Objective: We explored quality of implementation during a pilot evaluation in spring 2017, using a multiprong approach: principles-based fidelity, attendance, and participant reaction: interest, relevance, comfort level, and satisfaction. Description: We conducted live observation of a subset of sessions with a checklist of "core concepts". Facilitators answered questions regarding participant engagement and understanding of concepts presented. Participants completed a session evaluation that assessed understanding of core concepts presented (knowledge), and facilitator rapport. We aimed to assess adherence but also other site-specific nuances associated with learning and key outcomes. Evaluation: Of the 13 participating families (fathers), most attended six sessions. In total, parents completed 109 after-session (one-page) evaluation forms. Most (90%) indicated class sessions were somewhat or very useful, somewhat or very interesting, and that participants felt comfortable sharing opinions. Most (94%) of their responses rated facilitators as supportive and as having addressed participants' needs and interests. Conclusions and Implications: This process evaluation findings illustrate quality implementation assessment. Overall facilitators had high levels of facilitation skills. The principle-based fidelity addressed the necessity, not only to capture adherence, but also whether the program has been able to achieve the desired results. It also provided insight to implementation that allows for adaptability to "real life" situations without loss of effectiveness. However, it called for a highly-skilled evaluator and developing the indicators of that can be broadly used in community settings. Funding: USDA.
Nutritionally balanced nutri-meals may be a healthier and acceptable alternative to regular Filipino school meals. Further optimization of nutri-meals is required to meet the nutritional needs of adolescents and reduce sodium content.
This study evaluated the effects of a multi-micronutrient fortified juice drink given in different frequencies of consumption on hemoglobin (Hb) concentration of schoolchildren. Hb was measured in 2423 schoolchildren aged 6- to 9-years-old at baseline. All anemic children (n = 246) were randomly allocated into groups: Daily dose (HD: high dose), 5X/week (MD: Moderate Dose), 3X/week (LD: Low Dose) and unfortified (Control). Pre- and post-study measurements of micronutrients were collected from 228 children. At the endpoint, significant Hb increases were observed in all groups, but there was no significant difference between groups. There was a significant reduction in anemia prevalence in all groups from 100% to 36% (Control), 30% (LD), 23% (MD) and 26% (HD). No dose-response effect was observed in Hb in this population. Most likely, this resulted from better than expected micronutrient status and lower than expected severity of anemia and micronutrient deficiencies in this cohort. It is unlikely that the addition of a fortified beverage to school feeding programs in this population would have a positive impact. Whether such an intervention would be cost-effective as a preventative approach needs to be assessed. This study demonstrates the importance of targeting such interventions to appropriate populations.
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