Special Institute for Preventive Cardiology And Nutrition - SIPCAN, Salzburg, Austria.
Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
Eur J Public Health. 2021 Feb 1;31(1):136-142. doi: 10.1093/eurpub/ckaa219.
The objective was to evaluate a 5-week nutrition education programme (ACTION) in fifth-grade schoolchildren in Austria on free sugar intake, nutrition-related knowledge (NRK) and with the RE-AIM framework on the overall public health impact.
A prospective case-controlled cohort (pre-post design) from seven secondary schools in Vienna tested programme efficacy. NRK was assessed with a 20-item questionnaire and dietary behaviour and free sugar intake with a semi-quantitative Food Frequency Questionnaire. A total of 12 intervention classes (IG) received the programme, conducted by teachers and integrated in the curriculum, and 6 control classes followed their usual curriculum.
In 344 children, aged 10.4 (0.8) years, free sugar intake decreased significantly over time in IG by 13% (P=0.001) with a group difference of -10.1 (95% CI -18.8, -1.5; P=0.021) g/day. The food groups 'sweets & pastries', 'soft drinks', 'fast food' and 'salty snacks' mainly contributed to this reduction. Moreover, NRK increased significantly over time in IG with a group difference of 9.0% of correct answers (95% CI 5.8, 12.2; P<0.001; Cohen's d 0.57). The programme was disseminated to 10% of fifth-grade classrooms in Austrian secondary schools and to 12% in Vienna.
The ACTION programme shows potential for public health impact with improving dietary behaviour as free sugar intake, NRK, and its dissemination. It required a minimum of money per schoolchild as the programme was conducted by teachers and was integrated in the curriculum.
本研究旨在评估奥地利五年级学生为期 5 周的营养教育项目（ACTION）对游离糖摄入量、营养相关知识（NRK）的影响，并采用 RE-AIM 框架评估其对整体公共卫生的影响。
来自维也纳 7 所中学的前瞻性病例对照队列（前后设计）测试了该项目的效果。NRK 通过 20 项问卷进行评估，饮食行为和游离糖摄入量通过半定量食物频率问卷进行评估。共有 12 个干预班（IG）接受了由教师授课并纳入课程的项目，而 6 个对照组则按照常规课程进行。
在 344 名年龄为 10.4（0.8）岁的儿童中，IG 组的游离糖摄入量随时间显著下降，降幅为 13%（P=0.001），组间差异为-10.1（95% CI -18.8，-1.5；P=0.021）g/天。“甜食和糕点”、“软饮料”、“快餐”和“咸零食”等食物组主要促成了这一降幅。此外，IG 组的 NRK 随时间显著增加，正确答案的组间差异为 9.0%（95% CI 5.8，12.2；P<0.001；Cohen's d 0.57）。该项目在奥地利中学的五年级课堂中传播到 10%，在维也纳则传播到 12%。
ACTION 项目在改善饮食行为（如游离糖摄入量、NRK）及其传播方面显示出具有公共卫生影响的潜力。该项目所需的每个学生的费用很少，因为该项目由教师授课并纳入课程。
