Prevenzione precoce dell'obesità infantile: validazione trans-culturale dell'intervento europeo ToyBox nel setting della scuola dell'infanzia

ABSTRACT The World Health Organization (WHO) declared obesity a major public health problem in the world and the neologism globesity evokes its alarming spread, contributing to a global obesity epidemic, in particular during developmental age. Children with an excessive ponderal index are more likely to stay obese into adulthood with increased risk of several serious health conditions associated with obesity, which also has a significant social and economic impact. Thus, the development of evidence-based prevention interventions for early childhood (3-5 years of age), deemed a crucial period, is fundamental because the behaviours related to energy balance, the psychological characteristics and the physiological development during this age. Therefore, preschool represents an ideal setting to implement obesity prevention programmes because, on the one hand, a change in behaviour patterns can be encouraged and, on the other hand, a larger population, including children and their families, can be reached. This research project aims at achieving a cross-cultural validation, in Italy, of the ToyBox intervention designed to prevent early obesity within the preschool settings. An effectiveness trial has already been conducted and the projects has been implemented across Europe thanks to a multi-centre international research funded by the European Commission. In 2017, following the formal agreement with the steering committee of the ToyBox-Study, for the acquisition of the materials in their English standard version, the trial began and developed over a 3-year period, through different phases: organization and validation of the materials (teachers’ guides and assessment tools, in particular the questionnaires targeted to the children's parents and to the teachers); cross-sectional epidemiological analysis of the baseline data related in particular to the dietary pattern; assessment of the feasibility of the intervention. Because of the COVID-19 pandemic, the programme had to be adapted to the health emergency by experimenting a ‘distance’ implementation of the ToyBox. Overall, the project involved 10 schools, in 6 provinces in the North, Centre and South of Italy, enrolling a total of 704 children and their parents, and 92 teachers. Notwithstanding some limitations of the methods and the contents, and the distance implementation, the study has highlighted the relevance, reproducibility and the approval of the intervention and, as an operative result, it has made available an effective prevention tool to the Italian cultural context.