Preventing overweight and obesity among preschool children: lessons learned in Cuenca, Ecuador

Abstract

Introduction: Childhood overweight and obesity are major public health problems globally, including in Ecuador, and there is increasing interest in intervening as early as possible. We previously developed and evaluated a behavioural and educational intervention aiming to improve diet and physical activity habits among children at municipal preschools in Cuenca, Ecuador, after which it was implemented. Objective: To describe some of the key lessons learned in the process of intervention development, evaluation, and implementation. Methods: We conducted program evaluation using a survey questionnaire with open-ended questions with the coordinators, teachers, and kitchen staff of the preschools that participated in the intervention. Results: Human resource changes were a threat to the continued success of the intervention; therefore, these changes need to be anticipated and peer training emphasized. Careful consideration also needs to be given to impact on preschool staff workload. Teachers and other stakeholders like administrators should take ownership of the intervention and play a leadership role, distinct from that of researchers. Regarding the intervention itself, we identified that both fidelity and adaptability were critical for continued success. Conclusion: Lessons learned from our setting may be useful to inform the design, evaluation, and implementation of sustainable preschool-based interventions aiming to improve diet and physical activity habits elsewhere.