title: Design, Implementation, and Study Protocol of a Kindergarten-Based Health Promotion Intervention.
abstract: Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. "Join the Healthy Boat" is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew's Intervention Mapping approach considering Bandura's social-cognitive theory and Bronfenbrenner's ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation.Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089.
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Susanne
authors.identifier: 0000-0002-0545-1500
authors.initials: S
authors.lastname: Kobel
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Olivia
authors.initials: O
authors.lastname: Wartha
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Tamara
authors.identifier: 0000-0002-3930-9174
authors.initials: T
authors.lastname: Wirt
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Dreyhaupt
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Lämmle
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Friedemann
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Kelso
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Claire
authors.initials: C
authors.lastname: Kutzner
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Lina
authors.initials: L
authors.lastname: Hermeling
authors.affiliation: Division of Sports and Rehabilitation, Department of Internal Medicine II, Ulm University Medical Centre, Frauensteige 6, Haus 58/33, 89075 Ulm, Germany.
authors.forename: Jürgen M
authors.identifier: 0000-0001-8901-9450
authors.initials: JM
authors.lastname: Steinacker
mesh_terms: D002648:Child; D002675:Child, Preschool; D004032:Diet; D015444:Exercise / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D009765:Obesity / Q000503:physiopathology / Q000517:prevention & control*; D050177:Overweight / Q000503:physiopathology / Q000517:prevention & control*; D015397:Program Evaluation