Promoting Healthy Behaviours among Children Living in Disadvantaged Neighbourhoods : development and evaluation of a Social Marketing intervention: the ‘Water Campaign’

This thesis focused on the development and evaluation of an intervention aimed to promote a healthy lifestyle among children. This intervention – the ‘Water Campaign’- was developed with Social Marketing, aimed to decrease the consumption of sugar-sweetened beverages (SSB) among primary school children (aged 6 to 12 years old) by promoting the intake of water. The ‘Water Campaign’ targeted both children and their parents (primarily mothers) through activities at school and in the neighbourhood (i.e., school- and community-based). The campaign was developed as an enrichment of an existing school-based programme ‘Enjoy Being Fit!’ (Rotterdam Lekker Fit! programma). The ‘Water Campaign’ was implemented in two multi-ethnic, disadvantaged neighbourhoods in Rotterdam. Using a controlled-trial design, we found after one year a significant decrease of SSB intake among children who participated in the Water Campaign.
Besides the focus on effectiveness of interventions to improve lifestyle behaviours among children, this thesis also focused on the underlying determinants of children’s health behaviours and on possible ways to assess nutritional behaviour of children. The various associations between determinants and the health behaviours of the child appear to be different for children with distinct ethnic backgrounds. Intervention developers and health promotors might give special attention to differences between subgroups – ethnically or culturally diverse – when developing tailored interventions and thereby improve interventions’ reception, acceptance and effectiveness.