Abstract
BackgroundThe aim of the current study is to describe the effectiveness of a school-based intervention when delivered by a non-nutrition specialist (trained schoolteachers) as compared to an expert in nutrition.MethodsTwo trials of the same school-based intervention using the same intervention package were delivered, one by nutritionists and another by trained schoolteachers. The intervention focused mainly on dietary behaviours, as well as physical activity. In both trials, purposively selected schools were randomized to intervention or control groups; students (aged 9–11 years) in both groups were compared at post-test on knowledge and self-efficacy scores, as well as dietary and physical activity behaviours, controlling for their baseline status on the various measures. All analyses accounted for clustering at the school level.ResultsIn both trials, a statistically significantly greater improvement was observed for both the knowledge and self-efficacy scores in intervention vs. school students. When the programme was delivered by trained schoolteachers, frequency of breakfast intake was increased, crisps consumption was reduced, but no change in fruit and vegetable consumption was observed (latter increased when delivered by nutrition professionals only). Physical activity did not improve in both trials.ConclusionTrained schoolteachers can have a positive impact on students’ dietary behaviours with the appropriate training to ensure they are equipped with the right information, skills, and resources to deliver the programme with the highest fidelity.Trial registrationClinicalTrial.gov Identifier: NCT03040271. Retrospectively registered on 2 February 2017.
Highlights
The aim of the current study is to describe the effectiveness of a school-based intervention when delivered by a non-nutrition specialist as compared to an expert in nutrition
In the first trial delivered by nutritionists, the odds of daily breakfast intake was the same in both intervention and control groups at post-test when controlling for their baseline breakfast intake (OR: 1.02, 95% CI: 0.56; 1.85); in contrast, when the intervention was delivered by trained schoolteachers, the odds of consuming breakfast daily was twice as high on average among students in the intervention versus control schools at post-test controlling for baseline status (OR: 2.04, 95% CI: 1.34; 3.11)
Significant improvements were observed for recommended levels of fruits (OR: 1.61, 95% CI: 1.19; 2.19) and vegetables (OR: 1.90, 95% CI: 1.31; 2.75) when the intervention was delivered by the nutritionists (Table 2) but not the trained teachers (Table 2)
Summary
The aim of the current study is to describe the effectiveness of a school-based intervention when delivered by a non-nutrition specialist (trained schoolteachers) as compared to an expert in nutrition. In Lebanon, a small country in the Eastern Mediterranean region, the prevalence of overweight and obesity have doubled in the past 12 years [22], and in parallel, behavioural risk factors including unhealthy eating habits and low physical activity have become more prevalent [23]. To this end, a school-based multicomponent intervention focusing on the promotion of healthy eating and active living was pilot-tested in 2009 [24]. The main challenges and lessons learned emanating from this school-based intervention has been summarized elsewhere [25]
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