Background: School programs can be effective in modifying knowledge, attitudes, and habits relevant to long-term risk of chronic diseases associated with sedentary lifestyles. As part of a long-term research strategy, we conducted an educational intervention in preschool facilities to assess changes in preschoolers' knowledge, attitudes, and habits toward healthy eating and living an active lifestyle. Methods: Using a cluster design, we randomly assigned 14 preschool facilities in Bogotá, Colombia to a 5-month educational and playful intervention (7 preschool facilities) or to usual curriculum (7 preschool facilities). A total of 1216 children aged 3-5 years, 928 parents, and 120 teachers participated. A structured survey was used at baseline, at the end of the study, and 12 months later to evaluate changes in knowledge, attitudes, and habits. Results: Children in the intervention group showed a 10.9percent-flag-change increase in weighted score, compared with 5.3percent-flag-change in controls. The absolute adjusted difference was 3.90 units (95percent-flag-change confidence interval [CI], 1.64-6.16; P ylt;.001). Among parents, the equivalent statistics were 8.9percent-flag-change and 3.1percent-flag-change, respectively (absolute difference 4.08 units; 95percent-flag-change CI, 2.03 to 6.12; P ylt;.001), and among teachers, 9.4percent-flag-change and 2.5percent-flag-change, respectively (absolute difference 5.36 units; 95percent-flag-change CI, -0.29-11.01; P =.06). In the intervened cohort 1 year after the intervention, children still showed a significant increase in weighted score (absolute difference of 6.38 units; P ylt;.001). Conclusions: A preschool-based intervention aimed at improving knowledge, attitudes, and habits related to healthy diet and active lifestyle is feasible, efficacious, and sustainable in very young children.
