Kindergarten-based Intervention for Childhood Obesity in Guangzhou(KICOG)
Condition: Childhood Obesity
MeSH terms: Obesity; Pediatric Obesity
Study type: Interventional

Summary: 
      Early life interventions for childhood obesity may provide substantial benefits. Most
      existing studies aimed at school children have reported limited effectiveness, however few
      have targeted preschool children. This study aimed to pilot procedures for a multifaceted,
      culturally appropriate intervention for preschool children and to provide a preliminary
      assessment of effectiveness of the intervention.
    

Detailed description: 
      The intervention protocol was developed by an expert group from the National Children Obesity
      Intervention Team, comprising pediatricians, children healthcare doctors, preschool teachers,
      and nutritionists, and included three integrated components:

      Component 1 - training of kindergarten staff: Before the start of the program, two members of
      the intervention team (a dietitian and a physician) delivered eight 40-min sessions (twice a
      week for a month) on dietary management in children and daily food purchasing for school
      doctors and kitchen staff. During the trial, two health education doctors gave lectures every
      two months on general knowledge in nutrition to all preschool staff, focusing on the
      promotion of healthy food and restriction of unhealthy food. To assess the effectiveness of
      these lectures, we administered a questionnaire on the material covered. We also trained the
      kitchen staff to use the dietary software to plan menu with balanced nutrition for preschool
      children.

      Component 2 - a curriculum promoting healthy diet and lifestyle: We designed a health
      education curriculum and associated picture books for the children. Children in the
      intervention group received a 20-minute health education lesson every week, where they had
      learning activities and games covering healthy food choice, appropriate portion sizes and
      eating pace, and reduction of sedentary behaviours. Learning aids such as colourful picture
      books or cards, food models, nursery rhymes and stories were used. Two elements were
      introduce to increase children's activity such as lunchtime activity and daily dance at less
      than 10 minutes during break.

      Component 3 - collaboration between families and kindergartens: We organized lectures
      designed for parents every two months during the intervention period. Topics covered included
      the cause and harms of childhood obesity, advice on healthy diet (increasing consumption of
      vegetables and fruits, reducing consumption of meat, snacks, fast foods, and eating out, and
      avoiding sugary drinks), body mass index (BMI) reference for preschool-age children, and how
      to use growth curves. We produced a handbook for communication between families and schools,
      to be handed out to every family weekly, in which children's health behaviours were
      documented and reviewed by teachers and parents. Finally, parents were notified of their
      children's anthropometric measurements every three months, so that they could plot and
      interpret their children's growth curves.
    

Intervention name(s): Healthy Lifestyles Intervention
Intervention type(s): Behavioral
Intervention description(s): The program included three major components. The first component consists of live lectures to kindergarten staff about basic nutrition and food concepts that attempted to correct false beliefs. The second component was a health curriculum for children that focused on promoting healthy nutrition habits and a healthy living style. Preschools were required to ensure that children received a health education lesson every two weeks. The third component was aimed at educating parents and consisted of lectures every two months, preschool-home communication every week and child growth monitoring every three months.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Childhood obesity