Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka

Abstract Background Obesity rates are rising rapidly in low-middle-income-countries (LMICs). School-based interventions have shown moderate efficacy in improving diet and lifestyle associated with obesity in high-income countries. However, there is little data available on effective interventions su...

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Autores principales:	Sumudu Nimali Seneviratne, Sanathanee Sachchithananthan, Pavithra Sewwandi Angulugaha Gamage, Renuka Peiris, Vithanage Pujitha Wickramasinghe, Noel Somasundaram
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Obesity Overweight Schoolchildren Food diary South-Asia Healthy-eating Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/89e1da7649ec4a0080647f05ac3b2b0c
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spelling	oai:doaj.org-article:89e1da7649ec4a0080647f05ac3b2b0c2021-11-14T12:14:21ZEffectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka10.1186/s12889-021-12041-81471-2458https://doaj.org/article/89e1da7649ec4a0080647f05ac3b2b0c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12041-8https://doaj.org/toc/1471-2458Abstract Background Obesity rates are rising rapidly in low-middle-income-countries (LMICs). School-based interventions have shown moderate efficacy in improving diet and lifestyle associated with obesity in high-income countries. However, there is little data available on effective interventions suitable for LMICs. We devised a novel program for primary school children including a simple storybook and sticker-based food-diary (FD) and conducted a pilot study to evaluate the acceptability and short-term effectiveness of the program. Methods This pre-post intervention study included grade 1 and 2 students from four public schools in Colombo, Sri Lanka. Weight and height were assessed, and participating children self-monitored their diet using sticker-based FDs for one week at baseline (pre-test). The following week, class teachers discussed the storybook, which incorporated the benefits/disadvantages of a healthy/unhealthy diet and lifestyle in classrooms. At the end of the intervention, participating children were self-monitoring their diet again for a week (post-test). A simple scoring system was used to derive a weekly score based on the healthiness of the meals consumed each week (FD-score). The primary outcome of the study was change in eating habits following the story book discussion (post-test FD score - pre-test FD score). Acceptability and effectiveness were also assessed by anonymized feedback questionnaires for parents and teachers. Results One thousand and forty-two students completed the program. There was an improvement in eating habits of participating children, with FD scores improving by 12% from 51 ± 23 at baseline to 63 ± 24 following the intervention (p < 0.001). Further, when considering BMI category of participants: 69.1% were normal weight (NW), 18.3% underweight (UW), 7.4% overweight (OW) and 5.2% obese (OB). Improvement in eating habits were seen among children of all BMI categories (change in FD-score: UW 13.2%, NW 12.3%, OW 10.4% and OB 12.4% (p < 0.001)). Furthermore,> 90% parents(n = 1028) and > 95% teachers(n = 39) strongly agreed/agreed that the intervention was easy to implement, motivated children and led to an observable improvement in healthy eating. Conclusion This novel program led to an immediate improvement in eating habits and was well accepted by parents and teachers making it a potentially suitable intervention for wider implementation in primary schools in urban Sri Lanka.Sumudu Nimali SeneviratneSanathanee SachchithananthanPavithra Sewwandi Angulugaha GamageRenuka PeirisVithanage Pujitha WickramasingheNoel SomasundaramBMCarticleObesityOverweightSchoolchildrenFood diarySouth-AsiaHealthy-eatingPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Obesity Overweight Schoolchildren Food diary South-Asia Healthy-eating Public aspects of medicine RA1-1270
spellingShingle	Obesity Overweight Schoolchildren Food diary South-Asia Healthy-eating Public aspects of medicine RA1-1270 Sumudu Nimali Seneviratne Sanathanee Sachchithananthan Pavithra Sewwandi Angulugaha Gamage Renuka Peiris Vithanage Pujitha Wickramasinghe Noel Somasundaram Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka
description	Abstract Background Obesity rates are rising rapidly in low-middle-income-countries (LMICs). School-based interventions have shown moderate efficacy in improving diet and lifestyle associated with obesity in high-income countries. However, there is little data available on effective interventions suitable for LMICs. We devised a novel program for primary school children including a simple storybook and sticker-based food-diary (FD) and conducted a pilot study to evaluate the acceptability and short-term effectiveness of the program. Methods This pre-post intervention study included grade 1 and 2 students from four public schools in Colombo, Sri Lanka. Weight and height were assessed, and participating children self-monitored their diet using sticker-based FDs for one week at baseline (pre-test). The following week, class teachers discussed the storybook, which incorporated the benefits/disadvantages of a healthy/unhealthy diet and lifestyle in classrooms. At the end of the intervention, participating children were self-monitoring their diet again for a week (post-test). A simple scoring system was used to derive a weekly score based on the healthiness of the meals consumed each week (FD-score). The primary outcome of the study was change in eating habits following the story book discussion (post-test FD score - pre-test FD score). Acceptability and effectiveness were also assessed by anonymized feedback questionnaires for parents and teachers. Results One thousand and forty-two students completed the program. There was an improvement in eating habits of participating children, with FD scores improving by 12% from 51 ± 23 at baseline to 63 ± 24 following the intervention (p < 0.001). Further, when considering BMI category of participants: 69.1% were normal weight (NW), 18.3% underweight (UW), 7.4% overweight (OW) and 5.2% obese (OB). Improvement in eating habits were seen among children of all BMI categories (change in FD-score: UW 13.2%, NW 12.3%, OW 10.4% and OB 12.4% (p < 0.001)). Furthermore,> 90% parents(n = 1028) and > 95% teachers(n = 39) strongly agreed/agreed that the intervention was easy to implement, motivated children and led to an observable improvement in healthy eating. Conclusion This novel program led to an immediate improvement in eating habits and was well accepted by parents and teachers making it a potentially suitable intervention for wider implementation in primary schools in urban Sri Lanka.
format	article
author	Sumudu Nimali Seneviratne Sanathanee Sachchithananthan Pavithra Sewwandi Angulugaha Gamage Renuka Peiris Vithanage Pujitha Wickramasinghe Noel Somasundaram
author_facet	Sumudu Nimali Seneviratne Sanathanee Sachchithananthan Pavithra Sewwandi Angulugaha Gamage Renuka Peiris Vithanage Pujitha Wickramasinghe Noel Somasundaram
author_sort	Sumudu Nimali Seneviratne
title	Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka
title_short	Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka
title_full	Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka
title_fullStr	Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka
title_full_unstemmed	Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka
title_sort	effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban sri lanka
publisher	BMC
publishDate	2021
url	https://doaj.org/article/89e1da7649ec4a0080647f05ac3b2b0c
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Effectiveness and acceptability of a novel school-based healthy eating program among primary school children in urban Sri Lanka

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