Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial

BMC Public Health

John Wiggers⁶  Debra Hector³  Andrew J Milat⁴  Rachel Sutherland²  Michelle Butler²  Philip J Morgan¹  Rebecca Wyse²  Andrew C Bell⁵  Luke Wolfenden⁶  Nicole Nathan⁶ 

[1]Priority Research Centre in Physical Activity & Nutrition, Faculty of Education & Arts, The University of Newcastle, Newcastle, NSW, 2308, Australia

[2]Priority Research Centre for Health Behavior, The University of Newcastle, Newcastle, NSW, 2308, Australia

[3]Physical Activity, Nutrition and Obesity Research Group, School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia

[4]Centre for Epidemiology and Evidence, NSW Ministry of Health, North Sydney, NSW, 2060, Australia

[5]School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, 2308, Australia

[6]Hunter Medical Research Institute, Newcastle, NSW, 2300, Australia

关键词: Diffusion;    Dissemination;    Intervention;    Vegetables;    Fruit;    Primary schools;    Implementation;   

Others  :  1163295
DOI  :  10.1186/1471-2458-12-651

 received in 2012-04-03, accepted in 2012-08-06,  发布年份 2012

【 摘 要 】

Background

Limited evidence exists describing the effectiveness of strategies in facilitating the implementation of vegetable and fruit programs by schools on a population wide basis. The aim of this study was to examine the effectiveness of a multi-strategy intervention in increasing the population-wide implementation of vegetable and fruit breaks by primary schools and to determine if intervention effectiveness varied by school characteristics.

Methods

A quasi-experimental study was conducted in primary schools in the state of New South Wales, Australia. All primary schools in one region of the state (n = 422) received a multi-strategy intervention. A random sample of schools (n = 406) in the remainder of the state served as comparison schools. The multi-strategy intervention to increase vegetable and fruit breaks involved the development and provision of: program consensus and leadership; staff training; program materials; incentives; follow-up support; and implementation feedback. Comparison schools had access to routine information-based Government support. Data to assess the prevalence of vegetable and fruit breaks were collected by telephone from Principals of the intervention and comparison schools at baseline (2006–2007) and 11 to 15 months following the commencement of the intervention (2009–2010). GEE analysis was used to examine the change in the prevalence of vegetable and fruit breaks in intervention schools compared to comparison schools.

Results

At follow-up, prevalence of vegetable and fruit breaks increased significantly in both intervention (50.3 % to 82.0 %, p < 0.001) and comparison (45.4 % to 60.9 % p < 0.001) schools. The increase in prevalence in intervention schools was significantly larger than among comparison schools (OR 2.36; 95 % CI 1.60-3.49, p <0.001). The effect size was similar between schools regardless of the rurality or socioeconomic status of school location, school size or government or non-government school type.

Conclusion

The findings suggest that a multi-strategy intervention can significantly increase the implementation of vegetable and fruit breaks by a large number of Australian primary schools.

【 授权许可】

   
2012 Nathan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1 .

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