DUTCH OBESITY INTERVENTION IN TEENAGERS (NRG-DOiT)

This program is designed to change student’s lifestyle independently. This intervention focussed on (1) reduction of the consumption of sugar-sweetened beverages, (2) reduction of energy intake derived from snacks, (3) decrease of levels of sedentary behaviour, and (4) increase of levels of physical activity (i.e. active transport behaviour and sports participation). The intervention program consisted of an individual classroom-based component (i.e. an educational program, covering 11 lessons of both biology and physical education classes), and an environmental component (i.e. encouraging and supporting changes at the school canteens, as well as offering additional physical education classes). The duration of the study was 8 months. This program needs big effort from teachers and school because they have to actively change many things.

Determinant	Methods from theory	Strategy	Tools/Materials
Knowledge	Passive learning/providing information	Providing written and verbal information	Information in print materials (workbook/worksheets) during school lessons on label reading health consequences of excessive consumption SSBs Videotape on clandestine advertising Posters in school canteen
	Active processing of information	Evaluating understanding	Knowledge tests (quizzes: DRINKiT) Cut and paste worksheets regarding SSB Role model stories Group discussions Questionnaires (TESTiT) Test recipes (workbook/worksheet) Invent own recipes (website)
Awareness	Self-monitoring and feedback	Monitoring of own behaviour (social) comparison	Pocket-size diary (CHECKiT, 3 days) Worksheets Computer-tailored advice
Skills	Guided practice	Skills training (label reading and taste) Provide feedback	Practice label reading in groups Worksheets
Social support	Social modelling/peer modelling/social comparison	Providing information	Workbook/worksheets/computer tailored advice (questionnaires, website or CD-rom) Role play Group discussions
Habit	Breaking automatic stimulus-response relations, rising awareness of habitual behaviour	Changing the environment/point-of-decision prompts	Posters near food access points/changing canteen assortment
Self efficacy	Goal setting	Formulation of implementation intentions Individualized feedback	Worksheets to help exact planning goals (How? When? Where? With whom?) Role model stories Discussion barriers/difficult situations, possible solutions Computer tailored advice (website or CD-rom)
	Reinforcement	Providing feedback Evaluation of change processes Analyses difficult situations	Computer tailored advice (website or CD-rom) Worksheets Group discussions
	Association of attitude object with other positive stimuli		Role model stories Group discussions
	Environmental changes	Facilitation of healthy behaviours	Changes in school canteen assortment Posters in school canteen

Singh, Amika S., et al. (2006). Design of the Dutch Obesity Intervention in Teenagers (NRG-DOiT): systematic development, implementation and evaluation of a school-based intervention aimed at the prevention of excessive weight gain in adolescents. BMC public health 6(1):1.