Jamaluddine Zeina, Choufani Jowel, Masterson Amelia Reese, Hoteit Reem, Sahyoun Nadine R, Ghattas Hala
Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon.
The George Washington University, Washington, DC, USA.
Curr Dev Nutr. 2020 Nov 24;4(11):nzaa164. doi: 10.1093/cdn/nzaa164. eCollection 2020 Nov.
School feeding programs have the potential to supply children with healthy school food, alleviate short-term hunger, and improve children's educational outcomes.
We linked community kitchens to a subsidized school snack intervention and assessed the impact of this intervention on nutritional (diet diversity, hemoglobin, and anthropometry) and educational (attendance and academic performance) outcomes of Palestinian refugee schoolchildren.
We collected data from 1362 students (aged 5-15 y) and their parents at baseline, and at an 8-mo follow-up in 2 control and 2 intervention schools. We conducted linear, logistic, and negative binomial regression analyses to assess changes in outcomes of children participating in the intervention schools compared with children in control schools (intention-to-treat). We also assessed the impact of the snack intervention in children who participated ≥50% of the time (HP, high-participation) compared with those who participated <50% (LP, low-participation), or who only received nutrition education (control) (per protocol). All the analyses were adjusted for child age and gender, maternal education, household expenditure, and school-level clustering effect.
At endline, there were 648 children in the control group, and within the intervention group, 260 children were LP and 454 were HP. There was a significantly greater increase in overall diet diversity score and dairy consumption in the HP group compared with controls. Both LP and HP groups were more likely to consume proteins, and less likely to consume desserts than controls. Furthermore, the HP group had a significant increase in hemoglobin, and both LP and HP groups had a significant decrease in school absenteeism compared with controls.
This community-based school nutrition intervention had a positive impact on diet diversity, hemoglobin, and school attendance of children.
学校供餐计划有潜力为儿童提供健康的学校食物，缓解短期饥饿，并改善儿童的教育成果。
我们将社区厨房与一项有补贴的学校零食干预措施相联系，并评估了该干预措施对巴勒斯坦难民学童的营养（饮食多样性、血红蛋白和人体测量指标）和教育（出勤率和学业成绩）成果的影响。
我们在基线时以及在2所对照学校和2所干预学校进行8个月随访时，收集了1362名学生（5 - 15岁）及其父母的数据。我们进行了线性、逻辑和负二项回归分析，以评估与对照学校的儿童相比，参与干预学校的儿童在各项成果方面的变化（意向性分析）。我们还评估了零食干预措施对参与时间≥50%的儿童（高参与度，HP）与参与时间<50%的儿童（低参与度，LP）或仅接受营养教育的儿童（对照）相比的影响（符合方案分析）。所有分析均对儿童年龄和性别、母亲教育程度、家庭支出以及学校层面的聚类效应进行了调整。
在终期时，对照组有648名儿童，在干预组中，260名儿童为低参与度，454名儿童为高参与度。与对照组相比，高参与度组的总体饮食多样性得分和乳制品消费量显著增加。低参与度组和高参与度组与对照组相比，摄入蛋白质的可能性更大，摄入甜点的可能性更小。此外，与对照组相比，高参与度组的血红蛋白显著增加，低参与度组和高参与度组的学校缺勤率均显著降低。
这种基于社区的学校营养干预措施对儿童的饮食多样性、血红蛋白和学校出勤率产生了积极影响。
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