Background
Children’s weight development is influenced by a wide range of factors, many of which play a significant role from the earliest years of life. It is therefore crucial to support and promote a safe and healthy start in life, ensuring children experience well-being and healthy weight development throughout childhood. Currently, there are no specific guidelines or recommendations on how to best implement early primary prevention targeting healthy weight development. Limited knowledge exists on the effectiveness of such interventions, and the available evidence is primarily based on international studies. Therefore, there is a need to generate knowledge within a Danish context.
Aim and target group
The aim of the Bloom Study is to develop, implement, and evaluate a universal, theory- and evidence-based intervention, anchored in the Danish system of community health nurses, to promote child well-being and healthy weight development in infancy and toddlerhood. The target group consists of all first-time parents and their children in participating municipalities. The project focuses on the family as a whole and follows them from pregnancy until the child is approximately 2.5 years old.
The Bloom intervention
The core of the project is to strengthen the community health nurses’ existing efforts in guiding and advising parents on factors influencing well-being and healthy weight development in infants and toddlers. This includes the establishment of healthy habits and routines related to food and meals, movement and motor skills, screen use, sleep, and sense of security in the family. The intervention includes additional home visits, phone calls from community health nurses, and access to a comprehensive video library for parents.
The intervention was developed in close collaboration with several Danish municipalities and through the use of the Intervention Mapping protocol, a recognized planning tool for systematically developing theory- and evidence-based health promotion interventions. As a result, the intervention is based on close collaboration with highly qualified and relevant practice partners, the strongest available scientific literature, health behavior theories, and the research group’s own qualitative studies.
Methodology
The project is conducted as a cluster-randomized controlled trial. Community health nurses in 11 municipalities will implement the intervention with approximately 1,600 first-time parents and their children. The effectiveness of the intervention will be assessed by comparing results from these intervention municipalities with results from 11 comparison municipalities, where families receive existing publicly available community health nurse services.
All parents will complete questionnaires throughout the study period. Additionally, the research team will visit families when the child is approximately 3 years old to assess the child's well-being and weight development.
Beyond evaluating the effect of the intervention on participating children’s well-being and weight development, the project will also conduct a comprehensive assessment of how the intervention is implemented. This includes evaluating community health nurses’ experiences with delivering the intervention as well as parents' experiences of receiving it. Finally, the project will conduct a thorough health economic evaluation, examining the societal costs and benefits of the intervention.
Project organization
The project is based at the National Institute of Public Health, University of Southern Denmark. The project group consists of the principal investigator (PI) postdoc Camilla Thørring Bonnesen, co-PI senior researcher Mette Rasmussen, postdoc Marie Pil Jensen, PhD student Lene Kierkegaard, PhD student Rikke Rothkegel Carlsson, research assistant Thilde Risager Ubbesen, senior researcher Trine Pagh Pedersen, and senior researcher Katrine Rich Madsen
Additionally, health economists from DaCHE – Danish Centre for Health Economics, University of Southern Denmark are responsible for conducting the economic analyses.
Collaborators
The Bloom Study has several collaborating partners. The intervention has been developed in close collaboration with five municipalities (Aarhus, Billund, Brønderslev, Randers, and Slagelse), Center for Prevention in Practice, Local Government Denmark, and Copenhagen University College.
Funding
Centre for Childhood Health funds implementation and evaluation of the Bloom Study.
TrygFonden funded the first part of the project, which examined the need for an intervention (the Healthy Childhood Study), and the Novo Nordisk Foundation funded the development of the study.
Project period
The development of the intervention began in January 2021. The trial phase commenced in 2024, and the project period runs until 2029.