Eichhorn C, Loss J, Nagel E
Institut für Medizinmanagement und Gesundheitswissenschaften, Universität Bayreuth, Bayreuth.
Gesundheitswesen. 2007 Nov;69(11):612-20. doi: 10.1055/s-2007-992779.
The international literature describes comprehensive nutrition interventions for children and adolescents, and gives recommendations for successful program planning. For Germany, only few studies on these issues are available, and there is a particular scarcity of data on implementation, acceptance and effectiveness of nutrition interventions. Thus the aim of this study was to record nutrition interventions at state and regional levels in Germany, and to assess their project design and evaluation quality. On the basis of these data, conclusions about implementation, acceptance and effectiveness of interventions are made.
Quality indicators for project design, process and outcome evaluation were developed according to international literature and related quality assurance models. State ministries, public health departments, non-governmental institutions for health at state level and "Healthy Cities" (n=105) were surveyed about their nutrition interventions for children and adolescents including evaluation with a standardised questionnaire. The interventions were assessed using the developed quality criteria.
The response rate was 70.5%. 42 primary preventive nutrition interventions were recorded. The quality criteria for program planning were only partly fulfilled. Encouraging results were, among others, that 54.8% of the projects combined behaviourally focused and environment focused criterions, 90.5% started in kindergarten or primary school, 88.1% involved parents, 85.7% cooperated with other institutions and 73.8% integrated nutrition specialists. 77.8% of the projects conducted a process evaluation (n=28), 60.7% of those had a good evaluation quality. Changing the environmental context proved to be the greatest challenge. The projects were well accepted by the target group. An outcome evaluation was conducted by 61.1% of the projects (n=22), 27.2% of those evaluations had a (very) good quality. Among these projects, 3 could improve nutrition knowledge, 3 environmental context and 3 nutrition behaviour. Improvements of medical parameters have not been recorded.
In Germany, a high number of nutrition interventions for children and adolescents is being conducted. However, only five quality indicators were fulfilled by more than 75% of the projects. Because of inadequate evaluation quality, only little evidence for implementation, acceptance, and effectiveness could be found. More evaluation studies are needed to more successfully plan, implement and assess future interventions.
国际文献介绍了针对儿童和青少年的综合营养干预措施，并给出了成功项目规划的建议。在德国，关于这些问题的研究很少，关于营养干预措施的实施、接受度和有效性的数据尤为匮乏。因此，本研究的目的是记录德国州和地区层面的营养干预措施，并评估其项目设计和评估质量。基于这些数据，得出关于干预措施实施、接受度和有效性的结论。
根据国际文献和相关质量保证模型，制定了项目设计、过程和结果评估的质量指标。对州政府部门、公共卫生部门、州级非政府卫生机构和“健康城市”（n = 105）进行了调查，询问他们针对儿童和青少年的营养干预措施，包括使用标准化问卷进行评估。使用制定的质量标准对干预措施进行评估。
回复率为70.5%。记录了42项初级预防性营养干预措施。项目规划的质量标准仅部分得到满足。令人鼓舞的结果包括，54.8%的项目结合了以行为为重点和以环境为重点的标准，90.5%从幼儿园或小学开始，88.1%涉及家长，85.7%与其他机构合作，73.8%整合了营养专家。77.8%的项目进行了过程评估（n = 28），其中60.7%的评估质量良好。事实证明，改变环境背景是最大的挑战。这些项目受到目标群体的广泛接受。61.1%的项目（n = 22）进行了结果评估，其中27.2%的评估质量（非常）良好。在这些项目中，3项可以提高营养知识，3项改善环境背景，3项改善营养行为。未记录到医学参数的改善情况。
在德国，正在开展大量针对儿童和青少年的营养干预措施。然而，超过75%的项目仅满足五项质量指标。由于评估质量不足，关于实施、接受度和有效性的证据很少。需要更多的评估研究，以便更成功地规划、实施和评估未来的干预措施。
