Increased Health and Wellbeing in Preschools – the DAGIS study

The DAGIS intervention is a randomized control trial aiming to promote preschoolers’ healthy energy balance-related behavior and self-regulation skills, and it aims to have greater effects on children with low parental education level backgrounds. This article presents results from the intervention development process.

To develop and evaluate complex interventions aiming to change behavior is challenging. The intervention mapping (IM) framework serves as a guidance tool in systematical development of intervention programs aiming to change health behavior. The aim of this study was to present results from the developing process of the DAGIS intervention research, which applied the IM framework.

The DAGIS intervention study is a preschool-based family-including randomized control trial aiming to promote preschoolers’ energy balance-related behavior (EBRB; increase physical activity and fruit and vegetable consumption, decrease excessive screen time and sugary food- and drink consumption), and self-regulation (SR) skills. It aims to have greater effects on children with low parental education level (PEL) backgrounds.

The first step in the IM framework is to conduct a comprehensive needs assessment. In DAGIS, the main actions were a cross-sectional survey in years 2015–2016, a qualitative study in the year 2014, several pilot studies, and an informal literature review. Results from the needs assessment, together with behavioral change theories, formed the logic model of change. The logic change model was utilized in producing the program and developing the evaluation plan. The evaluation plan includes effect assessments and a comprehensive process evaluation. The use of the IM approach is a strength in the DAGIS intervention study, as it enables a systematic evaluation. This will increase knowledge of how to successfully promote EBRBs and SR skills among preschoolers, simultaneously having higher impact on families with low PEL backgrounds.

In conclusion, the IM framework enabled a systematic approach to developing the DAGIS health promoting intervention, even though the development process was resource consuming.

Original article:

Ray C, Kaukonen R, Lehto E, Vepsäläinen E, Sajaniemi N, Erkkola M, Roos E. Development of the DAGIS intervention study: a preschool-based family-involving study promoting preschoolers’ energy balance-related behaviours and self-regulation skills. BMC Public Health 19: 1670, 2019 (doi: 10.1186/s12889-019-7864-0).