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Table 1 Targets of the ‘BBOFT+’ approach

From: Primary prevention of overweight in preschool children, the BeeBOFT study (breastfeeding, breakfast daily, outside playing, few sweet drinks, less TV viewing): design of a cluster randomized controlled trial

Enlarging parenting skills is operationalized as: - Increase children’s self-esteem by spending time with the child, talk and show affection to the child. Regularly interact with a child while it is behaving positive, and talk with children about their activities, cuddle, touch, and hold the child (body contact)
- Encourage healthy behaviors: reinforce positive behavior by praising the specific behavior
- Give positive attention: offer non-verbal attention (smiling, touching)
- Offer attractive activities: play material etc. (age and development phase related)
- Parent is positive example (modeling)
- Reinforce spontaneous learning moments
- Reinforce learning by experience, instruction
Stimulus control - Basic rules and regulations (age en development phase related)
- Direct intervention when child is misbehaving
- Clear instructions in a quiet way
Operant conditioning - Misbehavior will be related to direct consequence
- Time out
- Positive reinforcement
- Child rearing: warm, positive, and also monitoring and setting borders
- Grandparent’s behavior (no spoiling)
Optimize nutrition is operationalized as: - Establishing eating routine (0–9 months regularity and stimulus reduction)
- > 6 months specific times for meals and snacks (stimulus control)
- Prevention of introduction of extra foods (unhealthy snack foods, take away, sugar drinks)
- Provision of healthy alternatives
Optimize physical activity is operationalized as: - Prevention of sedentary activities (TV etc.)
- Improve daily physical activity (daily walk, play-pen, tummy time, play outside etc.)
Optimize sleep duration and sleep behavior is operationalized as: - Optimal sleep duration per day
- Hours an infant can remain awake
- Time the child needs to fall asleep
- Number of times the child wakes up during the night