Park Sohyun, Kwon Kwang-Il, Kweon Soon Ju, Wang Youfa, Gittelsohn Joel
Department of Food Science and Nutrition, Hallym University, Life Science Building Room 8519, 1 Hallymdaehak-gil, Chuncheon, Gangwon 24251, Korea.
Center for Human Nutrition, Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street Baltimore, MD 21205, USA.
Nutr Res Pract. 2017 Oct;11(5):402-411. doi: 10.4162/nrp.2017.11.5.402. Epub 2017 Sep 23.
BACKGROUND/OBJECTIVES: The role of a school's nutrition environment in explaining students' eating behaviors and weight status has not been examined in an Asian setting. The purpose of this study was to create a school nutrition environment index and to pilot test the index in elementary and middle schools in urban South Korea.
SUBJECTS/METHODS: This study used a mixed-methods approach. Environment assessment tools were developed based on formative research, which comprised literature reviews, in-depth interviews, and focus group discussions. Key elements from the formative research were included in the assessment tool, which consisted of a structured survey questionnaire for school dietitians. Fifteen school dietitians from 7 elementary and 8 middle schools in Seoul completed the questionnaire.
The formative research revealed four main sections that guided a summary index to assess a school's nutrition environment: resource availability, education and programs, dietitians' perceptions and characteristics, and school lunch menu. Based on the literature reviews and interviews, an index scoring system was developed. The total possible score from the combined four index sections was 40 points. From the 15 schools participating in the pilot survey, the mean school nutrition-environment index was 22.5 (standard deviation ± 3.2; range 17-28). The majority of the schools did not offer classroom-based nutrition education or nutrition counseling for students and parents. The popular modes of nutrition education were school websites, posters, and newsletters.
This paper illustrates the process used to develop an instrument to assess a school's nutrition environment. Moreover, it presents the steps used to develop a scoring system for creation of a school nutrition environment index. As pilot testing indicated the total index score has some variation across schools, we suggest applying this instrument in future studies involving a larger number of schools. Future studies with larger samples will allow investigation of the validity and reliability of this newly developed tool.
背景/目的：学校营养环境在解释学生饮食行为和体重状况方面所起的作用，尚未在亚洲背景下进行研究。本研究的目的是创建一个学校营养环境指数，并在韩国城市的中小学对该指数进行试点测试。
对象/方法：本研究采用混合方法。基于形成性研究开发了环境评估工具，形成性研究包括文献综述、深入访谈和焦点小组讨论。形成性研究的关键要素被纳入评估工具，该工具由一份针对学校营养师的结构化调查问卷组成。首尔7所小学和8所中学的15名学校营养师完成了问卷。
形成性研究揭示了四个主要部分，这些部分指导了一个用于评估学校营养环境的综合指数：资源可用性、教育与项目、营养师的认知与特征以及学校午餐菜单。基于文献综述和访谈，开发了一个指数评分系统。四个指数部分的总可能分数为40分。在参与试点调查的15所学校中，学校营养环境指数的平均值为22.5（标准差±3.2；范围17 - 28）。大多数学校没有为学生和家长提供基于课堂的营养教育或营养咨询。营养教育的常见方式是学校网站、海报和时事通讯。
本文阐述了用于开发评估学校营养环境工具的过程。此外，还介绍了为创建学校营养环境指数而开发评分系统所采用的步骤。由于试点测试表明各学校的总指数得分存在一定差异，我们建议在未来涉及更多学校的研究中应用该工具。未来更大样本量的研究将能够调查这个新开发工具的有效性和可靠性。
