ArticlePloS one2017
Effect and process evaluation of a kindergarten-based, family-involved intervention with a randomized cluster design on sedentary behaviour in 4- to 6- year old European preschool children: The ToyBox-study.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02116296 (Multifactorial Evidence Based Approach Using Behavioural Models in Understanding and Promoting Fun, Healthy Food, Play and Policy for the Prevention of Obesity in Early Childhood), which is not on this map. Cited by 15 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multifactorial Evidence Based Approach Using Behavioural Models in Understanding and Promoting Fun, Healthy Food, Play and Policy for the Prevention of Obesity in Early Childhood
Who cites it
15 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Interventions to Reduce Screen Time in Preschool-Aged Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Pooled it
- Effect of intervention on screen time in preschoolers: a systematic review and meta-analysis of randomized controlled trials.BMC public health · 2025Pooled it
- Home- and Community-Based Interventions for Physical Activity and Early Child Development: A Systematic Review of Effective Strategies.International journal of environmental research and public health · 2022Pooled it
- The Effectiveness of Interventions to Reduce Sedentary Time in Different Target Groups and Settings in Germany: Systematic Review, Meta-Analysis and Recommendations on Interventions.International journal of environmental research and public health · 2022Pooled it
- Measurement of screen time among young children aged 0-6 years: A systematic review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2021Pooled it
- Effectiveness of a program to lower unwanted media screens among 2-5-year-old children: a randomized controlled trial.Frontiers in public health · 2024Trial
- Pre-school-based behaviour change intervention to increase physical activity levels amongst young children: a feasibility cluster randomised controlled trial.Frontiers in public health · 2024Trial
- Process evaluation of a kindergarten-based intervention for obesity prevention in early childhood: the Toybox study Malaysia.BMC public health · 2023Trial
- Prospective BMI changes in preschool children are associated with parental characteristics and body weight perceptions: the ToyBox-study.Public health nutrition · 2022Trial
- Combining Effect and Process Evaluation on European Preschool Children's Snacking Behavior in a Kindergarten-Based, Family-Involved Cluster Randomized Controlled Trial: The ToyBox Study.International journal of environmental research and public health · 2020Trial
- Trial
- Effect and process evaluation of a kindergarten-based, family-involved cluster randomised controlled trial in six European countries on four- to six-year-old children's steps per day: the ToyBox-study.The international journal of behavioral nutrition and physical activity · 2017Trial
- Effect of a Community-Based Program on Preschoolers' Physical Activity and Nutrition in Chile.Journal of functional morphology and kinesiology · 2025Article
- A feasibility cluster randomised controlled trial of a preschool obesity prevention intervention: ToyBox-Scotland.Pilot and feasibility studies · 2019Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of the present study evaluated the effect and process of the ToyBox-intervention on proxy-reported sedentary behaviours in 4- to 6-year-old preschoolers from six European countries.
methodsIn total, 2434 preschoolers' parents/primary caregivers (mean age: 4.7±0.4 years, 52.2% boys) filled out a questionnaire, assessing preschoolers' sedentary behaviours (TV/DVD/video viewing, computer/video games use and quiet play) on weekdays and weekend days. Multilevel repeated measures analyses were conducted to measure the intervention effects. Additionally, process evaluation data were included to better understand the intervention effects.
resultsPositive intervention effects were found for computer/video games use. In the total sample, the intervention group showed a smaller increase in computer/video games use on weekdays (ß = -3.40, p = 0.06; intervention: +5.48 min/day, control: +8.89 min/day) and on weekend days (ß = -5.97, p = 0.05; intervention: +9.46 min/day, control: +15.43 min/day) from baseline to follow-up, compared to the control group. Country-specific analyses showed similar effects in Belgium and Bulgaria, while no significant intervention effects were found in the other countries. Process evaluation data showed relatively low teachers' and low parents' process evaluation scores for the sedentary behaviour component of the intervention (mean: 15.6/24, range: 2.5-23.5 and mean: 8.7/17, range: 0-17, respectively). Higher parents' process evaluation scores were related to a larger intervention effect, but higher teachers' process evaluation scores were not.
conclusionsThe ToyBox-intervention had a small, positive effect on European preschoolers' computer/video games use on both weekdays and weekend days, but not on TV/DVD/video viewing or quiet play. The lack of larger effects can possibly be due to the fact that parents were only passively involved in the intervention and to the fact that the intervention was too demanding for the teachers. Future interventions targeting preschoolers' behaviours should involve parents more actively in both the development and the implementation of the intervention and, when involving schools, less demanding activities for teachers should be developed.
trial registrationclinicaltrials.gov NCT02116296.
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