Institute for Global Food Security, Queen's University Belfast, Belfast, BT9 5AG, UK.
Centre for Public Health, Queen's University Belfast, Belfast, BT12 6BA, UK.
Int J Behav Nutr Phys Act. 2021 Feb 4;18(1):23. doi: 10.1186/s12966-021-01086-y.
Evidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children's health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions.
Daire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) 'Nourish', ii) 'Engage', iii) 'Nourish' and 'Engage' and iv) Control (Delayed). 'Nourish' was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. 'Engage' was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured.
Fifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6-7 years and n = 458 aged 10-11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6-7 and 10-11 year old pupils) who received the 'Nourish' intervention compared with those that did not (adjusted difference in mean = - 0.82; 95% CI -1.46, - 0.17; P < 0.02). No statistically significant difference in Health-Related Quality of Life was observed. The 'Nourish' intervention also produced some changes in school-based dietary behaviour, which were most apparent in the 10-11 year old pupils. The 'Nourish' intervention also produced improvements in understanding of food labels (adjusted difference in mean = 0.15; 95% CI 0.05, 0.25; P < 0.01) and knowledge of vegetables in season (adjusted difference in mean = 0.29; 95% CI 0.01,0.56; P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed.
Improvements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the 'Nourish' whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted.
National Institute of Health (NIH) U.S. National Library of Medicine Clinical Trials.gov (ID: NCT04277312 ).
有证据表明，英国儿童的饮食摄入并不理想。由于学校为公共卫生干预提供了理想的自然环境，因此必须确定有效和可持续的方法来改善这一人群的食物知识和饮食习惯。Daire 项目旨在通过两项多组分干预措施来提高儿童的健康相关生活质量、幸福感、食物知识和饮食习惯。
Daire 是一项随机对照、析因设计试验，在四个组中评估了两项干预措施。北爱尔兰的小学被随机分配到四个 6 个月干预组之一：i）“滋养”，ii）“参与”，iii）“滋养”和“参与”，iv）对照组（延迟）。“滋养”是一项旨在改变整个学校食品环境、提供与食品相关的体验和接触本地生产食品的干预措施。“参与”是一项针对食物、农业、营养科学和相关职业的适龄、跨课程教育干预措施。主要结局是情绪和行为健康以及健康相关的生活质量。还测量了一些次要结局，包括饮食摄入、烹饪能力和与食物相关的知识。
来自不同社会经济地位地区的 15 所学校参加了随机试验。共有 903 名（6-7 岁儿童 n=445，10-11 岁儿童 n=458）小学生参加了该试验。接受“滋养”干预的所有学生（6-7 岁和 10-11 岁的学生）的总困难评分均有所改善，而未接受干预的学生则没有（调整后的平均差异为-0.82；95%CI-1.46，-0.17；P<0.02）。未观察到健康相关生活质量的统计学显著差异。“滋养”干预还对基于学校的饮食行为产生了一些变化，在 10-11 岁的学生中最为明显。“滋养”干预还提高了对食品标签的理解（调整后的平均差异为 0.15；95%CI0.05，0.25；P<0.01）和对当季蔬菜的了解（调整后的平均差异为 0.29；95%CI0.01，0.56；P=0.04），同时还观察到愿意尝试新食物的意愿增强和烹饪能力的提高。
儿童情绪和行为健康、饮食摄入、食物知识、烹饪技能和尝试新食物的意愿的改善与“滋养”整个学校的食品环境干预有关。应探索这种全学校食品干预措施的可持续性和长期效果。
美国国立卫生研究院（NIH）美国国立医学图书馆临床试验.gov（ID：NCT04277312）。
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