Key result
SI! Program increases preschool knowledge, attitudes, and habits scores by ~5 points vs. usual curriculum.
Why the study?
The preschool years offer a unique opportunity to instill healthy lifestyle behaviors and promote cardiovascular health, but the effect of a multidimensional school-based intervention was not established.
Does a 3-year multidimensional school-based intervention (SI! Program) improve cardiovascular health knowledge, habits, and adiposity markers in preschool children aged 3 to 5 years?
RCT (n=2,062)
Cluster-randomized
Yes
Does a 3-year multidimensional school-based intervention (SI! Program) improve cardiovascular health knowledge, habits, and adiposity markers in preschool children aged 3 to 5 years?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“There is a need for a complete change in the timing of when we deliver care. Until now, the clinical community has focused on cardiovascular disease, which typically manifests in the later stages of life. Now, we need to focus our care in the opposite stage of life--we need start promoting health at the earliest years, as early as 3 to 5 years old, in order to prevent cardiovascular disease.”
“It may not only be the cardiovascular health information from the program that is helpful but also the cognitive stimulation from and exposure to positive adult role models, which in turn influence personality traits critical for health behavior and habits.”
A school-based educational intervention starting in preschool significantly improves healthy lifestyle habits and favorably alters adiposity trajectories over 3 years.
BACKGROUND: The preschool years offer a unique window of opportunity to instill healthy life-style behaviors and promote cardiovascular health. OBJECTIVES: This study sought to evaluate the effect of a 3-year multidimensional school-based intervention to improve life-style-related behaviors. METHODS: We performed a cluster-randomized controlled intervention trial involving 24 public schools in Madrid, Spain, that were assigned to either the SI! Program intervention or the usual curriculum and followed for 3 years. The SI! Program aimed to instill and develop healthy behaviors in relation to diet, physical activity, and understanding how the human body and heart work. The primary outcome was change in the overall knowledge, attitudes, and habits (KAH) score (range 0 to 80). The intervention's effect on adiposity markers was also evaluated. RESULTS: A total of 2,062 children from 3 to 5 years of age were randomized. After 3 years of follow-up, the overall KAH score was 4.9% higher in children in the intervention group compared with the control group (21.7 vs. 16.4; p < 0.001). A peak effect was observed at the second year (improvement 7.1% higher than in the control group; p < 0.001). Physical activity was the main driver of the change in KAH at all evaluation times. Children in the intervention group for 2 years and 1 year showed greater improvement than control subjects (5.9%; p < 0.001 and 2.9%; p = 0.002, respectively). After 3 years, the intervention group showed a higher probability than the control group of reducing the triceps skinfold z-score by at least 0.1 (hazard ratio: 1.40, 95% confidence interval: 1.04 to 1.89; p = 0.027). CONCLUSIONS: The SI! Program is an effective strategy for instilling healthy habits among preschoolers, translating into a beneficial effect on adiposity, with maximal effect when started at the earliest age and maintained over 3 years. Wider adoption may have a meaningful effect on cardiovascular health promotion. (Evaluation of the Program SI! for Preschool Education: A School-Based Randomized Controlled Trial [Preschool_PSI!]; NCT01579708).
No takes yet. Share an insight, caveat, or question.
Peñalvo et al. (2015) conducted an RCT in Cardiovascular health promotion (n=2,062). SI! Program vs. Usual curriculum was evaluated on Change in the overall knowledge, attitudes, and habits (KAH) score (range 0 to 80) (p=<0.001). The SI! Program increased overall knowledge, attitudes, and habits scores in preschool children compared with the usual curriculum at 3 years (21.7 vs. 16.4; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: