Evaluation The Effect Of Nutrition Education In Rural Primary Schools

BackgroundWith the development of social economy and improvement of people's living standards,the effects of nutrition on human health were becoming more and more significant.The nutrition status of children not only affects their intelligence and the physical development,but also affects the health and productivity in adult.Children and adolescents were also the critical period for the development of dietary behavior.Once the diet habit formed,it often lasts for a lifetime.At present,many the primary or secondary school students were still lack of nutrition knowledge,not eating breakfast,having unhealthy snacks and some other unhealthy nutrition behavior in china,Nutrition education can make children understand a reasonable diet concept,and guide them to increase the intake of milk,eggs,meat,vegetables and fruits.With more methods,lower cost and wider range,nutrition education has been the main means of improving the nutritional status of children by health government departments and nutrition sector in different countries and regions.In order to improve the status of the students' nutrition knowledge,attitude and behavior and explore the suitable nutrition education model for rural primary schools,9 schools in Hebei Pingquan County,Hubei Wufeng County,Longyang District of Yunnan Province were selected to carry out the research of nutrition education from September 2014 to July 2016.Objective:1.To assess the influence of education on nutrition knowledge,attitudes and behavior of pupils.2.To provide basic data and suggestions for nutrition work in primary schools in rural poverty wereas,and accumulate experience.3.Summarize the model of nutrition education that could be promoted in primary schools in rural poverty wereas.SubjectsThis study was a two-year intervention study,using a multi-stage stratified random cluster sampling method for sampling.Select the Hebei Pingquan,Hubei Wufeng,Yunnan Longyang three counties,each county(district)the choice of three primary school cafeteria,requiring the school from the county different distance.From September 2014 to July 2016,teacher-student nutrition education model were carried out in the selected schools.All the students in the school were educated.Selected schools were stratified by grade and randomized cluster sampling as a unit.From grade 2 to grade 6,one class was recruited for each grade.All students of the class,all the nutrition teachers of the school,and the school in charge of nutrition education leadership(hereinafter referred to as "school leadership")were assessed.Methods:The teacher-student model of school nutrition education including distribution of materials for students and teachers,teachers training,nutrition posters,nutrition knowledge speech competition for students,nutrition course plan comparison were carried out in intervention schools.The nutritional knowledge questionnaire survey of students and teachers were conducted by investigators in September 2014,June 2015 and June 2016.According to the sampling formula,the student sample size was 1500 people.The information collected by student questionnaire including basic social economic status,nutrition knowledge,dietary behavior,nutritional attitudes.Basic situation,the attitude of nutrition classes was collected by the teacher questionnaire.Leadership interviews were mainly collect information on school nutrition classes.Results:1.Nutrition education in primary schoolThe nutrition education was conducted in two periods,each lasted for one academic year,from September 2014 to July 2015 for the first part,from September 2015 to July 2016 for the second part.Nutrition classes were orgonized as frequency of 1 course every 2 weeks,mostly arranged in the local classes,health and regular classes or safety courses.According to the content of the students the contents of teacher training were developed,once in each semester and lasted for 1.5 days,with 4 times.2.The Effect of Students' Nutrition Education2.1 Student nutrition knowledgeTwo years later after nutrition education,as to the concept of health,protein food sources,calcium food sources,the prevention of iron deficiency anemia,nutritional breakfast food composition,the choice of drinks,fruits and vegetables not replacinge each other,and coarse grains nutrition the correct rate of 10 nutrition knowledge points was significantly improved in the rural primary school students.The range of improvement was between 40.5%and 99.5%,and the right rate of response of 10 nutrition knowledge points was different significantly(P<0.01).During the two years,the average score of nutrition knowledge increased year by year,and the second year of growth was higher than the first year.2.2 Dietary structureAfter two years of nutrition education,the frequency of eating milk,meat and eggs weekly in rural primary school students,increased significantly.Milk,meat and eggs,increased from the baseline survey of 4.8,3.8 and 4 times a week to 5.3,5.2 and 4.6 times a week,respectively.2.3 Dietary behaviorAfter two years of nutrition education,the frequency of breakfast increased significantly,from 6.3 to 6.3 in the baseline survey in rural primary school students.The breakfast food catigaries increased from an average of 1.4 in the baseline to 2,and the differences were statistically significant(P<0.05).Among them,the proportion of eating breakfast daily increased by 7%,and the proportion of breakfast including more than 3 kinds food increased by 24.9%,with more increase in second year than in the first year.The time of snacks intake per day decreased significantly from 1.2 to 1.1 in the baseline survey(P<0.05).Among them,the protortion of snack intake ? 3 times one day decreased by 3.7%.2.4 Physical activityAfter two years of nutrition education,the daily sports time and leisure time was increasing,the daily physical activity time increased from 73.4 minutes to 82.1 minutes,leisure time increased from 63.2 minutes to 68.9 minutes,and the differences were significantly(P<0.05).Among them,the cumulative daily activity time more than 60 minutes per day increased 9.6%and more than 30 minutes per day increased 15.4%.The daily homework time decreased significantly from 72.5 minutes to 66.9 minutes(P<0.05),with a cumulative reduction of 8.1%per day for more than 120 minutes and a decrease in the second year.The magnitude was greater than the first year.2.5 Nutritional statusAfter two years of nutrition education,the nutrition status of rural primary school students continued to improve,more students became to be normal.The proportion of students with normal nutrition status increased from 68.8%to 75.1%,increasing by 6.3%;the proportion of malnutrition decreased from 18.2%to 8.3%,decreasing by 9.9%,the difference was statistically significant(P<0.001).Conclusion:It was possible to improve the nutrition knowledge,eating behavior and promote the health of the students by carrying out the nutrition education through the students 'nutrition training course and the teachers' teaching plan evaluation.The effect of nutrition education for two years was better than one year.