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Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group Randomized Controlled Trial on Children's Food, Beverage, and Calorie Consumption among Snacks Served.

ABSTRACT: BACKGROUND:Afterschool interventions have been found to improve the nutritional quality of snacks served. However, there is limited evidence on how these interventions affect children's snacking behaviors. OBJECTIVE:Our aim was to determine the impact of an afterschool intervention focused at the school district, site, family, and child levels on dietary consumption of foods and beverages served at snack. DESIGN:This was a secondary analysis of a group-randomized controlled trial. PARTICIPANTS/SETTING:Data were collected from 400 children at 20 afterschool sites in Boston, MA before (fall 2010) and after (spring 2011) intervention implementation. INTERVENTION:The Out-of-School Nutrition and Physical Activity intervention aimed to promote fruits, vegetables, whole grains, and water, while limiting sugary drinks and trans fats. Researchers worked with district foodservice staff to change snack foods and beverages. Teams of afterschool staff participated in three 3-hour learning collaborative sessions to build skills and created action plans for changing site practices. The intervention included family and child nutrition education. MAIN OUTCOME MEASURES:Research assistants observed dietary snack consumption using a validated measure on 2 days per site at baseline and follow-up. STATISTICAL ANALYSES PERFORMED:This study used multivariable regression models, accounting for clustering of observations, to assess the intervention effect, and conducted post-hoc stratified analyses by foodservice type. RESULTS:Children in intervention sites had greater decreases in consumption of juice (-0.61 oz/snack, 95% CI -1.11 to -0.12), beverage calories (-29.1 kcal/snack, 95% CI -40.2 to 18.0), foods with trans fats (-0.12 servings/snack, 95% CI -0.19 to -0.04), total calories (-47.7 kcal/snack, 95% CI -68.2 to -27.2), and increases in consumption of whole grains (0.10 servings/snack, 95% CI 0.02 to 0.18) compared to controls. In post-hoc analyses, sites with on-site foodservice had significant improvements for all outcomes (P<0.001), with no effect for sites with satellite foodservice. CONCLUSIONS:Results demonstrate that an afterschool intervention can improve children's dietary snack consumption, particularly at sites with on-site foodservice.

SUBMITTER: Lee RM

PROVIDER: S-EPMC7604883 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group Randomized Controlled Trial on Children's Food, Beverage, and Calorie Consumption among Snacks Served.

Lee Rebekka M RM Giles Catherine M CM Cradock Angie L AL Emmons Karen M KM Okechukwu Cassandra C Kenney Erica L EL Thayer J J Gortmaker Steven L SL

Journal of the Academy of Nutrition and Dietetics 20180801 8

<h4>Background</h4>Afterschool interventions have been found to improve the nutritional quality of snacks served. However, there is limited evidence on how these interventions affect children's snacking behaviors.<h4>Objective</h4>Our aim was to determine the impact of an afterschool intervention focused at the school district, site, family, and child levels on dietary consumption of foods and beverages served at snack.<h4>Design</h4>This was a secondary analysis of a group-randomized controlled ...[more]

PMID: 30055710

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Project description:BackgroundWith KiESEL, the Children's Nutrition Survey to Record Food Consumption, the German Federal Institute for Risk Assessment (BfR) collected representative food consumption data for children aged six months up to five years. KiESEL was one of five modules of KiGGS Wave2 (German Health Interview and Examination Survey for Children and Adolescents) conducted by the Robert Koch Institute (RKI). The objective was to update the consumption data for children in Germany and to fill a data gap for the age group of five-year-old children. The study provides an up-to-date and comprehensive database that will be used for exposure assessment, as part of risk assessment of Germany's youngest consumers.MethodsIn the years 2014 to 2017, 1104 children from all over Germany participated in KiESEL. During home visits, survey staff conducted a questionnaire-based interview including a food propensity questionnaire (FPQ) on seldom eaten foods and questions concerning consumption outside home, dietary habits and diet during first year. The interviewer measured the children's height and weight. Families and childcare workers filled out a food record, covering three consecutive days and one independent day. Data are based on the FPQ and present consumption frequencies. Depending on the question, socioeconomic status (SES) and migration background were considered.Results1104 participants had an interview and filled out the questionnaire on usual food intake, seldom eaten foods and consumption away from home. They were included in sample1. 1008 of these participants additionally reported food consumption of at least three days (sample2). 91.2% of the children follow no special diet and 0.8% are vegetarians. 7% of the older children consuming soya-drink. For some foods differences in consumption across SES or migration status were noted. Children from families with higher SES consume more often soya-based substitute milk as families with lower SES (p < 0.00005).ConclusionsKiESEL gathered up-to-date consumption data for more than 1000 children living in Germany, aged six month up to including five years. The data will be used for risk assessments of the BfR and provided to national and international partners.

Project description:Although social support from fathers is associated with improved child feeding practices, evidence on feasible, acceptable, and effective ways to involve fathers in supporting child nutrition, including animal source food (ASF) consumption, is limited. This study was a follow-on to a trial that tested the effects of social and behavior change communication (SBCC) targeted mainly at mothers to promote ASF consumption by children in households that received an exotic or crossbred cow through the government of Rwanda's Girinka "One Cow Per Poor Family" program (NCT0345567). A delayed SBCC intervention was provided to mothers in the non-intervention arms prior to the present pre/post study, which targeted fathers in households across the trial study arms. Baseline and endline surveys with a cohort of 149 fathers with a child <5 years were used to evaluate the effects of a SBCC intervention for fathers on their children's ASF consumption and on fathers' knowledge, awareness, and support for children's ASF consumption. Qualitative data collected from fathers, mothers, and program implementers were used to assess feasibility and acceptability of the intervention for fathers. The SBCC intervention comprised group meetings led by model fathers, text messages, print materials, and megaphone blasts. The odds of children consuming any type of ASF ≥2 times in the last week increased from baseline to endline (OR 4.9, 95% CI 1.9, 12.3), as did the odds consuming milk, eggs, and beef, but not fish. Fathers' mean ASF knowledge and awareness scores increased from baseline to endline (knowledge: 2.3 to 3.5 out of 4 items, P<0.001; awareness: 2.5 to 3.0 out of 3 items, P<0.001), with the largest changes observed in knowledge of timing of introduction of milk and other ASFs. The percentage of fathers who offered two or more supportive actions for their children's milk and other ASF consumption increased from baseline to endline (milk: 19.5% to 31.5%, P = 0.017; other ASFs: 18.8% to 37.6%, P<0.001). Fathers appreciated gaining knowledge on child nutrition in a setting specifically for men and liked the print materials that offered clear actions they could take to support their children's ASF consumption. This study shows that an SBCC intervention for fathers can improve children's ASF consumption and increase fathers' knowledge, awareness, and support for children's nutrition.

Dataset Information

Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group Randomized Controlled Trial on Children's Food, Beverage, and Calorie Consumption among Snacks Served.

Publications

Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group Randomized Controlled Trial on Children's Food, Beverage, and Calorie Consumption among Snacks Served.

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