Faculty of Public Health, Al-Quds University, Abu Dis 22100, Palestine.
Linda Joy Pollin Cardiovascular Wellness Center for Women, Division of Cardiology, Hadassah University Medical Center, Jerusalem 9574425, Israel.
Int J Environ Res Public Health. 2022 Mar 7;19(5):3128. doi: 10.3390/ijerph19053128.
School-based health promotion interventions have been shown to lead to measurable changes in the nutrition and physical activity behaviors. This study examines whether the impact of an intervention program on students’ healthy eating and physical activity was mediated by teacher training and engagement in health promotion. The trial was conducted in three phases: needs assessment of the baseline survey of teachers, mothers’ and children; intervention among seven randomly selected schools that included teacher training in healthy eating and physical activity; and a post-intervention evaluation survey. The SPSS PROCESS for Hayes (Model8) was used to determine moderation and mediation effects. The difference in difference (DID) was calculated for the three main outcomes of the study: eating breakfast daily (DID = 17.5%, p < 0.001); consuming the recommended servings of F&V (DID = 29.4%, p < 0.001); and being physically active for at least 5 days/week (DID = 45.2%, p < 0.001). Schoolchildren’s eating breakfast daily was mediated by their teachers’ training in nutrition (β = 0.424, p = 0.002), teachers’ engagement (β = 0.167, p = 0.036), and mothers preparing breakfast (β = 1.309, p < 0.001). Schoolchildren’s consumption of F&V was mediated by teachers’ engagement (β = 0.427, p = 0.001) and knowing the recommended F&V servings (β = 0.485, p < 0.001). Schoolchildren’s physical activity was mediated by their teachers’ training in physical activity (β = 0.420, p = 0.020) and teachers’ engagement (β = 0.655, p < 0.001). Health behavior changes in the school setting including improvements in eating breakfast, consuming the recommended F&V and physical activity was mediated by teacher training and engagement. Effective teacher training leading to teacher engagement is warranted in the design of health-promotion interventions in the school setting.
学校为基础的健康促进干预措施已被证明可导致营养和身体活动行为的可衡量变化。本研究检验了干预计划对学生健康饮食和身体活动的影响是否通过教师培训和参与健康促进来介导。该试验分三个阶段进行：教师、母亲和儿童的基线调查需求评估；在七所随机选择的学校中进行干预，包括健康饮食和身体活动方面的教师培训；以及干预后评估调查。使用 SPSS PROCESS for Hayes（模型 8）来确定调节和中介效应。研究的三个主要结果的差值（DID）进行了计算：每天吃早餐（DID = 17.5%，p < 0.001）；食用推荐量的 F&V（DID = 29.4%，p < 0.001）；每周至少 5 天进行身体活动（DID = 45.2%，p < 0.001）。学校儿童每天吃早餐是由教师营养培训（β = 0.424，p = 0.002）、教师参与（β = 0.167，p = 0.036）和母亲准备早餐（β = 1.309，p < 0.001）介导的。学校儿童食用 F&V 是由教师参与（β = 0.427，p = 0.001）和知道推荐的 F&V 份量（β = 0.485，p < 0.001）介导的。学校儿童的身体活动是由教师的身体活动培训（β = 0.420，p = 0.020）和教师参与（β = 0.655，p < 0.001）介导的。学校环境中的健康行为变化，包括改善早餐、食用推荐量的 F&V 和身体活动，是由教师培训和参与介导的。在学校环境中设计健康促进干预措施时，需要进行有效的教师培训，以促使教师参与。
