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

Research Article

Andrew J Milat¹  Rebecca Wyse²  Rachel Sutherland²  Michelle Butler²  Nicole Nathan³  John Wiggers³  Luke Wolfenden³  Debra Hector⁴  Philip J Morgan⁵  Andrew C Bell⁶ 

[1] Centre for Epidemiology and Evidence, NSW Ministry of Health, 2060, North Sydney, NSW, Australia;Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Locked Bag No. 10, 2287, Wallsend, NSW, Australia;School of Medicine and Public Health, The University of Newcastle, 2308, Newcastle, NSW, Australia;Priority Research Centre for Health Behavior, The University of Newcastle, 2308, Newcastle, NSW, Australia;Hunter New England Population Health, Hunter New England Area Health Service, Newcastle, Locked Bag No. 10, 2287, Wallsend, NSW, Australia;School of Medicine and Public Health, The University of Newcastle, 2308, Newcastle, NSW, Australia;Priority Research Centre for Health Behavior, The University of Newcastle, 2308, Newcastle, NSW, Australia;Hunter Medical Research Institute, 2300, Newcastle, NSW, Australia;Physical Activity, Nutrition and Obesity Research Group, School of Public Health, The University of Sydney, 2006, Sydney, NSW, Australia;Priority Research Centre in Physical Activity & Nutrition, Faculty of Education & Arts, The University of Newcastle, 2308, Newcastle, NSW, Australia;School of Medicine and Public Health, The University of Newcastle, 2308, Newcastle, NSW, Australia;

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

DOI  :  10.1186/1471-2458-12-651

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

来源: Springer

【 摘 要 】

BackgroundLimited 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.MethodsA 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.ResultsAt 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.ConclusionThe 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】

CC BY   
© Nathan et al.; licensee BioMed Central Ltd. 2012