Oud gedaan is jong geleerd Stef Kremers Professor Preventie van Obesitas Vakgroep Gezondheidsbevordering Universiteit Maastricht
Beweeggedrag van kinderen
• De rol van gewoontes
• De rol van de ouder • Interventies
Department of Health Promotion
Jong gedaan is ouder gedaan Lichamelijke activiteit
Effect sizes: 4% groot, 60% gemiddeld, 36% klein Department of Health Promotion
Zitgedrag
Effect sizes: 33% groot, 50% gemiddeld, 17% klein Jones et al., Am J Prev Med, 2013
Zitgedrag • Voorspeller van excessieve gewichtsstijging van kind naar volwassen leeftijd (Thorp et al., 2011) • Voorspeller van cardiovasculaire aandoeningen en sterfte bij ouderen (Proper et al., 2011) • ‘Growing body of evidence’
• Growing body of aantrekkelijke verleidingen
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‘Clustering’ • Zitgedrag als voorspeller van ongezonde voedingsinname (Sleddens et al., 2013) • In hoge mate gestuurd door gewoonte
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Kenmerken van een gewoonte
• Geschiedenis van herhaling
• Automaticiteit (uitgedrukt in oncontroleerbaarheid, gebrek aan bewustzijn, en efficiëntie) • Uitdrukking van identiteit Department of Health Promotion
Kracht van gewoonte 1.00
G E D R A G
0.90
β = -.09, p > .05 β = .09, p > .05
STERKE GEWOONTE
0.80
β = .26, p < .01
0.70 MATIGE GEWOONTE
0.60
Zitgedrag pubers: 0.50
Sterke gewoonte .07 (ns) ZWAKKE GEWOONTE
0.40
Zwakke gewoonte .37 (p<.001) Kremers & Brug, 2008
0.30 -5
-4
-3
-2
-1
INTENTIE Department of Health Promotion
-0
1
2
EnRG framework Environmental Research framework for weight Gain prevention
Kremers et al. Environmental influences on energy balance-related behaviors: A dual-process view. Int J Behav Nutr Phys Act 2006; 3: 9. Department of Health Promotion
Ouder gedaan, jongere geleerd
• Transfer van gewoonten
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Ouderschapspraktijken Toegepast op snacken Concept Accessibility Availability Discussing Educating Emotional feeding
Prototypic description parenting practice Storing snacks in a location the child cannot access on his or her own Not having snacks at home Discussing availability of snacks with the child Teaching the child about healthy foods Using snacks in response to the child's emotional distress
Encouragement Instrumental feeding Involving Meal routines Modeling Monitoring Permissiveness Pressure to eat Providing feedback Rewarding Rules Structure Visibility
Encouraging the child to eat a large variety of foods Using foods to persuade the child to do something Allowing the child to assist in preparing snacks Eating meals together as a family Eating healthy foods in the presence of the child Keeping track of the number of snacks the child eats Giving in to the child's pestering for snacks Pressuring the child to eat more foods Criticizing when the child eats snacks Offering toys or other non-food rewards for good eating Setting explicit rules about what kind of snacks the child is allowed to eat Giving snacks at fixed times Having healthy foods easy to see
Department of Health Promotion
Gevers et al., submitted
Ouderschapspraktijken Snacken Accessibility Availability Discussing Educating Emotional feeding Encouragement Instrumental feeding Involving Meal routines Modeling Monitoring Permissiveness Pressure to eat Providing feedback Rewarding Rules Structure Visibility
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Zitten Accessibility Availability Discussing Educating Emotional sitting Encouragement Instrumental sitting Involving Physical activity routines Modeling Monitoring Permissiveness Pressure to sport Providing feedback Rewarding Rules Structure Visibility
Ouderschapspraktijken Zitten Accessibility Availability Discussing Educating
Emotional sitting Encouragement
Instrumental sitting Involving
Physical activity routines Modeling Monitoring Permissiveness Pressure to sport Providing feedback Rewarding Rules
Structure Visibility Department of Health Promotion
Ouderschapspraktijken Zitten Accessibility Availability Discussing Educating
Emotional sitting Encouragement
Instrumental sitting Involving
Physical activity routines Modeling Monitoring Permissiveness Pressure to sport Providing feedback Rewarding Rules
Structure Visibility Department of Health Promotion
Zittende routines
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Zittende routines
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Rutten GM, Savelberg HH, Biddle SJH, Kremers SPJ. Interrupting long periods of sitting: Good STUFF. International Journal of Behavioral Nutrition and Physical Activity 2013: 10, 1.
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Interventies
• Ouder helpen om gedrag kind te veranderen • Lifestyle Triple P
• Kind helpen om gedrag ouder te veranderen • Active Living
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Lifestyle Triple P
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Gerards et al., 2012
Lifestyle Triple P interventie
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Outcome measures Secondary:
Primary:
Parenting behaviours
– Parenting style – Feeding styles – Parenting practices
Behaviour child
– Nutrition – Physical activity
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Anthropometry child - BMI z-score - Waist circumference - Skinfolds
RCT
Baseline (n=86)
Gem. leeftijd 7.2 jaar, 44% jongens, BMIz 1.84
Randomisatie Controle conditie (n=42)
6 Lifestyle Triple P groepen (n=44)
T1, 4 maanden (n=36, 82%)
T1, 4 maanden (n=35, 82%)
T2, 12 maanden (n=35, 80%)
T2, 12 maanden (n=32, 76%)
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Kind helpen om gedrag ouder te veranderen
Academische Werkplaats Publieke Gezondheid Limburg Universiteit Maastricht GGD Zuid Limburg TNO Gemeenten Veilig Verkeer Nederland Department of Health Promotion
Wat is Active Living? Stimulering van beweging van kinderen op basisscholen in de leeftijd van 9-12 jaar (groep 6 t/m 8)
Actief transport
Beweging in vrije tijd
Beweging op school Department of Health Promotion
Wat is Active Living? Stimulering van beweging van kinderen op basisscholen in de leeftijd van 9-12 jaar (groep 6 t/m 8)
Actief transport
Department of Health Promotion
Veilige schoolroutes Department of Health Promotion
Conclusies
• Oud gedaan is jong (ook al) gedaan • Tracking • De kracht van gewoonte
• Ouder gedaan is jongere geleerd • Vaak onbewuste, subtiele beïnvloeding
• Ouder geleerd: jong doet • Ook ouders zijn niet te jong om te leren
Department of Health Promotion
Dank voor uw aandacht
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