Monikomponenttisen varhaisen interventioiden arviointi lasten lihavuuden ehkäisemiseksi haavoittuvaisissa perheissä (Bambú)

Kontrolliryhmä ei saa interventiota. Kontrolliryhmään sijoitetut perheet saavat tavanomaista hoitoaan.

Perheille tai terveyskeskuksille ei aseteta rajoituksia muiden koulutus- ja tukipalvelujen käyttöön tutkimuksen aikana, mutta tätä tietoa seurataan mahdollisena sekoittavana tekijänä.

Interventioryhmään sijoitetuilta terveyskeskuksilta pyydetään olemaan jakamatta interventiosisältöjä muille kontrolliryhmän terveyskeskuksille ennen tutkimuksen päättymistä.

This arm will include all primary care centers assigned to the intervention group.

All participants (parents) within these centers will receive the Bambú intervention.

They will participate in a 9-session group-based face-to-face intervention. Sessions will last 2 hours. The first 5 sessions will be delivered weekly and the following 4 sessions will be delivered monthly. They will be delivered at primary care centers in Catalonia, Andalusia, the Balearic Islands and Castile and León. They will be led by two professionals, either healthcare professionals working at the primary care center (who will be previously trained) or by members of the research team.

The following main topics will be covered in the program: (1) nutrition; (2) physical activity and interactive play; (3) emotion regulation; (4) positive parenting; (5) child sleep; and (6) community support networks.

Approximately 38 groups will be conducted, and each of them will include around 7 families.

Bambú-ohjelma on kasvokkain järjestettävä 9 istunnon ryhmäpohjainen interventio lasten vanhemmille, joiden lapset ovat 6 kuukauden - 3.11 vuoden ikäisiä ja joista vähintään toisella vanhemmalla on ylipainoa tai lihavuutta. Istunnot kestävät 2 tuntia. Ensimmäiset viisi istuntoa järjestetään viikoittain ja loput neljä istuntoa kuukausittain. Istuntoja johtavat kaksi koulutettua yhteisjohtajaa (koulutus sisältää kaksi verkkoistuntoa ja pääsyn virtuaalialustalle, jossa on kaikki interventiomateriaalit).

Ohjelma kattaa kuusi pääaihetta: (1) ravitsemus: ruokintakäytännöt ja ravitsemussuositukset; (2) fyysinen aktiivisuus ja vuorovaikutteinen leikki; (3) tunnesäätelytaidot ja -tekniikat; (4) positiivinen vanhemmuus; (5) lapsen uni; ja (6) yhteisön tukiverkostot.

Interventio on strukturoitu ja sisältää videovisualisointeja ja vuorovaikutteisia aktiviteetteja.

Ohjelma on aiemmin yhteissuunniteltu perheiden ja terveydenhuollon ammattilaisten kanssa tarkoituksena kohdentaa se haavoittuvien ylipainoisten tai lihavien perheiden tarpeisiin ja mieltymyksiin.

The Feeding Practices and Structure Questionnaire is a self-administered questionnaire that measures parental feeding practices, specifically maternal responsiveness to children's hunger/satiety signals facilitated by routine and structure in feeding.

Age- and feeding-stage-appropriate versions of the questionnaire will be administered: (a) the specific FPSQ-28 version for children aged ≥2 years; and (b) the FPSQ version for children aged <2 years, either the FPSQ milk-feeding version (for caregivers predominantly feeding their child with milk) or the FPSQ (semi-)solids version (for caregivers predominantly feeding their child with solid food.

Each subscale is scored separately (range 1-5). No overall total score is calculated. Higher scores indicate greater endorsement of the feeding practice represented by the subscale.

The Movement Behavior Questionnaire is a self-administered questionnaire that measures physical activity, screen time and sleep in infants, toddlers and preschoolers.

The two age-specific versions of the questionnaire will be used: the MBQ-Baby (MBQ-B) for infants who have not yet reached the walking milestone, and the MBQ-Child (MBQ-C) for children who are able to walk. The closed-ended versions of the MBQ will be used.

The questionnaire does not produce a total score. It assesses individual movement behaviours (e.g., tummy time, physical activity, screen time, restrained time, sleep duration). Interpretation depends on the behaviour measured and its alignment with age-specific movement guidelines.

Parents' eating patterns will be measured with the self-administered Dutch Eating Behavior Questionnaire.

The questionnaire comprises three subscales (Restrained Eating, Emotional Eating, and External Eating), each scored separately by averaging item responses (range 1-5). No overall total score is calculated. Higher scores indicate greater endorsement of the eating behaviour measured by each subscale; the interpretation of whether this represents a more or less desirable outcome depends on the subscale.

Selected items (applicable to the whole children's age range included in the study) from the Brief Infant Sleep Questionnaire (BISQ) will be used to measure child sleep.

The complete BISQ will not be administered because the original questionnaire is not appropriate for the full age range of the study population. Sleep parameters derived from selected BISQ items will be analyzed individually. No total sleep score will be calculated; therefore, there is no overall minimum or maximum score. The direction of interpretation depends on the specific sleep parameter assessed (e.g., longer sleep duration is generally considered favorable, whereas more frequent night awakenings or longer nocturnal wakefulness may indicate poorer sleep).

Parents' acceptability and satisfaction with the program will be assessed with a Final Participant Satisfaction Questionnaire. Data will be collected after the last session of the intervention.

Higher scores indicate greater acceptability and satisfaction with the intervention.