Background: Nutrition interventions during the early years of a child’s life are anchored on the need to provide good nutrition and proper health care to optimize their growth potential as adults. In the Philippines, undernutrition is a persistent problem among 0–10 year old Filipino children. In this age group, children consume a diet poor in quantity and quality. Aim: This study aimed to assess the effects of a school-lunch and nutrition education intervention among schoolchildren in terms of attaining good nutrition. Method: Using a quasi-experimental design, children aged 7–9 years from public elementary schools in the province of Laguna, Philippines were categorized into three intervention groups and one non-intervention group. Anthropometric measurements; nutrition knowledge, attitude and behavior; and food intake among children and households were collected at baseline and endline periods. SPSS for Windows version 16 and Stata version 15 were utilized for data analysis. Results: Mean scores on knowledge, attitude and behavior of schoolchildren in intervention groups increased significantly at endline ( p<0.05). Protein requirement was met by more children and households than the energy requirement. Most children with normal nutritional status after the interventions (25.3%) belonged to the group with the complete intervention of school-lunch and nutrition education. Conclusions: The provision of both school-lunch feeding and nutrition education is effective in improving the knowledge, attitude and behavior scores and nutritional status of schoolchildren. The adoption and institutionalization of complete intervention with school-lunch and nutrition education in elementary public schools should be pursued.
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.
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