We use cookies to ensure that we give you the best experience on our website. By continuing to browse this repository, you give consent for essential cookies to be used. You can read more about our Privacy and Cookie Policy.

Durham Research Online
You are in:

Teachers’ and Parents’ Perspectives on the Feasibility of a Preschool-Based Behavioral Intervention to Prevent Obesity: An Embedded Qualitative Study within ToyBox Study Malaysia

Lee, J. A. C. and Cheah, W. L. and Anchang, G. N. J. and Noor Hafizah, Y. and Abim, M. and Ruzita, A. T. and Koh, D. and Reeves, S. and Summerbell, C. and Essau, C. A. and Poh, B. K. and Gibson, E. L. (2022) 'Teachers’ and Parents’ Perspectives on the Feasibility of a Preschool-Based Behavioral Intervention to Prevent Obesity: An Embedded Qualitative Study within ToyBox Study Malaysia.', Early Childhood Education Journal .


The aim of this qualitative study, an embedded component of ToyBox Study Malaysia (TSM), was to elicit the perspectives of teachers and parents regarding the implementation of TSM. TSM is a preschool-based behavioral intervention program aimed at improving healthy energy balance-related behaviors among young children attending preschools. The qualitative study adopted a descriptive-interpretive methodology, and triangulated data collected through semi-structured focus groups with artifacts collected. The setting involved rural and metropolitan preschools in Sarawak and Peninsular Malaysia, respectively. In Sarawak, 11 teachers and 20 parents from six intervention preschools participated in this study. In Peninsular Malaysia, 14 preschool teachers and seven assistant teachers representing all 15 intervention preschools participated in the study. Data were analyzed thematically and four overarching themes were identified: impact of TSM on the children’s knowledge and practices of healthy energy balance-related behaviors; spheres of influence upon the children’s energy balance-related behaviors; constraints and affordances related to the implementation of TSM; and prospective sustainability of TSM. The triangulation of data from teachers, parents, and the artifacts related to TSM enabled the corroboration of evidence to support the themes identified. This study provides evidence on the reciprocal interactions between the teachers and parents who played key roles in facilitating behavioral change in the children, and the children who, in turn, served as change agents beyond the preschool. Furthermore, the mediational tools such as the TSM crockery and availability of healthy food and water led to the reported behavioral changes at both rural and metropolitan settings.

Item Type:Article
Full text:Publisher-imposed embargo until 01 January 2023.
(AM) Accepted Manuscript
File format - PDF
Publisher Web site:
Publisher statement:This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:
Date accepted:19 November 2021
Date deposited:01 June 2022
Date of first online publication:01 January 2022
Date first made open access:01 January 2023

Save or Share this output

Look up in GoogleScholar