Expanding the reach, impact and sustainability of ToyBox Study Malaysia: a kindergarten-based healthy behaviour intervention

The NFIS project will increase the reach and sustainability of the ToyBox Study Malaysia kindergarten-based intervention to prevent obesity. The intervention targeted four key behaviours in preschool children: healthy snacking, drinking water, reducing sedentary behaviour and promoting physical activity. This NFIS project sustains and strengthens the experienced team of professionals who delivered the successful ToyBox Malaysia intervention, through training, skill-sharing and knowledge exchange. The team has a wide range of expertise covering public health nutrition, education, community health, epidemiology, intervention trials and psychology, and represents two UK universities and two Malaysian universities representing both peninsular Malaysia and Sarawak. We aim to present the evidence to Malaysian government departments and kindergarten organisations that show how the successful and fundamental aspects of the ToyBox Malaysia programme should become standard delivery nationally in Malaysia. Importantly, we will develop innovative online interactive and animated learning modules and web-based applications promoting healthy behaviours that reduce the risk of obesity. This use of current digital technologies will increase the learning impact and engagement of both kindergarten teachers and children and their parents In addition, we intend to work with stakeholders to revise guidance and practices in relation to kindergarten teacher training, and engagement of parents, so that beneficial energy-balance related health behaviours are encouraged to become habitual among the kindergarten children and their families. By establishing the behavioural and educational basis for development of lifelong healthy behaviours that reduce the risk of obesity and associated health consequences, this collaborative project has the potential to have positive impacts on both costs to Malaysian health services and productivity of individuals and communities throughout the nation.

This project will increase the reach and sustainability of the ToyBox Study Malaysia kindergarten-based intervention. Impact will be extended by:
(1) Translation of research outputs to improve teacher training and family engagement: a. Enhance the Train the trainers approach based on experience and feedback from ToyBox research: i. Increased understanding of behavioural and social factors contributing to health behaviours among preschool children ii. Empowered to act on this knowledge. b. Translate research intervention into pre-packaged programme materials (videos, animated stories). c. Develop, maintain and update programme materials on website. New online training and teaching materials will be developed to allow more flexibility in terms of time and environment and to reduce cost in training preschool teachers; online interactive teaching materials will make learning process more fun for teachers, children and their families.
(2) Strengthen partnerships and knowledge exchange: a. Policy brief: Advice on programme sustainability and evaluation. b. Policy and legislation: Point of contact for expertise on the programme for policy makers and practitioners. c. Community benefits: Increased support in preventive strategies to promote healthier lifestyle for children and families. The experience of KEMAS and their kindergartens in implementing Toybox previously, their insights and understanding of the barriers for Toybox programme, will be invaluable in developing relevant and effective training and teaching resources for preschool teachers and children. We will also include additional stakeholders beyond KEMAS to bring Toybox to a wider community in Malaysia (e.g. Min. of Ed., Perpaduan).
(3) Innovation: a. Develop interactive WebApp (videos, animation) and update programme materials as required (for new potential users, existing ToyBox users and researchers). b. Embed user surveys and monitor engagement using the Website/App feedback platform (Qualtrics).