Table 6 Detailed description of the different applications used in the intervention

Individual level and organizational level ^a

Handbook: Stories of the kangaroo and its friends (a cat, a bear and a rabbit)

1. Story 1: the kangaroo and his friends start an adventurous trip to the forest in search of a cave. The cat prefers to watch TV instead and the other animals wanting to change the cat’s behavior, try to persuade her that a real adventure is much more fun compared to watching TV.

2. Story 2: the animals arrive at school only to discover that their teacher, Mrs. Owl, has mysteriously disappeared. They have to choose whether they will watch TV or start a new adventure and search for their favorite teacher.

3. Story 3: the kangaroo received a new present; a pair of magic socks that stopped him from being sedentary. But in the end, the little kangaroo understands that it is not magic that makes him move; it is actually what his own body is asking for.

Handbook: Classroom activities in the form of short and long movement breaks

Short (1–5 minutes) movement breaks: e.g., ‘Playing a statue’: preschoolers have to walk through the classroom and when the teachers says ‘STOP’, they have to stay still for some seconds.

Long (15–20 minutes) movement breaks: e.g., preschoolers can walk through the classroom and when the teachers says ‘SEARCH A FRIEND’, each preschooler have to look for a friend to stand still for about 3 seconds.

Activities to be done while standing up (provided in the handbook and in the movement breaks)

Different activities were listed. For example:

- The teacher can remove the chairs and let the preschoolers paint or color on a raised desk

- Putting the sandbox on a raised desk for the preschoolers to play while standing up.

Repeated interruption moments at kindergarten

Kindergarten teachers could include repeated sitting interruption moments while preschoolers are at kindergarten. It is suggested in the handbook to interrupt prolonged periods of sitting down and set time rules to interrupt this behavior every 30 – 40 minutes.

Parent–child activities at kindergarten

Parents/caregivers are invited to participate in these parent–child activities and to come to the kindergarten where they can do nice activities together with their child (e.g., a role play).

Teachers’ guide

The teachers’ guide is developed for teachers and included the following topics:

- An explanation of why we need the ToyBox-study

- A description of all the different materials that are included in the ToyBox-study and how these materials should be used

- Some information on how they can be a team together with the parents/caregivers to change different preschoolers’ behaviors.

Teachers’ training

All teachers from the intervention schools were invited to attend two different training sessions.

1. First training session (June 2012): a general introduction was given to the teachers, the teachers’ guide was presented and the environmental changes teachers could perform in their classroom to change the different behaviors included in the ToyBox-study and the different classroom activities were explained. At the end of the training, there was also some time for discussion.

2. Second training session (September – October 2012): teachers could first share experiences and a small repetition of the information provided in the first training was done. Afterwards, the teachers went through the classroom activities together with the researchers. The second training was closed by a discussion.

Interpersonal level ^b

Newsletters

A clear definition of sedentary behavior is included in the first newsletters and also the activities that cover this behavior are mentioned. Furthermore, also the recommendations for preschoolers’ sedentary behavior and screen time are included in the newsletters.

Tip cards

Parents/caregivers are provided with different tips of how to decrease preschoolers’ sedentary behavior (e.g., try to avoid that your child turns the TV on without your permission).

In these tip cards, parent–child activities that could be performed at home were suggested as well. For example, preschoolers and parents/caregivers could decrease their sedentary time by doing things in the household together instead of watching television together.

Poster

Four different key messages were mentioned:

- ‘Don’t sit down for a long time, get up and be active’

- ‘Include active movement breaks in the children’s daily lives’

- ‘Limit screen viewing activities – make your own experiences’

- ‘Don’t eat in front of screens’

On the posters, different pictures of the kangaroo were provided for the preschoolers to color.