A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox "SWAP IT'
A randomized controlled trial to assess the potential efficacy, feasibility and acceptability of an m-health intervention targeting parents of school aged children to improve the nutritional quality of foods packed in the lunchbox "SWAP IT'
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DOI：
10.1186/s12966-019-0812-7
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发表时间：
2019-07-02
影响因子：
8.7
通讯作者：
Wolfenden, Luke
中科院分区：
文献类型：
--
作者：
Sutherland, Rachel;Nathan, Nicole;Wolfenden, Luke
研究背景可扩展的干预措施，改善儿童午餐盒中食物的营养质量，有相当大的潜力，以改善儿童公共卫生营养。这项研究评估了潜在的有效性，可行性和可接受性的移动健康干预，SWAP IT '，以提高能量和营养质量的食品包装在儿童的午餐boxs.MethodsThe研究采用了2X2因子聚类随机对照试验设计。澳大利亚新南威尔士州的12所小学被随机分配到四组中的一组：（i）没有干预;（ii）只进行体育活动干预;（iii）只进行午餐盒干预;或（iv）体育活动和午餐盒干预相结合。两种干预策略分别进行了评价。本文仅关注午餐盒干预的影响。午餐盒干预包括四个策略：1）学校营养指南; 2）午餐盒课程; 3）通过学校沟通应用程序向家长推送信息; 4）解决包装健康午餐盒障碍的家长资源。在基线和干预后立即（10周）进行结果测量，包括有效性（午餐盒中的平均能量（kJ），与澳大利亚膳食指南一致的推荐食物的总能量和能量百分比），可行性（向学校提供干预，家长应用程序参与和行为改变）以及学校工作人员和家长的可接受性。结果在1915份午餐观察中，随访时干预组和对照组午餐盒内食物的平均能量无显著性差异（-118.39kJ，CI =-307.08，70.30，p=0.22）。从推荐食物中获得的平均午餐能量的次要结果（79.21 kJ，CI=1.99，156.43，p=0.04）显著增加，干预学校从推荐食物中获得的午餐能量百分比无显著增加（4.57%，CI=-0.52，9.66，p=0.08）。通过应用程序推送的消息的浏览量范围为每周387至1550次（平均浏览量=每周1025次）。一个大比例（71%）的父母报告的干预意识，使健康的互换午餐盒（55%），并推动内容是有益的（84%）。ConclusionThe study is the first RCT to assess the potential of a multi-component m-health lunchbox intervention.干预是可行的，可接受的，并可能有效地改善儿童午餐盒内包装的食物的营养质量。试验注册澳大利亚临床试验注册ACTRN：ACTRN 12616001228471。
BackgroundScalable interventions that improve the nutritional quality of foods in children's lunchboxes have considerable potential to improve child public health nutrition. This study assessed the potential efficacy, feasibility and acceptability of an m-health intervention, SWAP IT', to improve the energy and nutritional quality of foods packed in children's lunchboxes.MethodsThe study employed a 2X2 factorial cluster randomized-controlled trial design. Twelve primary schools in New South Wales, Australia were randomly allocated to one of four groups: (i) no intervention;(ii) physical activity intervention only;(iii) lunchbox intervention only; or(iv) physical activity and lunchbox intervention combined. The two intervention strategies were evaluated separately. This paper focuses on the effects of the lunchbox intervention only. The lunchbox intervention comprised four strategies: 1) school nutrition guidelines; 2) lunchbox lessons; 3) information pushed to parents via a school-communication app and 4) parent resources addressing barriers to packing healthy lunchboxes. Outcome measures were taken at baseline and immediately post-intervention (10weeks) and included measures of effectiveness (mean energy (kJ) packed in lunchboxes, total energy and percentage energy from recommended foods consistent with Australian Dietary Guidelines), feasibility (of delivering intervention to schools, parent app engagement and behaviour change) and acceptability to school staff and parents. Linear mixed models were used to assess intervention efficacy.ResultsOf the 1915 lunchbox observations, at follow-up there was no significant differences between intervention and control group in mean energy of foods packed within lunchboxes (-118.39kJ, CI=-307.08, 70.30, p=0.22). There was a significant increase favouring the intervention in the secondary outcome of mean lunchbox energy from recommended foods (79.21kJ, CI=1.99, 156.43, p=0.04), and a non-significant increase in percentage of lunchbox energy from recommended foods in intervention schools (4.57%, CI=-0.52, 9.66, p=0.08). The views of the messages pushed via the app ranged from 387 to 1550 views per week (mean views =1025 per week). A large proportion (71%) of parents reported awareness of the intervention, making healthier swaps in the lunchbox (55%), and pushed content was helpful (84%).ConclusionThe study is the first RCT to assess the potential of a multi-component m-health lunchbox intervention. The intervention was feasible, acceptable and potentially effective in improving the nutritional quality of foods packed within children's lunchboxes.Trial registrationAustralian Clinical Trials Registry ACTRN: ACTRN12616001228471.