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Protocol for an effectiveness-implementation hybrid trial to assess the effectiveness and cost-effectiveness of an m-health intervention to decrease the consumption of discretionary foods packed in school lunchboxes: The ‘SWAP IT’ trial
journal contribution
posted on 2023-02-16, 04:05 authored by R Sutherland, A Brown, N Nathan, L Janssen, R Reynolds, A Walton, N Hudson, A Chooi, Serene YoongSerene Yoong, J Wiggers, A Bailey, N Evans, K Gillham, C Oldmeadow, A Searles, P Reeves, C Rissel, M Davies, K Reilly, B Cohen, T McCallum, L WolfendenBackground: At a population level, small reductions in energy intake have the potential to contribute to a reduction in the prevalence of childhood obesity. In many school systems, there is the potential to achieve a reduction in energy intake through modest improvements in foods packed in children’s school lunchboxes. This study will assess the effectiveness and cost-effectiveness of a multi-component intervention that uses an existing school-based communication application to reduce the kilojoule content from discretionary foods and drinks consumed by children from school lunchboxes whilst at school. Methods: A Type I hybrid effectiveness-implementation cluster randomised controlled trial will be conducted in up to 36 primary schools in the Hunter New England, Central Coast and Mid North Coast regions of New South Wales, Australia. Designed using the Behaviour Change Wheel, schools will be randomly allocated to receive either a 5-month (1.5 school terms) multi-component intervention that includes: 1) school lunchbox nutrition guidelines; 2) curriculum lessons; 3) information pushed to parents via an existing school-based communication application and 4) additional parent resources to address common barriers to packing healthy lunchboxes or a control arm (standard school practices). The study will assess both child level dietary outcomes and school-level implementation outcomes. The primary trial outcome, mean energy (kJ) content of discretionary lunchbox foods packed in children’s lunchboxes, will be assessed at baseline and immediately post intervention (5 months or 1.5 school terms). Analyses will be performed using intention to treat principles, assessing differences between groups via hierarchical linear regression models. Discussion: This study will be the first fully powered randomised controlled trial internationally to examine the impact of an m-health intervention to reduce the mean energy from discretionary food and drinks packed in the school lunchbox. The intervention has been designed with scalability in mind and will address an important evidence gap which if shown to be effective has the potential to be applied at a population level.
History
Journal
BMC Public HealthVolume
19Article number
1510Pagination
1510-Location
EnglandPublisher DOI
ISSN
1471-2458eISSN
1471-2458Language
enIssue
1Publisher
Springer Science and Business Media LLCUsage metrics
Categories
Keywords
Child nutritionChildhood obesityChildrenHybridLunchboxesM-healthRandomised controlled trialSchoolsTechnologyChildChild, PreschoolCommunicationCost-Benefit AnalysisCurriculumDietEnergy IntakeFemaleHealth PromotionHumansLunchMaleMobile ApplicationsNew South WalesNutrition PolicyParentsPediatric ObesityProgram EvaluationResearch DesignSchool Health ServicesTelemedicineNutritionPreventionClinical Trials and Supportive ActivitiesCost Effectiveness ResearchObesityClinical ResearchPediatric3.1 Primary prevention interventions to modify behaviours or promote wellbeing3 Prevention of disease and conditions, and promotion of well-being3.3 Nutrition and chemopreventionCardiovascularOral and gastrointestinalMetabolic and endocrineStrokeCancerPublic Health and Health Services not elsewhere classified
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