedentary time (ST) in 2- to 9.9-year-old European boys and girls.
  
  
  METHODS
  The intervention was evaluated after 2 years through a non-randomized cluster-controlled trial in eight European countries (one control and one intervention community per country). All children in the intervention group received a culturally adapted childhood obesity prevention programme through the community, schools/kindergartens and family. A random sub-sample of children participating in the IDEFICS study wore an accelerometer at baseline and follow-up for at least 3 days (n = 9,184). Of this sample, 81% provided valid accelerometer data at baseline (n = 7,413; 51% boys; 6.21 ± 1.76 years; boys: 617 ± 170 cpm day(-1) ; girls 556 ± 156 cpm day(-1) ) and 3,010 children provided valid accelerometer data at baseline and during the follow-up survey 2 years later.
  
  
  RESULTS
  In boys and girls, no significant differences in PA and ST were found between intervention and control groups over 2 years. Strong temporal effects were found in the total sample of boys and girls: the percentage of time spent in light PA per day decreased by 4 percentage points in both boys and girls between baseline and follow-up (both: p < 0.001), while time spent in ST per day increased by 4 percentage points in both sexes over time (both: p < 0.001). Percentage of time spent in moderate-to-vigorous PA per day remained stable over time in boys and girls.
  
  
  CONCLUSIONS
  Despite the socio-ecological approach and implementation of a culturally adapted intervention in each country, no effects of the IDEFICS intervention were found on children's objectively measured PA and ST. Behavioural interventions for children may need to enhance specificity and intensity at the family level using other behaviour change techniques and more direct strategies to reach parents.
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Verbestel
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: De Henauw
authors.affiliation: Unit of Epidemiology and Population Genetics, Institute of Food Science, National Research Council, Avellino, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barba
authors.affiliation: Department of Public Health and Community Medicine, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Eiben
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Gallois
authors.affiliation: Research and Education Institute of Child Health, Strovolos, Cyprus.
authors.forename: C
authors.initials: C
authors.lastname: Hadjigeorgiou
authors.affiliation: National Institute for Health Development, Tallinn, Estonia.
authors.forename: K
authors.initials: K
authors.lastname: Konstabel
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Maes
authors.affiliation: Department of Pediatrics, The Queen Silvia Childrens' University Hospital, Göteborg University, Göteborg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Mårild
authors.affiliation: Department of Pediatrics, University of Pécs, Pécs, Hungary.
authors.forename: D
authors.initials: D
authors.lastname: Molnár
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.|Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: National Institute for Health Development, Tallinn, Estonia.
authors.forename: L
authors.initials: L
authors.lastname: Oja
authors.affiliation: College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Pitsiladis
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.|Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Ahrens
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.|Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Pigeot
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: De Bourdeaudhuij
mesh_terms: D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005060:Europe / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009043:Motor Activity; D010290:Parents / Q000193:education* / Q000523:psychology; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D011322:Primary Prevention / Q000458:organization & administration*; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D057185:Sedentary Behavior; D012959:Socioeconomic Factors; D061217:Weight Reduction Programs; D044465:White People
keywords: Children; multi-level intervention; physical activity; sedentary time