Abstract
The objective of this study was to examine the relationships between students' perceptions of their school policies and environments (i.e. sugar-sweetened beverages (SSB) free policy, plain water drinking, vegetables and fruit eating campaign, outdoor physical activity initiative, and the SH150 programme (exercise 150 min/week at school)) and their dietary behaviours and physical activity. Cross-sectional study. Primary, middle and high schools in Taiwan. A nationally representative sample of 2433 primary school (5th-6th grade) students, 3212 middle school students and 2829 high school students completed the online survey in 2018. Multivariate analysis results showed that after controlling for school level, gender and age, the students' perceptions of school sugar-free policies were negatively associated with the consumption of SSB and positively associated with consumption of plain water. Schools' campaigns promoting the eating of vegetables and fruit were positively associated with students' consumption of vegetables. In addition, schools' initiatives promoting outdoor physical activity and the SH150 programme were positively associated with students' engagement in outdoor physical activities and daily moderate-to-vigorous physical activity. Students' perceptions of healthy school policies and environments promote healthy eating and an increase in physical activity for students.
Highlights
The rate of students who perceived that their schools had implemented policies banning SSB and refusing to drink SSB was significantly higher in primary school (60·6 and 53·8 %, respectively) than in middle school (40·3 and 34·2 %, respectively) and high school (23·9 and 27·5 %)
The rates of students who perceived that their schools had implemented initiatives promoting the drinking of plain water and the consumption of vegetables and fruit were significantly higher in primary school (87·5 and 85·9 %, respectively) than in middle school (79·3 and 74·5 %, respectively) and high school (70·6 and 66·5 %, respectively)
Primary school students reported higher levels of drinking enough water daily (5·27 d/week) compared with that reported by middle school students (4·74 d/week) and by high school students (4·43 d/week)
Summary
Participants Nationally representative samples of primary school students (5th–6th grade), middle school students (7th–9th grade) and high school students (10th–12th grade) were included. A probability-proportionate-to-size sampling method was used to systematically draw a random sample of schools. Three to four classes were randomly selected from each school. Since Taiwan school lunch programmes and school food and beverage sales policies were different at primary, middle and high schools and at different cities/counties, the degree of the implementation of health policies and campaigns in these schools were different. A total of 2433 primary school students (5th– 6th grade), 3212 middle school students (7th–9th grade) and 2829 high school students (10th–12th grade) completed the online survey in 2018. The questionnaire used was online and self-administered
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