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Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial

Nathan, Nicole, Wolfenden, Luke, Bell, Andrew C., Wyse, Rebecca, Morgan, Phillip J., Butler, Michelle, Sutherland, Rachel, Milat, Andrew J., Hector, Debra and Wiggers, John 2012, 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, vol. 12, pp. 1-9, doi: 10.1186/1471-2458-12-651.

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Title Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial
Author(s) Nathan, Nicole
Wolfenden, Luke
Bell, Andrew C.
Wyse, Rebecca
Morgan, Phillip J.
Butler, Michelle
Sutherland, Rachel
Milat, Andrew J.
Hector, Debra
Wiggers, John
Journal name BMC public health
Volume number 12
Article ID 651
Start page 1
End page 9
Total pages 9
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2012-08-13
ISSN 1471-2458
Keyword(s) Adolescent
Child
Confidence Intervals
Diet
Fruit
Health Promotion
Humans
New South Wales
Odds Ratio
Program Evaluation
Qualitative Research
Schools
Vegetables
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Implementation
Primary schools
Intervention
Dissemination
Diffusion
Summary BACKGROUND: Limited 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.
METHODS: A 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.
RESULTS: At 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.
CONCLUSION: The 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.
Language eng
DOI 10.1186/1471-2458-12-651
Field of Research 111102 Dietetics and Nutrigenomics
1117 Public Health And Health Services
Socio Economic Objective 920501 Child Health
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, Nathan et al
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30070594

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.