一项通过在线食堂进行多策略干预以改善小学生课间预订餐食和饮品营养质量的整群随机对照试验的探索性分析。

Exploratory analysis of a cluster randomized controlled trial of a multi-strategy intervention delivered via online canteens on improving the nutritional quality of primary school students' pre-ordered foods & drinks at recess.

作者信息

Delaney Tessa, Jackson Jacklyn, Lecathelinais Christophe, Yoong Sze Lin, Wolfenden Luke, Sutherland Rachel, Webb Emily, Wyse Rebecca

机构信息

School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia; Hunter Medical Research Institute (HMRI), New Lambton, NSW, 2305, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, 2287, Australia.

出版信息

Appetite. 2023 Jun 1;185:106528. doi: 10.1016/j.appet.2023.106528. Epub 2023 Mar 10.

DOI:10.1016/j.appet.2023.106528

PMID:36907518

Abstract

School canteens are a recommended setting to deliver public health nutrition strategies given their wide reach, and frequent use by children. Online canteens, where users (i.e. students or their carers) pre-order and pay for food and drinks online, represent attractive systems to deliver strategies that encourage healthier food choices. There have been few studies exploring the efficacy of public health nutrition interventions in online food ordering environments. Therefore, this study aims to assess the efficacy of a multi-strategy intervention implemented in an online school canteen ordering system in reducing the energy, saturated fat, sugar, and sodium content of students' online recess orders (i.e. foods ordered during the mid-morning or afternoon snack period). This was an exploratory analysis of recess purchases for a cluster randomized controlled trial that initially sought to examine the efficacy of the intervention on lunch orders. A total of 314 students from 5 schools received the multi-strategy intervention (involving menu labelling, placement, prompting and availability) that was integrated into the online ordering system, and 171 students from 3 schools received the control (usual online ordering). Analysis of main outcomes found that the mean energy (difference: -269.3 kJ; P = 0.006), saturated fat (difference: -1.1 g; P = 0.011) and sodium (difference: -128.6 mg; P = 0.014) content per student recess order was significantly lower in the intervention group than the control group at 2-month follow-up. Findings suggest that embedding strategies to encourage healthier choices within online canteen ordering systems can improve the nutrient composition of student recess purchases. These results add to the current evidence base suggesting that interventions delivered via online food ordering systems represent an effective strategy for improving child public health nutrition in schools.

摘要

鉴于学校食堂受众广泛且孩子们经常光顾，它是实施公共卫生营养策略的理想场所。在线食堂是指用户（即学生或其监护人）在网上预先订购食品和饮料并付款的食堂，是实施鼓励更健康食品选择策略的有吸引力的系统。很少有研究探讨公共卫生营养干预措施在在线食品订购环境中的效果。因此，本研究旨在评估在在线学校食堂订购系统中实施的多策略干预措施在降低学生在线课间休息订单（即在上午课间或下午零食时间订购的食品）的能量、饱和脂肪、糖和钠含量方面的效果。这是一项对课间购买情况的探索性分析，该分析是针对一项整群随机对照试验进行的，该试验最初旨在研究该干预措施对午餐订单的效果。来自5所学校的314名学生接受了整合到在线订购系统中的多策略干预措施（包括菜单标签、摆放位置、提示和供应情况），来自3所学校的171名学生接受了对照干预（即常规在线订购）。对主要结果的分析发现，在2个月的随访中，干预组学生每份课间休息订单的平均能量（差值：-269.3千焦；P = 0.006）、饱和脂肪（差值：-1.1克；P = 0.011）和钠（差值：-128.6毫克；P = 0.014）含量显著低于对照组。研究结果表明，在在线食堂订购系统中嵌入鼓励更健康选择的策略可以改善学生课间购买食品的营养成分。这些结果增加了当前的证据基础，表明通过在线食品订购系统实施的干预措施是改善学校儿童公共卫生营养的有效策略。