Thesis

Adapting an existing preschool-based intervention for use in the Scottish preschool setting to prevent childhood obesity and its co-morbidities

Creator
Rights statement
Awarding institution
  • University of Strathclyde
Date of award
  • 2020
Thesis identifier
  • T16139
Person Identifier (Local)
  • 201665495
Qualification Level
Qualification Name
Department, School or Faculty
Abstract
  • Background: Scotland has one of the highest rates of childhood obesity in Europe, and efforts to prevent obesity in young children are needed. This thesis aimed to highlight the detrimental health impacts of obesity in younger children and adapt an existing obesity prevention intervention for use in Scottish preschools. Methods: This thesis presents five manuscripts. The first is a systematic review of the relationship between obesity and co-morbid conditions in childhood (specifically, asthma, vitamin D deficiency, iron deficiency, flat-footedness and allergies). Two methodology manuscripts are then presented, one detailing the steps taken to adapt the ToyBox intervention for use in Scottish preschools, which is followed by a protocol for the feasibility cluster randomised controlled trial (cRCT) of the adapted intervention. Results reporting on intervention fidelity, recruitment rates and secondary outcome measures of the cRCT is first presented, followed by a manuscript detailing acceptability of the intervention using both qualitative and quantitative methods. Results: The systematic review identified 41 papers which investigated associations between obesity and childhood (defined as <10 years) health conditions. Meta-analysis showed that childhood obesity significantly increased the odds of asthma (OR 1.5; 95% CI: 1.3-1.7), vitamin D deficiency (OR 1.9; 95%, CI 1.4-2.5) and iron deficiency (OR 2.1; 95%; 1.4-3.2). There was a lack of high quality longitudinal studies identified in the review. Participant recruitment rates to the cRCT were low (18%), and overall intervention fidelity was high in preschools, but low in the home environment. Barriers to intervention delivery included lack of time, insufficient space and conflicting preschool policies, while the simple layout of materials facilitated delivery. Conclusions: Obesity is associated with a number of conditions in childhood, although more high quality, longitudinal and experimental research is needed in this area. The ToyBox-Scotland intervention was feasible and acceptable in the Scottish preschool environment. However, more development work is needed to increase recruitment rates, compliance with outcome measures, and acceptability of the intervention in the home environment.
Advisor / supervisor
  • Hughes, Adrienne
Resource Type
DOI
Embargo Note
  • THIS THESIS IS UNDER MORATORIUM. IT WILL NOT BE AVAILABLE FOR LOAN OR CONSULTATION UNTIL 28 AUGUST 2022.

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