The goal of this cluster randomized controlled pilot trial is to assess the feasibility and effect of a school-based nutrition intervention program called "Nutrition Goes to School" (NGTS) in improving a healthy diet and physical activities as part of the prevention and management of obesity among adolescents in urban Indonesia. The main questions it aims to answer concern the feasibility of the NGTS multi-component school-based nutrition intervention model in selected secondary schools in an urban setting to inform the design of the future effectiveness study. Additionally, it aims to evaluate the effect of the school-based nutrition intervention in the healthy eating knowledge and behavior (fruit and vegetable consumption, energy-dense nutrient poor food, and sugary beverages consumption, as measured by food frequency questionnaire) and physical activities as well as its effect on nutrition status (body mass index, mid-upper arm circumference \[MUAC\] and waist circumference). The intervention components consist of nutrition education to school communities (teachers, management, students and parents), healthy school canteen, school garden, hygiene and sanitation promotion of the school environment and obesogenic environment control, and promotion of physical activities among students. Five secondary schools in Jakarta will be randomly assigned to receive the intervention for 6 months, and five other schools will serve as the control group.
High school students in grades 10-11
Aged 15-17 years
Attending school in Jakarta
unwilling and/or unable to complete the questionnaire thoroughly
Parallel
Nutrition Goes To School (NGTS) Program Intervention Package
BehavioralThe NGTS Program intervention package in this project consists of four components: 1. A comprehensive Nutrition Education to improve healthy eating, physical activity, and hygiene-sanitation practices. This is a weekly interactive and fun nutrition and health promotion with different kinds of activities. 2. Healthy School Canteen to improve the availability of healthy food in school. This is an effort to strengthen the school canteen referring to the 4 Pillars of a Healthy School Canteen, including School Commitment and Management, Human Resources, Facilities and Infrastructure, and Food Quality. 3. School Garden. This is a gardening activity as a form of school garden as a media for nutrition education, character building, and contribute to supply vegetables during cooking class sessions in school. 4. Entrepreneurship nutrition. Entrepreneurship nutrition aims to foster entrepreneurial potential and skills among school members in providing healthy food at school.
Nutrition Education Capacity Building for Teachers and Management
BehavioralThe intervention schools will receive Nutrition Education Capacity Building for Teachers and School Management, before the above four NGTS components is implemented in the respective school. Three representatives from each school will be invited to attend a 5-day training that include knowledge on adolescent nutrition and health issues, as well as skills in implementing the NGTS Program.
Knowledge on healthy diet among children - clinical outcome
Multiple choices' questionnaire Analyzed as Comparison of score (mean difference \[MD\] and 95% CI): * before and after the intervention * between the intervention and control schools
Eating attitude-clinical outcome
The Eating Attitudes Test (EAT-26) Analyzed for a comparison of proportion eating disorder (difference and 95% CI): * before and after the intervention * between the intervention and control schools
Healthy diet behaviour-clinical outcome
Fruits and vegetables, energy-dense nutrient poor food and sugary beverages consumption using semi-quantitative food frequency questionnaire (FFQ) Analyzed for a comparison of proportion (difference and 95% CI): * before and after the intervention * between the intervention and control schools
Physical activity-clinical outcome
Rapid Assessment of Physical Activities (RAPA) Comparison of proportion (difference and 95% CI): * before and after the intervention * between the intervention and control schools
School readiness on the implementation of the program - - Descriptive, Quantitative (proportion), Qualitative
Data source : School readiness questionnaire (Likert scale; validated)
Attendance of teachers to training sessions-proportion
Data source: Training attendance list
Activity report completed-proportion
Data source: NGTS monitoring dashboard
Adherence to NGTS protocol - Descriptive, Quantitative (proportion), Qualitative
Data source: NGTS monitoring dashboard, interview, and observation by the field coordinator
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SEAMEO Regional Centre for Food and Nutrition
Lead sponsor
Fakultas Kedokteran Universitas Indonesia
Collaborator
