BACKGROUND An alarmingly low number of children meet public health guidelines for physical activity and healthy dietary behaviours, and are at increased risk of developing lifestyle-related diseases. Importantly, this burden is already unequally distributed at an early age. Unhealthy lifestyle behaviours are driven by complex mechanisms that differ across boys and girls growing up under different socio-economic circumstances. Outdoor play is an important contributor to children's levels of physical activity. Yet, children growing up in underprivileged neighbourhoods play less outside due to limited access to safe and attractive outdoor spaces and appropriate and affordable after school activities than other children. At the same time, today's children have abundant access to inexpensive energy-dense foods and online sedentary activities. AIM B-challenged aims to tackle the complexity of equality in children's active outdoor play and healthy dietary behaviours by co-creating, implementing and evaluating interventions in the physical and social environmental together with children growing up in socio-economically underprivileged neighbourhoods and other key actors. APPROACH B-challenged introduces a multi-actor, inter-sectorial democratic approach in five European countries (Denmark, Germany, Spain, Poland and the Netherlands), including all key actors (e.g. children, parents, teachers, policy makers). The investigators in B-Challenged will closely collaborate with all key actors, conduct analyses in European cohort data and consider the broader system (e.g. neighbourhood, family) as well as previous lessons-learned. Therewith, B-challenged aims at structural, relevant and feasible improvements in the physical and social environment promoting children's active outdoor play and dietary behaviours. B-challenged will impact all key actors in the selected neighbourhoods and far beyond through disseminating protocols and recommendations (research and policy) for upscaling the B-challenged approach.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
850
To be determined in the co-creation groups at the five sites (Denmark, Germany, Poland, Spain, the Netherlands)
University of Southern Denmark
Odense, Denmark
University of Bremen, Leibniz Institute for Prevention Research and Epidemiology
Bremen, Germany
Amsterdam UMC, location VUmc
Amsterdam, Netherlands
Institute of Mother and Child
Warsaw, Poland
Fundación Instituto Investigación Sanitaria Aragón
Zaragoza, Spain
Time spent in outdoor play
Time spent in outdoor play is assessed by a child-questionnaire (based on HBSC questionnaire, US national Kids Survey, and nationwide survey from Norway) and covers active travel, organised outdoor activities and unorganised outdoor play. Duration reported using 6 response options (longer duration of outdoor play contributing to a healthier lifestyle): 0-½ hour; ½-1 hour; 1-1 ½ hour; 1 ½-2 hours; and More than 2 hours.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation).
Frequency of fruit consumption during outdoor play, assessed by:
Child-questionnaire item on the frequency of consumption of fruits during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of fruit consumption contributes to a healthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
Frequency of vegetable consumption during outdoor play, assessed by:
Child-questionnaire item on the frequency of consumption of vegetables during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway. Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of vegetable consumption contributes to a healthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
Frequency of consumption of sweets during outdoor play, assessed by:
Child-questionnaire item on the frequency of consumption of sweets (candy or chocolate) during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway. Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of consumption of sweets contributes to a more unhealthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
Frequency of consumption of crisps and other salty snacks during outdoor play, assessed by:
Child-questionnaire items on the frequency of consumption of crisps and other salty snacks during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway. Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of crisps and other salty snacks consumption contributes to a more unhealthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
Frequency of consumption of coke or other soft drinks that contain sugar during outdoor play, assessed by:
Child-questionnaire items on the frequency of consumption of coke or other soft drinks that contain sugar during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway. Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of consumption of coke or other soft drinks that contain sugar contributes to a more unhealthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
Frequency of consumption of fast-food (pizza, kebab, burgers) during outdoor play, assessed by:
Child-questionnaire items on the frequency of consumption of fast-food (pizza, kebab, burgers) during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway. Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of fast-food (pizza, kebab, burgers) consumption contributes to a more unhealthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
Frequency of consumption of energy drinks (such as Red Bull) during outdoor play, assessed by:
Child-questionnaire items on the frequency of consumption of energy drinks (such as Red Bull) during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway. Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of energy drinks (such as Red Bull) consumption contributes to a more unhealthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
Frequency of consumption of water during outdoor play, assessed by:
Child-questionnaire items on the frequency of consumption of water during outdoor play, partially based on the HBSC questionnaire, the US national Kids Survey and a nationwide survey from Norway. Frequency reported on a 7-point scale: Never Less than once a week; Once a week; 2-4 days a week; 5-6 days a week; Once a day, every day; Every day, more than once. Higher frequency of water consumption contributes to a healthy lifestyle.
Time frame: Baseline and 12 months follow up (i.e., after intervention implementation)
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