Reduced stunting in young children following a multicomponent kindergarten-based behavioural intervention: ToyBox Study Malaysia

Activity: Talk or presentation for an academic audienceOral presentation for an academic audience


Background: ToyBox Study Malaysia is a multi-component intervention to improve energy-balance behaviours in 3-6 year-old kindergarten children. Based on the European ToyBox-Study, the teacher-led intervention focused on improving four target behaviours: drinking water, eating healthily, reducing sedentary behaviour and increasing physical activity.

Aims: To test the hypothesis that stunted children (standardised height for age, HAZ < -2.0) in the intervention group would show improved growth compared to those in the control group.

Methods: The intervention lasted 24 weeks, with 4-week periods focusing on each behaviour, then 2-week repetitions. Kindergartens were recruited via the Community Development Department (KEMAS), Malaysia, sampling from 3 states with different urbanisation and ethnicities: Kuala Lumpur/Selangor (n=10/5 intervention, 13/5 control), Sarawak (7 intervention, 8 control), with random allocation to group. Anthropometric outcomes were examined in 812 children who completed either the intervention (n=403) or control (n=409) conditions (dropout: 9%, 11%, respectively).

Results: Changes in standardised height for age (HAZ) were compared between groups in children with stunted growth at baseline (WHO: HAZ < 2; intervention n=48, control n=39). HAZ increased in the intervention group vs. control, interaction effect, p<0.05, 2-tail, partial η2 =0.05, and also when adjusting for baseline HAZ (ANCOVA group effect, p=0.05, 2-tail, partial η2 =0.04), post-intervention adjusted means, intervention HAZ = -2.0, SE=0.10; control HAZ = -2.30, SE=0.11.

Conclusions: ToyBox Study Malaysia can reduce stunted growth in young children, implying improved functional nutrition following the intervention.

Estimated audience numbers (if applicable)

Period7 Aug 20239 Aug 2023
Event title15th International Conference on Child and Adolescent Psychopathology
Event typeConference
LocationKuching, MalaysiaShow on map
Degree of RecognitionInternational


  • Stunting
  • Child health
  • Nutrition
  • Interventions
  • Preschool