title: Behavioural effects of a community-oriented setting-based intervention for prevention of childhood obesity in eight European countries. Main results from the IDEFICS study.
abstract: OBJECTIVE
  The objective of this paper is to evaluate the behavioural effects, as reported by the parents of the participating boys and girls, of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) intervention.
  
  
  METHODS
  The effectiveness of the IDEFICS intervention was evaluated through a cluster-controlled trial in eight European countries (control and intervention communities in each country) including more than 16,000 children. The 2- to 9.9-year-old children in the intervention group were exposed to a culturally adapted intervention that aimed to prevent childhood obesity through the community, schools/kindergartens and family. Parents completed questionnaires to measure water, soft drink and fruit juice intake; fruit and vegetable intake; daily TV viewing and other sedentary behaviours; daily physical activity levels and strengthening of the parent-child relationships at baseline and follow-up (2 years later). Mixed models with an additional random effect for country were used to account for the clustered study design, and results were stratified by sex.
  
  
  RESULTS
  The pan-European analysis revealed no significant time by condition interaction effects, neither for boys nor girls, i.e. the analysis revealed no intervention effects on the behaviours of the IDEFICS children as reported by their parents (F = 0.0 to 3.3, all p > 0.05). Also very few significances were found in the country-specific analyses. Positive intervention effects were only found for sport club participation in Swedish boys, for screen time in weekends for Spanish boys and for TV viewing in Belgian girls.
  
  
  CONCLUSIONS
  Although no expected intervention effects as reported by the parents on diet, physical activity and sedentary behaviours could be shown for the overall IDEFICS cohort, a few favourable intervention effects were found on specific behaviours in some individual countries. More in-depth analyses of the process evaluation data are needed to obtain more insight into the relationship between the level of exposure to the intervention and its effect.
authors.affiliation: Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: De Bourdeaudhuij
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: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Maes
authors.affiliation: Dietary Exposure Assessment Group, International Agency for Research on Cancer, Lyon, France.
authors.forename: I
authors.initials: I
authors.lastname: Huybrechts
authors.affiliation: Department of Pediatrics, University of Gothenburg, Göteborg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Mårild
authors.affiliation: Department of Public Health and Community Medicine, University of Gothenburg, Göteborg, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Eiben
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) research group, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: Institute of Food Science, National research Council, Avellino, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Barba
authors.affiliation: Department Paediatrics, University of Pécs, Pécs, Hungary.|Institute for Medical Information Processing, Biometrics and Epidemiology and German Centre for Vertigo and Balance Disorders, Ludwig Maximilian University, Munich, Germany.
authors.forename: É
authors.initials: É
authors.lastname: Kovács
authors.affiliation: National Institute for Health Development, Tallinn, Estonia.
authors.forename: K
authors.initials: K
authors.lastname: Konstabel
authors.affiliation: Research and Education Institute for Child Health, Strovolos, Cyprus.
authors.forename: M
authors.initials: M
authors.lastname: Tornaritis
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Gallois
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hebestreit
authors.affiliation: Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.|Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Pigeot
mesh_terms: D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003153:Community Health Services / Q000458:organization & administration*; D005060:Europe / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D011322:Primary Prevention; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D061217:Weight Reduction Programs; D044465:White People / Q000706:statistics & numerical data
keywords: behavioural effect; community intervention; obesity prevention