1. Mediators of the Effectiveness of an Intervention Promoting Water Consumption in Preschool Children: The ToyBox Study
- Author
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Violeta Iotova, Ilse De Bourdeaudhuij, Christina P. Lambrinou, Odysseas Androutsos, Berthold Koletzko, Maartje M. van Stralen, Yannis Manios, Piotr Socha, Luis A. Moreno, Prevention and Public Health, and APH - Health Behaviors & Chronic Diseases
- Subjects
Adult ,Male ,obesity ,Mediation (statistics) ,Complete data ,family determinants ,Health Behavior ,Psychological intervention ,Child Behavior ,Drinking Behavior ,030209 endocrinology & metabolism ,Intervention effect ,Health Promotion ,prevention, ToyBox-study ,preschool ,Water consumption ,Education ,03 medical and health sciences ,0302 clinical medicine ,prevention ,SDG 3 - Good Health and Well-being ,Intervention (counseling) ,Environmental health ,Surveys and Questionnaires ,Medicine ,Humans ,mediation ,030212 general & internal medicine ,preschool, obesity ,Socioeconomic status ,business.industry ,Drinking Water ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,Obesity ,Europe ,Philosophy ,Child, Preschool ,ToyBox-study ,Female ,SDG 6 - Clean Water and Sanitation ,business ,water consumption ,Program Evaluation - Abstract
BACKGROUND: The ToyBox-intervention has increased preschool children's water consumption. This study aimed to examine if family-related determinants mediate the effects of the ToyBox-intervention on preschoolers' water consumption. METHODS: Overall, 6290 preschoolers and their families from 6 European countries participated in the ToyBox-intervention and returned parental questionnaires in May/June 2012 and 2013. This study included the 3725 preschoolers/families who had complete data on water consumption, all mediators, and confounders. Mediation effects were assessed with bootstrapping procedure. RESULTS: Regarding the intervention effects on family-related determinants, the ToyBox-intervention significantly increased water availability during meals, parental water consumption, parental encouragement to their children to drink water, and parental knowledge on water recommendations. In the multiple mediator model, all factors were independently associated with preschoolers' water consumption and mediated the intervention effect on preschoolers' water consumption (total mediation effect = 40%). After including all mediators into the model, the direct intervention effect remained significant. CONCLUSIONS: The effect of the ToyBox-intervention on preschool children's water consumption was mediated by most family-related determinants examined in this study (ie, availability, parental modeling, parental encouragement, and parental knowledge). Interventions aiming to promote water in preschoolers should target these mediators to enhance their effectiveness.
- Published
- 2017
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