A systematic review of educational nutrition interventions based on behavioral theories in school adolescents.

The purpose of this study was to summarize the evidence from studies conducted on adolescents, evaluating educational nutrition interventions for the modification of food consumption through controlled trials based on behavior change theories or models and implemented in school settings. A systematic search was carried out through PubMed and ERIC databases between November and December 2020, and updated in February 2023; English-language keywords were used, and no publication date limits were applied. Two authors independently performed the search, data extraction, data synthesis and risk of bias assessment. Twelve studies meeting the inclusion criteria were included. The interventions were based on different theories; the most used was the Social Cognitive Theory. Eleven of the twelve studies showed favorable modifications in the consumption of at least two of the food groups. Most studies were at low risk of bias, and only one was classified as high risk. It is concluded that educational nutrition interventions based on behavior change theories/models and implemented in the school setting influence positive changes in adolescents eating behavior.

Global e-Learning in Early Nutrition and Lifestyle for International Healthcare Professionals: Design and Evaluation of the Early Nutrition Specialist Programme (ENS).

BACKGROUND: Every encounter a healthcare professional has with new or expecting parents offers an opportunity for addressing improved early nutrition and lifestyle. Evidence-based qualification programmes via e-learning offer valuable tools for attenuating the world's huge double burden of both under- and overnutrition in early childhood. We evaluated use and learner satisfaction of a global e-learning programme on early nutrition and lifestyle addressing international healthcare professionals. METHODS: We implemented the Early Nutrition Specialist Programme (ENS) with six interactive e-learning courses on early nutrition building on more than ten years of experience with global e-learning platforms, expert knowledge and an international network in the subject field. We collected descriptive and explorative evaluation data on usage and learner satisfaction with a questionnaire and log data over three years among 4003 learners from 48 countries. RESULTS: Results show high completion of the ENS programme, with 85.5% of learners finalizing the programme after enrollment into the first of six courses. Very good results were provided for learner satisfaction with the courses (96.7% of users), for increasing understanding of the topic (97.4%) and matching the indicated time investment (94.4%). Most predominant themes in the open text fields of user feedback questionnaires were "Increase interactivity or number of audio-visuals", "Content suggestions or more examples" and "Technical (quality) issues or navigation problems". CONCLUSIONS: The ENS programme evaluation shows high completion rates and level of satisfaction by learners from numerous countries. The different needs for Continuing Medical Education (CME) of healthcare professionals in diverse healthcare system settings can be met by a joint e-learning qualification programme. Further optimizations will be implemented based on user feedback. More research with a learning analytics approach may help to further identify the most effective and efficient didactic and pedagogic elements of e-learning.

Alimentação e obesidade de crianças na fase pré-escolar: significados atribuídos pelos pais / Children's food and obesity in the pre-school phase: meanings assigned by parents / Alimentos y obesidad de los niños en la fase preescolar: significados por los padres

Objetivos: Avaliar a percepção dos pais de crianças com sobrepeso ou obesidade, em relação à qualidade da alimentação dos seus filhos, na fase pré-escolar. Método: Estudo descritivo e qualitativo, realizado por meio de entrevistas semi-estruturadas, com pais de crianças com sobrepeso ou obesas matriculadas em um Centro Municipal de Educação Infantil (CEMEI) e cadastrado nas Estratégias de Saúde da Família (ESF's) do município de Divinópolis-MG. Resultados: Em relação à caracterização dos pais, todos eram do sexo feminino. A faixa etária alternou entre 22 a 45 anos. A partir da análise dos dados, as categorias elencadas foram: Alimentação inadequada; Tecnologia e sedentarismo; A subestimação do sobre peso; Prevenção e tratamento da obesidade infantil nas ESF. Conclusão: Identificou-se a necessidade de um melhor preparo por parte dos profissionais de saúde em relação a correta nutrição das crianças e também um envolvimento entre esses profissionais, os pais e a escola.(AU)

Objectives: To evaluate the perception of parents of overweight or obese children, in relation to the quality of their children's food, in the preschool phase. Method: Descriptive and qualitative study, carried out through semi-structured interviews, with parents of overweight or obese children enrolled in a Municipal Center for Early Childhood Education (CEMEI) and registered in the Family Health Strategies (ESF's) in the municipality of Divinópolis -MG. Results: Regarding the characterization of the parents, all were female. The age group alternated between 22 to 45 years. From the data analysis, the categories listed were: Inadequate food; Technology and sedentary lifestyle; The underestimation of overweight; Prevention and treatment of childhood obesity in the FHS. Conclusion: There was a need for better preparation by health professionals in relation to the correct nutrition of children and also an involvement between these professionals, parents and the school.(AU)

Objetivos: Evaluar la percepción de los padres de niños con sobrepeso u obesidad, en relación a la calidad de la alimentación de sus hijos, en la etapa preescolar. Método: Estudio descriptivo y cualitativo, realizado a través de entrevistas semiestructuradas, con padres de niños con sobrepeso u obesidad inscritos en un Centro Municipal de Educación Infantil (CEMEI) y registrados en las Estrategias de Salud de la Familia (ESF's) del municipio de Divinópolis. -MG. Resultados: En cuanto a la caracterización de los padres, todos fueron del sexo femenino. El grupo de edad alternaba entre 22 y 45 años. Del análisis de datos, las categorías enumeradas fueron: Alimentos inadecuados; Tecnología y estilo de vida sedentario; La subestimación del sobrepeso; Prevención y tratamiento de la obesidad infantil en la ESF. Conclusión: Se identificó la necesidad de una mejor preparación por parte de los profesionales de la salud en relación a la correcta nutrición de los niños y también una participación entre estos profesionales, los padres y la escuela.(AU)

Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China.

This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.

Contextual Factors Influence Professional Development Attendance Among Child Care Providers in Nebraska.

OBJECTIVE: To examine contextual factors that may influence child care providers' motivators for attending nutrition-related training and their preferences and barriers to attending professional development training. DESIGN: Cross-sectional survey completed between January and April 2017. SETTING: Licensed child care programs (n = 1,490) across urban and rural Nebraska. PARTICIPANTS: Child care center directors (n = 336) and family child care home providers (n = 1,154). MAIN OUTCOME MEASURE(S): Motivators, preferences, and barriers of child care providers for attending professional development. ANALYSIS: Descriptive statistics and multiple logistic regression analyses were conducted. RESULTS: Top motivators for attending nutrition-related training included meeting licensure requirements and improving job performance. Child care providers most commonly selected preferences for receiving training included in-person and online delivery. Top barriers to obtaining training were schedule conflicts, accessibility, and cost. Child care centers and participants in the Child and Adult Care Food Program (CACFP) and Nutrition and Physical Activity Self-Assessment in Child Care (Go NAP SACC) were more likely to be motivated by licensure requirements. Rural providers were also more likely to report barriers such as inability to travel and limited access to training. Results revealed that child care type, geographic location, CACFP and Go NAP SACC participation can influence child care providers' motivators, preferences, and barriers to attending training. CONCLUSIONS AND IMPLICATIONS: Results highlight the importance of offering professional development training that best fits child care providers' needs and preferences.

Pairing Feeding Content With a Nutrition Education Curriculum: A Comparison of Online and In-Class Delivery.

OBJECTIVE: To develop a childhood obesity prevention program, Food, Feeding and Your Family (FFYF), which encourages eating self-regulation in young children. This article describes the research methods for FFYF. Activities that will be used to guide the development of the program are illustrated in a logic model. DESIGN: A randomized control trial will be conducted with participant groups randomized into 1 of 3 conditions: (1) in-class delivery of feeding content and nutrition education, (2) online delivery of feeding content and in-class delivery of nutrition education, and (3) nutrition education only. Assessments will be collected at baseline, program completion, and 6 and 12 months after completion of the program. SETTING: Study will be conducted through the Expanded Food and Nutrition Education Program in Colorado and Washington State. PARTICIPANTS: Parents with 2- to 8-year-old children will be recruited from affiliated community agencies, 540 participants across both states. INTERVENTIONS: FFYF derives content from an empirically validated parental feeding program, Strategies for Effective Eating Development, and will be administered with Eating Smart • Being Active, an evidence-based, nutrition education curriculum. MAIN OUTCOME MEASURES: Parents will report on feeding practices, child eating behaviors, feeding styles, and acculturation. ANALYSIS: Because of the nested nature of the data, multilevel analyses will be used: time points, within parents, and within groups.

Effects of Nutritional Education Interventions on Metabolic Risk in Children and Adolescents: A Systematic Review of Controlled Trials.

Childhood obesity is a global public health issue and is linked to metabolic syndrome, which increases the risk of comorbidities such as type 2 diabetes, cardiovascular diseases and cancer. Social, economic and cultural factors influence changes in nutrition and lifestyle characterized by poorer diets and reduced physical activity. This systematic review summarizes the evidence for nutritional education interventions to improve metabolic risks in children and adolescents. Systematic searches of the databases Medline (via PubMed) and Scopus were conducted following PRISMA guidelines. The risk of bias for each study was assessed following the methodology of the Cochrane Collaboration. Ten case-controlled and randomized controlled studies testing nutritional educational interventions targeting children and adolescents from the general population were eligible for inclusion. The sample size was 3915 and the age range was 7-20 years. The duration of intervention ranged from 12 weeks to 20 years. All the studies that provided data on abdominal obesity reported differences in favour of the intervention. However, data on the effects on the remaining components of metabolic syndrome remain inconclusive. These results support the role of nutritional education interventions as a strategy to reduce central adiposity and its possible unhealthy consequences in children and adolescents.

An evidence-based nutrition education programme for orphans and vulnerable children: protocol on the development of nutrition education intervention for orphans in Soweto, South Africa using mixed methods research.

BACKGROUND: Focus on interventions for orphans and vulnerable children (OVC) in South Africa on education, quality of life (QoL) and nutrition-related matters have been reported diminutive. The risk of dropping out of school for an OVC with poor QoL and without varied food intake is very high. The problem with poor; QoL, nutritional care and academic performance (AP) of the OVC is that it sets the foundation for their adults' life. The purpose of this longitudinal study is to develop, implement and to test the efficacy of an evidence-based nutrition education programme (NEP) for OVC that will integrate their families/caregivers, schools and communities. METHODS: A longitudinal study, and a mixed-methods approach steered by action research will be used. This study will be in three phases. Phase 1 will be the needs assessment; Phase 2 will be the development of nutritional education materials, and Phase 3 is the intervention. QoL, dietary intakes, body composition, and anthropometric status, physical activities, and AP of 520 OVC in Soweto will be assessed using standard techniques. Nutrition knowledge, attitude and practices (KAP) of the caregivers will be assessed using previously validated questionnaires. Focus group discussion (FGD) will be conducted to gain an in-depth understanding of what OVC eat and factors affecting their food intakes. Data will be collected at baseline, week 12 and week 24. Generalised Least Squares (GLS) regression model will be used to test the study hypotheses. Atlas-ti and Thematic Framework Analysis (TFA) will be used for qualitative data analysis. DISCUSSION: This study will provide detailed information on the QoL, food intakes concerning academic performance and general well-being of OVC in an Africa setting. The participatory mixed methods nature of the study will provide valuable insights into the drivers and challenges to QoL, AP, and nutritional status of this group. This approach will assist the policymakers' and other stakeholders in decision making regarding the general well-being of the OVC. TRIAL REGISTRATION: ISRCTN12835783 . Date registered 14.01.2019.

Flipped classroom - An innovative teaching model to train undergraduate medical students in community medicine.

BACKGROUND: Second-year MBBS students need to be trained in applying theoretical knowledge into practice so that they can give appropriate advice during family visits in the community. For this, it is necessary to utilize the classroom timing for discussion and facilitation. In "flipped classrooms," what is normally done in class and what is normally done as homework is switched or flipped. Thus, a study was planned to train the students to apply theory into practice by using flipped classroom methodology. METHODS: After ethical committee approval and informed consent, 48 second year MBBS students were enrolled in the study. Selected topics (i.e., "nutrition in under-five children") was taught through the "flipped classroom"model after a pretest assessment. Students were allotted a family case in the urban slums having at least one under-five child so that they can apply theory into practice. The formal assessment was done through structured case viva and spot examination. After 3 months, a posttest was conducted in the classroom to assess retention in knowledge. Feedback of the students was taken on the flipped classroom model. RESULTS: The average marks scored in structured case viva with spot examination was 8.28 ± 2.4 marks. There was a statistically significant association of scores in the structured case viva with spot examination with participation in all pre- and in-class activities (P < 0.05). There was a statistically significant difference in pre- and posttest marks (10.03 ± 2.17 vs. 18.84 ± 3.8). The class average normalized gain was 44%. Overall, there was positive feedback for "flipped classroom teaching." Most of the students felt that this was a practical approach to the topic. DISCUSSION: Students can apply theory into practice and knowledge gained is also retained through the use of the flipped classroom teaching method.

A Web-Based Gamification Program to Improve Nutrition Literacy in Families of 3- to 5-Year-Old Children: The Nutriscience Project.

OBJECTIVE: Assess the impact of a web-based gamification program on nutrition literacy of families and explore differences in impact by socioeconomic status. DESIGN: Quasi-experimental. SETTING: Thirty-seven kindergartens from Portugal. PARTICIPANTS: Eight hundred seventy-seven families. INTERVENTION: Web-based social network of participants' interactions, educational materials, apps and nutritional challenges, focused on fruit, vegetables, sugar, and salt. MAIN OUTCOME MEASURES: Parental nutrition literacy (self-reported survey - 4 dimensions: Nutrients, Food portions, Portuguese food wheel groups, Food labeling). ANALYSIS: General linear model - Repeated measures was used to analyze the effect on the nutrition literacy score. RESULTS: Families uploaded 1267 items (recipes, photographs of challenges) and educators uploaded 327 items (photographs, videos) onto the interactive platform. For the intervention group (n = 106), the final mean (SD) score of nutrition literacy was significantly higher than the baseline: 78.8% (15.6) vs 72.7% (16.2); P < .001, regardless of parental education and perceived income status. No significant differences in the scores of the control group (n = 83) were observed (final 67.8% [16.1] vs initial 66.4% [15.6]; P = .364). CONCLUSIONS AND IMPLICATIONS: Gamified digital interactive platform seems to be a useful, easily adapted educational tool for the healthy eating learning process. Future implementations of the program will benefit from longer time intervention and assessment of the eating habits of families before and after intervention.

Behavior Modification of Diet and Parent Feeding Practices in a Community- Vs Primary Care-Centered Intervention for Childhood Obesity.

OBJECTIVE: To evaluate behavior modification of diet and parent feeding practices in childhood obesity interventions. DESIGN: Secondary analysis of randomized, controlled trial comparing Mind, Exercise, Nutrition … Do It! (MEND2-5 and MEND/Coordinated Approach to Child Health [CATCH6-12]) vs Next Steps at baseline and 3 and 12 months. SETTING: Austin and Houston, TX. PARTICIPANTS: A total of 549 Hispanic and black children randomized to programs by age groups (2-5, 6-8, and 9-12 years) INTERVENTIONS: Twelve-month MEND2-5 and MEND/CATCH6-12 vs Next Steps. MAIN OUTCOME MEASURE(S): Diet (MEND-friendly/unfriendly food groups and Healthy Eating Index-2010) and parent feeding practices (parental overt control, discipline, limit setting, monitoring, reinforcement, modeling, and covert control; and food neophobia). ANALYSIS: Mixed-effects linear regression. RESULTS: Changes in diet quality, consumption of MEND-unfriendly foods, and parent feeding practices did not differ between programs. In both interventions, MEND-unfriendly vegetables, grains, dairy and protein, added fat and desserts/sugar-sweetened beverages declined in 2-5- and 6-8-year-olds (P < .001). Healthy Eating Index-2010 improved in 2-5- (treatment; P = .002) and 6-8-year-olds (P = .001). Parental overt control decreased and limit setting, discipline, monitoring, reinforcement, and covert control increased with both interventions in 2-5- and 6-8-year-olds (P < 0.01-0.001). CONCLUSIONS: Diet quality, consumption of MEND-unfriendly foods, and parent feeding practices were altered constructively in 2 pediatric obesity interventions, especially in 2-5- and 6-8-year-olds.

Changing the Face of Health Education via Health Interventions: Social Ecological Perspectives on New Media Technologies and Elementary Nutrition Education.

The relationship between media use, family dynamics, and school environments on a child's likelihood to be overweight or obese is an area of research with limited empirical evidence; however, reports have indicated that children are increasingly developing more negative habits related to their health. The purpose of the present study was to employ a social ecological perspective in determining the effectiveness of a longitudinal health literacy/health intervention program on children's nutritional knowledge, attitudes toward healthy eating and exercise, food preferences, and eating behavior. Using a sample of elementary school children initially in Grades 2 and 3 and then in Grades 3 and 4, a field experiment was conducted using a new media technology to record their food intake at home and at school. Results from the study suggest that the health literacy program was successful with positive increases observed for cognition, attitudes, and behavior. From a perspective of social ecological model, the findings suggest that children's eating behaviors need to be considered at the intersection of children's health literacy/attitudes, community efforts, and media/screen time use.

Psychometric Testing of a Policy, Systems, and Environmental (PSE)-Focused SNAP-Ed Evaluation Tool.

OBJECTIVES: To validate the Healthy Youth Environment Survey, a pre-then-post survey completed by teachers to capture nutrition and physical activity-related changes in the classroom and school environment. METHODS: Analysis included 679 pretest surveys. A factor analysis was conducted to establish construct validity and Cronbach α was established to assess internal consistency reliability. RESULTS: The factor analysis extracted 10 main factors, with 97% of variables loading (≥ +0.30 factor loading) onto appropriate factors. After deleting one question, 6 of the 10 factors demonstrated acceptable internal reliability (Cronbach α ≥ 0.70). CONCLUSIONS AND IMPLICATIONS: After revision and subsequent retesting of construct validity, internal reliability, along with cognitive testing, The Healthy Youth Environment Survey may be suitable for use by other SNAP-Ed agencies implementing multi-level policy, systems, and environmental (PSE) interventions within youth education settings.

Youth Chef Academy: Pilot Results From a Plant-Based Culinary and Nutrition Literacy Program for Sixth and Seventh Graders.

BACKGROUND: National data confirm that youth are not eating recommended amounts of fruits and vegetables (F/V), legumes, and whole grains (WGs). Establishing plant-based eating patterns early in life may positively impact long-term health through tracking of adolescent eating patterns into adulthood and through potential associations between adolescent dietary intake and adult disease risk. The study aim was to examine the effectiveness of Youth Chef Academy (YCA), a classroom-based experiential culinary and nutrition literacy intervention for sixth and seventh graders (11- to 13-year-olds) designed to impact healthy eating. METHODS: Study used a nonequivalent control group design with 8 schools selected for similarity in: free/reduced-price lunch, race/ethnicity, and student mobility rate (N = 248). Primary outcomes were times per day of F/V, vegetable, and WG consumption. Students completed a survey to assess primary outcomes and other measures at baseline and post-intervention. RESULTS: Significant increases in times per day of F/V (p = .022) and vegetable only (p = .015) consumption in the intervention group compared to the control group. Increases in WG consumption showed trended toward significance (p = .071). Student engagement and nutrition knowledge showed significant intervention effects. CONCLUSIONS: YCA positively impacts behavioral and knowledge variables related to healthy eating and increases students' engagement in their classrooms.

A mixed-method evaluation of the views of medical teachers on the applicability of the 'infant and young child feeding chapter' in Saudi medical colleges.

BACKGROUND: Lack of sufficient preparation of physicians for the provision of breastfeeding support and counselling has been well-documented. The development of training in breastfeeding medicine for medical students is currently ongoing worldwide. This study was conducted to gain insights into a potential framework for a breastfeeding education curriculum. METHODS: A mixed-method design was used to evaluate the opinions of medical teachers regarding current lactation education and the applicability of the World Health Organization 'Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals' in medical colleges in Riyadh, Saudi Arabia. Twelve teachers from three medical schools were invited to participate in three rounds of research. The first round was carried out through an interview using open-ended questions under three headings: 1) The general opinion on breastfeeding medicine education in medical colleges; 2) The opinion on the contents of the chapter under investigation; and 3) The opinion on cultural points regarding Saudi Arabia and breastfeeding education in medical colleges. This was followed by a thematic analysis. Self-administered, closed-ended questionnaires were created for the second round based the results of the first round. The third round addressed areas of disagreement in opinions. To assess the degree of agreement objectively, rounds 2 and 3 were analyzed according to the 5-point Likert scale, with responses merged to a 3-point Likert scale where appropriate. A consensus was reached when greater than 70% agreement achieved. RESULTS: All participants agreed that breastfeeding education is suboptimal. Although they considered the world health organization resource on infant and young child chapter a suitable reference for the curriculum, they agreed that modifications to suit the Saudi Arabian context are necessary. The medical teachers suggested a unique curriculum for medical students, which is similar for both genders. However, disagreement existed regarding the provision of extra clinical training to female students. CONCLUSIONS: Breastfeeding medicine education in medical colleges should be developed using resources that are rich in content, are physician-specific and take into consideration the culture.

Systematic Review: Frameworks Used in School-Based Interventions, the Impact on Hispanic Children's Obesity-Related Outcomes.

BACKGROUND: Childhood obesity among Hispanic children is a public health concern in the United States and Mexico. Although experiences from school-based intervention programs aimed at influencing obesity-related behaviors have been positive, the understanding of those framework elements that are associated with successful outcomes is limited. The purpose of this study was to examine the frameworks used within school-based intervention programs in the United States and Mexico that showed improvements in obesity-related outcomes among Hispanic children. METHODS: A systematic review of the literature was conducted using 4 electronic databases. Inclusion criteria included: incorporating a framework or aspects of frameworks within an intervention, more than 50% of Hispanic children used in the study and obesity-related outcomes (eg, dietary behaviors and anthropometric measurements). Data extraction and evaluation were completed using the Academy of Nutrition and Dietetics Evidence Analysis Manual. RESULTS: Ten articles (United States = 4; Mexico = 6) meeting inclusion criteria were evaluated. Eight studies that included a community-based framework, intensive nutrition education, and continuous communication among stakeholders resulted in improvements in dietary behaviors and anthropometric measurements among children compared to control groups. CONCLUSIONS: Incorporating community-based frameworks may increase the efficacy of school-based intervention programs to reduce obesity-related outcomes among Hispanic children.

Using a Marketing Evaluation Tool to Optimize a Social Marketing Campaign: Insights From a Copy Test of a You're the Mom Campaign Ad.

A copy test is a business tool for assessing advertisements. This report provides an example of how copy test may be used within nutrition education practice and research. A public health nutrition advertisement for You're the Mom was copy tested with a market research firm. Mothers (n = 300) were aged 22-49years, had a household income <$50,000 and ≥1 child aged 4-8years and bought fast food ≥2-3times/mo. Compared with advertisements for for-profit goods, the advertisement scored high on impact (77th percentile) and moderate on persuasiveness (46th percentile) and communicated 2 key messages at higher rates than norms (51% and 46%) and a third at a lower rate (37%). Copy test results can best inform campaign development when the distinct purpose of the ad (versus the overall campaign) is clear; and when evaluation tools are designed to align directly with that purpose.

Effects of iron supplementation and nutrition education on haemoglobin, ferritin and oxidative stress in iron-deficient female adolescents in Palestine: randomized control trial.

BACKGROUND: Iron deficiency and iron-deficiency anaemia are associated with oxidative stress, but their role is largely unclear. Information is scarce on the effects of iron supplementation on biomarkers of oxidative stress in humans. AIMS: This study evaluated the effectiveness of iron supplementation and nutrition education on improving the levels of haemoglobin and ferritin, and decreasing oxidative stress among iron-deficient female adolescents in Gaza, Palestine. METHODS: A total 131 iron-deficient female adolescents were recruited and allocated randomly into 3 different groups. The iron supplementation group (A) received 200 mg of ferrous fumarate weekly during the 3-month intervention, the iron supplementation with nutrition education group (B) received iron supplements with nutrition education sessions, and the control group (C) did not receive any intervention. The levels of haemoglobin, ferritin and malonyl dialdehyde were measured at baseline, after 3 months (at which point the intervention was stopped), and then 3 months later. Trial registration number: ACTRN12618000960257. RESULTS: Haemoglobin levels increased significantly after supplementation in both groups A and B. At the follow-up stage (3 months after stopping the intervention), iron and haemoglobin levels in group B continued to increase and malonyl dialdehyde decreased. In Group A, haemoglobin, ferritin and malonyl dialdehyde levels decreased after 3 months of stopping the intervention. No changes were seen in Group C. CONCLUSIONS: A nutrition programme should be adopted and integrated into comprehensive intervention programmes to target iron-deficiency anaemia among female adolescents in Palestine.

Competencies of the nurse in educational institutions: a look from educational managers. / Competencias de la enfermera en instituciones educativas: una mirada desde los gestores educativos.

OBJECTIVE: Describe and analyze the attributes of the nurse competencies in caring of students since the manager look of educational institutions. METHOD: Qualitative descriptive-exploratory study. Seven principals of educational institutions of Trujillo (Peru) participates in a non-structured interview during the first semester of 2016 and the analysis of oral discourse was used. RESULTS: Empirical categories: The nurse in the promotion of educational community health; The nurse in the prevention of the educational community illness; The student nurse articulating health - education in the everyday life of students. FINAL CONSIDERATIONS: This study contributes to the conceptual support of the competencies of the student nurse for the intersectoral health - education action and the setting-up of health with students in the educational institutions.

Effect of nutrition education and psychosocial factors on child feeding practices: findings of a field experiment with biofortified foods and different women categories.

Despite the efforts to promote good practices in infant and young child feeding (IYCF), the adoption of such practices has been low. Using data from a sample of 665 women, and the theory of planned behavior, we examine the effect of different types of nutrition education and psychosocial factors on the use of recommended IYCF practices. Regression results show that nutrition education and psychosocial factors have strong positive effect on the extent to which IYCF practices are used, with the latter having conflicting individual but overall positive effect. Moreover, coefficients of latter were mostly less than those of the former indicating that pschosocial factors were less important in explaining variability in usage of IYCF than the nutrition education variables. It further finds that different sets of nutrition education and psychosocial factors affect different categories of women, with interactive nutrition education approaches having a greater effect. The findings also suggest need for targeting of beneficiaries with multiple nutrition education approaches.