Nutrition Goes to School: a School-based Nutrition Intervention to Promote Healthy Eating Behaviour Among Adolescents

NCT06515288 | Recruiting

• 1 other identifier: ESTEEM NGTS
• Study Type: interventional
• Target: 1,000
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this cluster randomized controlled pilot trial is to assess the feasibility and effect of a school-based nutrition intervention program called "Nutrition Goes to School" (NGTS) in improving a healthy diet and physical activities as part of the prevention and management of obesity among adolescents in urban Indonesia. The main questions it aims to answer concern the feasibility of the NGTS multi-component school-based nutrition intervention model in selected secondary schools in an urban setting to inform the design of the future effectiveness study. Additionally, it aims to evaluate the effect of the school-based nutrition intervention in the healthy eating knowledge and behavior (fruit and vegetable consumption, energy-dense nutrient poor food, and sugary beverages consumption, as measured by food frequency questionnaire) and physical activities as well as its effect on nutrition status (body mass index, mid-upper arm circumference \[MUAC\] and waist circumference). The intervention components consist of nutrition education to school communities (teachers, management, students and parents), healthy school canteen, school garden, hygiene and sanitation promotion of the school environment and obesogenic environment control, and promotion of physical activities among students. Five secondary schools in Jakarta will be randomly assigned to receive the intervention for 6 months, and five other schools will serve as the control group.

Conditions

Obesity, Adolescent

Keywords

School-based intervention; obesity; adolescent; prevention; nutrition

Outcome Measures

Primary Outcomes (7)

• Knowledge on healthy diet among children - clinical outcome

  Multiple choices' questionnaire Analyzed as Comparison of score (mean difference \[MD\] and 95% CI): * before and after the intervention * between the intervention and control schools

  at baseline and 6 months

• Eating attitude-clinical outcome

  The Eating Attitudes Test (EAT-26) Analyzed for a comparison of proportion eating disorder (difference and 95% CI): * before and after the intervention * between the intervention and control schools

  at baseline and 6 months

• Healthy diet behaviour-clinical outcome

  Fruits and vegetables, energy-dense nutrient poor food and sugary beverages consumption using semi-quantitative food frequency questionnaire (FFQ) Analyzed for a comparison of proportion (difference and 95% CI): * before and after the intervention * between the intervention and control schools

  at baseline and 6 months

• Physical activity-clinical outcome

  Rapid Assessment of Physical Activities (RAPA) Comparison of proportion (difference and 95% CI): * before and after the intervention * between the intervention and control schools

  at baseline and 6 months

• Nutritional status-clinical outcome

  Body Mass Index (BMI) for Age

  at baseline and 6 months

• mid-upper arm circumference (MUAC)

  Nutritional status-clinical outcome

  at baseline and 6 months

• waist circumference

  Nutritional status-clinical outcome

  at baseline and 6 months

Secondary Outcomes (5)

• School readiness on the implementation of the program - - Descriptive, Quantitative (proportion), Qualitative

  Baseline

• Attendance of teachers to training sessions-proportion

  at the end of the three days training

• Activity report completed-proportion

  during the 6-month of intervention

• Adherence to NGTS protocol - Descriptive, Quantitative (proportion), Qualitative

  during the 6-month intervention

• Students' and teachers' preference and acceptance on IEC material/modules - Qualitative

  during the 6-month intervention

Study Arms (2)

Intervention schools

EXPERIMENTAL

The intervention group will receive baseline educational intervention (Nutrition Education Capacity Building for Teachers and Management) and all components of the Nutrition Goes to School (NGTS) program.

Behavioral: Nutrition Goes To School (NGTS) Program Intervention Package; Behavioral: Nutrition Education Capacity Building for Teachers and Management

Control schools

NO INTERVENTION

The control group receive no specific intervention other than current school health program conducted by the local public health centers (puskesmas).

Interventions

Nutrition Goes To School (NGTS) Program Intervention Package BEHAVIORAL

The NGTS Program intervention package in this project consists of four components: 1. A comprehensive Nutrition Education to improve healthy eating, physical activity, and hygiene-sanitation practices. This is a weekly interactive and fun nutrition and health promotion with different kinds of activities. 2. Healthy School Canteen to improve the availability of healthy food in school. This is an effort to strengthen the school canteen referring to the 4 Pillars of a Healthy School Canteen, including School Commitment and Management, Human Resources, Facilities and Infrastructure, and Food Quality. 3. School Garden. This is a gardening activity as a form of school garden as a media for nutrition education, character building, and contribute to supply vegetables during cooking class sessions in school. 4. Entrepreneurship nutrition. Entrepreneurship nutrition aims to foster entrepreneurial potential and skills among school members in providing healthy food at school.

Intervention schools

Nutrition Education Capacity Building for Teachers and Management BEHAVIORAL

The intervention schools will receive Nutrition Education Capacity Building for Teachers and School Management, before the above four NGTS components is implemented in the respective school. Three representatives from each school will be invited to attend a 5-day training that include knowledge on adolescent nutrition and health issues, as well as skills in implementing the NGTS Program.

Intervention schools

Eligibility Criteria

• Age: 15 Years - 17 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• High school students in grades 10-11
• Aged 15-17 years
• Attending school in Jakarta

You may not qualify if:

• unwilling and/or unable to complete the questionnaire thoroughly

Sponsors & Collaborators

• SEAMEO Regional Centre for Food and Nutrition: lead
• Fakultas Kedokteran Universitas Indonesia: collaborator

Study Sites (1)

Seameo Recfon

Jakarta, The Special Capital Region of Jakarta, 13120, Indonesia

RECRUITING

Related Publications (17)

• National Institute of Health Research and Development. Basic Health Research 2013. Jakarta: Ministry of Health of the Republic of Indonesia, National Institute of Health Research and Development; 2013.

  BACKGROUND

• National Institute of Health Research and Development. Basic Health Research 2018. Jakarta: Ministry of Health of the Republic of Indonesia, National Institute of Health Research and Development; 2018.

  BACKGROUND

• Glanz K, Lankenau B, Foerster S, Temple S, Mullis R, Schmid T. Environmental and policy approaches to cardiovascular disease prevention through nutrition: opportunities for state and local action. Health Educ Q. 1995 Nov;22(4):512-27. doi: 10.1177/109019819502200408.

  PMID: 8550374 BACKGROUND

• World Health Organization. School Policy Framework: implementation of the WHO global strategy on diet, physical activity and health. Geneva: World Health Organization; 2008.

  BACKGROUND

• World Health Organization. Global status report of noncommunicable diseases 2014. Geneva, Switzerland: World Health Organization; 2014.

  BACKGROUND

• Parcel GS, Simons-Morton B, O'Hara NM, Baranowski T, Wilson B. School promotion of healthful diet and physical activity: impact on learning outcomes and self-reported behavior. Health Educ Q. 1989 Summer;16(2):181-99. doi: 10.1177/109019818901600204.

  PMID: 2732062 BACKGROUND

• Silveira JA, Taddei JA, Guerra PH, Nobre MR. Effectiveness of school-based nutrition education interventions to prevent and reduce excessive weight gain in children and adolescents: a systematic review. J Pediatr (Rio J). 2011 Sep-Oct;87(5):382-92. doi: 10.2223/JPED.2123. English, Portuguese.

  PMID: 22012577 BACKGROUND

• Verrotti A, Penta L, Zenzeri L, Agostinelli S, De Feo P. Childhood obesity: prevention and strategies of intervention. A systematic review of school-based interventions in primary schools. J Endocrinol Invest. 2014 Dec;37(12):1155-64. doi: 10.1007/s40618-014-0153-y. Epub 2014 Sep 9.

  PMID: 25200996 BACKGROUND

• Black AP, D'Onise K, McDermott R, Vally H, O'Dea K. How effective are family-based and institutional nutrition interventions in improving children's diet and health? A systematic review. BMC Public Health. 2017 Oct 17;17(1):818. doi: 10.1186/s12889-017-4795-5.

  PMID: 29041899 BACKGROUND

• Aloia CR, Shockey TA, Nahar VK, Knight KB. Pertinence of the recent school-based nutrition interventions targeting fruit and vegetable consumption in the United States:a systematic review. Health Promot Perspect. 2016 Mar 31;6(1):1-9. doi: 10.15171/hpp.2016.01. eCollection 2016.

  PMID: 27123430 BACKGROUND

• Colley P, Myer B, Seabrook J, Gilliland J. The Impact of Canadian School Food Programs on Children's Nutrition and Health: A Systematic Review. Can J Diet Pract Res. 2019 Jun 1;80(2):79-86. doi: 10.3148/cjdpr-2018-037. Epub 2018 Nov 15.

  PMID: 30430855 BACKGROUND

• Kong K, Liu J, Tao Y. Limitations of studies on school-based nutrition education interventions for obesity in China: a systematic review and meta-analysis. Asia Pac J Clin Nutr. 2016;25(3):589-601. doi: 10.6133/apjcn.092015.19.

  PMID: 27440695 BACKGROUND

• Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P. Framework for design and evaluation of complex interventions to improve health. BMJ. 2000 Sep 16;321(7262):694-6. doi: 10.1136/bmj.321.7262.694. No abstract available.

  PMID: 10987780 BACKGROUND

• Liu Z, Wu Y, Niu WY, Feng X, Lin Y, Gao A, Zhang F, Fang H, Gao P, Li HJ, Wang H; study team for the DECIDE-children study. A school-based, multi-faceted health promotion programme to prevent obesity among children: protocol of a cluster-randomised controlled trial (the DECIDE-Children study). BMJ Open. 2019 Nov 2;9(11):e027902. doi: 10.1136/bmjopen-2018-027902.

  PMID: 31678935 BACKGROUND

• Octaria Y, Apriningsih A, Dwiriani CM, Februhartanty J. School readiness to adopt a school-based adolescent nutrition intervention in urban Indonesia. Public Health Nutr. 2021 Jun;24(S2):s72-s83. doi: 10.1017/S1368980020001299. Epub 2020 May 7.

  PMID: 32375906 BACKGROUND

• Maehara M, Rah JH, Roshita A, Suryantan J, Rachmadewi A, Izwardy D. Patterns and risk factors of double burden of malnutrition among adolescent girls and boys in Indonesia. PLoS One. 2019 Aug 20;14(8):e0221273. doi: 10.1371/journal.pone.0221273. eCollection 2019.

  PMID: 31430324 BACKGROUND

• Topolski TD, LoGerfo J, Patrick DL, Williams B, Walwick J, Patrick MB. The Rapid Assessment of Physical Activity (RAPA) among older adults. Prev Chronic Dis. 2006 Oct;3(4):A118. Epub 2006 Sep 15.

  PMID: 16978493 BACKGROUND

Related Links

• South-east Asian Ministers of Education Organization - Regional Center for Food and Nutrition. Nutrition Goes to School Jakarta2020

MeSH Terms

Conditions

Pediatric Obesity; Obesity

Interventions

Therapeutics

Condition Hierarchy (Ancestors)

Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Indah S Widyahening, Professor

  SEAMEO RECFON

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Indah S Widyahening, Professor

CONTACT

+622122116225; indah.widyahening@seameo-recfon.org

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Five intervention schools and five control schools will be selected from five different municipalities in Jakarta, with each school having a minimum of 100 students (grade 10-11; 15-17 years old). First, recruitment will be based on the discussion with the local education office at the provincial level and ask for a list of schools considering eligibility criteria. Two schools in each municipality with comparable characteristics will be selected, and then each pair will be randomized to become either the intervention or the control group. Second, selected schools will be invited to participate in the study. The intervention group will receive baseline educational intervention (Nutrition Education Capacity Building for Teachers and Management) and all components of the NGTS program. While the control group will receive only the baseline educational intervention. The baseline educational intervention will be conducted in 5 days through face-to-face delivery training mode.

Study Record Dates

• First Submitted: July 16, 2024
• First Posted: July 23, 2024
• Study Start: January 9, 2024
• Primary Completion: August 31, 2024
• Study Completion: August 31, 2024
• Last Updated: July 23, 2024

Record last verified: 2024-07

Data Sharing

• IPD Sharing: Will not share

Locations

ID (1)