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Eur J Pediatr (2015) 174:217228 DOI 10.1007/s00431-014-2381-8
ORIGINAL ARTICLE
Kaledo, a board game for nutrition education of children and adolescents at school: cluster randomized controlled trial of healthy lifestyle promotion
Alessandro Viggiano & Emanuela Viggiano & Anna Di Costanzo & Andrea Viggiano &
Eleonora Andreozzi & Vincenzo Romano & Ines Rianna & Claudia Vicidomini &
Giuliana Gargano & Lucia Incarnato & Celeste Fevola & Pietro Volta & Caterina Tolomeo &
Giuseppina Scianni & Caterina Santangelo & Roberta Battista & Marcellino Monda &
Adela Viggiano & Bruno De Luca & Salvatore Amaro
Received: 3 November 2013 /Revised: 5 May 2014 /Accepted: 8 July 2014 /Published online: 22 July 2014 # Springer-Verlag Berlin Heidelberg 2014
Abstract During childhood and adolescence, a game could be an effective educational tool to learn healthy eating habits. We developed Kaledo, a new board game, to promote nutrition education and to improve dietary behavior. A two-group design with one pre-treatment assessment and two post-treatment assessments was employed. A total of 3,110 subjects (919 years old) from 20 schools in Campania, Italy, were included in the trial. In the treated group, the game was introduced each week over 20 consecutive weeks. Control group did not receive any intervention. The primary outcomes were (i) score on the Adolescent Food Habits Checklist (AFHC), (ii) scores on a
dietary questionnaire, and (iii) BMI z-score. At the first post-assessment (6 months), the treated group obtained significantly higher scores than the control group on the AFHC (14.4 (95 % confidence interval (CI) 14.0 to 14.8) vs 10.9 (95 % CI 10.6 to 11.2); F(1,20)=72.677; p<0.001) and on four sections of the dietary questionnaire: nutrition knowledge (6.5 (6.4 to 6.6) vs4.6 (4.5 to 4.7); F(1,16)=78.763; p<0.001), healthy and unhealthy diet and food (11.2 (11.0 to 11.4) vs 10.4 (10.3 to 10.6); F(1,32)=21.324; p<0.001), food habits (32.4 (32.0 to 32.8) vs 27.64 (27.3 to 28.0); F(1,26)=195.039; p<0.001), and physical activity (13.4 (13.2 to 13.7) vs 12.0 (11.8 to 12.6); F(1,20)=20.765; p<0.001). Moreover, the treated group had significantly lower BMI z-score with respect to the controls at the first (0.44 (0.42 to 0.46) vs 0.58 (0.56 to 0.59), F(1,18)=16.584, p=0.001) and at the second (18 months) (0.34 (0.30 to0.38) vs 0.58 (0.54 to 0.62), F(1,13)=7.577; p=0.017) post-assessments. Conclusion: Kaledo improved...