农村小学营养教育效果评估
发布时间：2018-09-01 20:27
【摘要】：研究背景随着社会经济发展和人们生活水平不断提高,营养相关疾病对人类健康的影响越来越突出。儿童时期的营养状况不仅影响他们的智力和体格发育,而且影响成年后健康状况及劳动生产力。儿童青少年时期也是饮食行为发展和形成的关键时期,饮食行为一旦形成往往会持续一生。目前我国中小学生仍然存在营养知识缺乏、不吃早餐、经常吃不健康零食等问题,通过营养教育,可以使儿童了解合理膳食概念,引导儿童增加奶、蛋、肉、蔬菜水果的摄入。营养教育的方法途径多、成本低、涉及面广,已被各国及地区的政府、卫生部门和营养界作为改善儿童营养状况的主要手段。为了探索适合在我国农村小学的营养教育模式,2014年9月至2016年7月,在河北平泉县、湖北五峰县、云南隆阳区的9个学校开展了营养教育研究,了解教育前、后学校营养教育实施状况、研究对象的营养知识、态度及行为,并对干预效果进行评价。研究目的1.评价营养教育对小学生的营养知识、态度和行为的影响。2.为农村小学开展营养教育基础数据和科学建议,积累经验。3.总结可在我国农村小学推广的营养教育模式。研究对象本研究是一项为期两年的干预研究,采用多阶段分层随机整群抽样的方法进行抽样。选取河北平泉、湖北五峰、云南隆阳3个县,每个县(区)各选择3个有食堂的小学,要求学校距离县城远近不同。从2014年9月开始至2016年7月,在选定学校开展教师-学生模式营养教育。学校的全部在册学生作为教育对象。选定学校按年级分层,以教学班为单位进行随机整群抽样。从2年级至6年级,每个年级抽取1个班。该班的所有学生、该校所有的营养课教师、以及该校分管营养教育领导(以下简称“学校领导”)均作为评估对象。研究方法研究学校开展教师-学生模式的学校营养教育,包括分发学生教材、教师参考教材、由受过培训的教师进行课堂授课、张贴宣传画、学生营养知识演讲比赛、教师教案评比等。分别在2014年9月、2015年6月和2016年6月,对营养授课教师和调查学生进行营养知识问卷调查、对学校领导进行访谈。根据抽样公式得学生样本量为1500人。学生调查问卷的项目包括:基本情况、营养知识、膳食行为、营养态度等,教师调查问卷包括基本情况、对营养课的态度等,领导访谈主要是学校营养课开展情况等。研究结果1小学营养教育开课情况本研究的营养课共实施两轮,每轮为一个学年,从2014年9月开始至2015年7月为第一轮,从2015年9月至2016年7月为第二轮。营养课开课频次达到每2周1课时,大多安排在地方课、卫生与常识课或安全课中上。根据学生教材内容制定对教师培训的内容,每学期1次,每次1.5天,共4次培训。2学生营养教育效果2.1学生营养知识营养教育2年后,农村小学生对健康的概念、蛋白质的食物来源、钙的食物来源、缺铁性贫血的预防、营养早餐的食物组成、饮品的选择、蔬菜水果不能互相代替、粗粮的营养特点、少吃酱咸菜、合理选择零食等10个营养知识点回答正确率显著提高,提高的幅度在40.5%-99.5%之间,10个营养知识点的回答正确率前后差异均有统计学意义(P0.01)。两年间,营养知识平均得分逐年增长,并且第二年的增长幅度高于第一年。2.2膳食结构经过两年的营养教育,农村小学生每周奶、肉、蛋的食用频率明显增加,每周喝奶的次数、吃肉的次数和吃蛋的个数,由基线调查时的每周4.8次、3.8次、4个,分别增加到5.3次、5.2次、4.6个,干预前后均有统计学意义(P0.05)。其中平均每天至少喝一杯奶的比例增长了 9.7个百分点,平均每天至少吃一次肉的比例增长了 15.1个百分点,每天至少吃一个蛋的比例增长了 9.7个百分点;而且,每周奶、肉、蛋的食用频率逐年增加的幅度,均是第二年大于第一年。每天吃蔬菜的种类和吃水果的次数增加不明显,干预前后均无统计学意义(P0.05)。2.3膳食行为经过两年的营养教育,农村小学生每周早餐的频次和早餐食物种类显著增加,早餐频次由基线调查时的每周6.3次增加到6.6次,早餐食物种类由基线调查时的平均1.4类增加到2类,干预前后比较均有统计学意义(P0.05)。其中,每天吃早餐的比例累积增长了 7个百分点,早餐食物3类及以上的比例累积增加了 24.9个百分点,第二年的增加幅度均大于第一年。每天吃零食的次数显著下降,由基线调查时的1.2次下降到1.1次,干预前后比较有统计学意义(P0.05)。其中,每天吃零食3次及以上的比例两年间累积下降了 3.7个百分点,第一年下降的幅度较大下降了 7.8个百分点,而在第二年出现反复,又上升了 4.1个百分点。2.4身体活动经过两年营养教育后,农村小学生每天体育活动时间和玩耍的时间均在增加,每天体育活动时间由73.4分钟增加到82.1分钟,每天玩耍时间由63.2分钟增加到68.9分钟,且差异均有统计学意义(P0.05)。其中,每天体育活动时间大于等于60分钟的比例累积增加了 9.6个百分点,每天玩耍的时间大于30分钟的比例累积增加了 15.4个百分点。每天静坐时间在干预前后无统计学意义(P0.05)。每天写作的时间显著下降,由72.5分钟下降到66.9分钟,在干预前后有统计学意义(P0.05),其中,每天写作业时间超过120分钟的比例累积减少了 8.1个百分点,第二年减少的幅度大于第一年。2.5营养状况经过两年营养教育后,农村小学生的营养状况持续改善,更多的调查学生营养状况回复到正常范围。营养状况正常的学生比例由68.8%上升到了 75.1%,上升了 6.3个百分点;营养不良的比例由18.2%下降到8.3%,下降了 9.9个百分点,差异有统计学意义(P0.001)。结论采取教师-学生的模式,由经过培训的教师讲授营养课,通过学生营养演讲比赛和教师教案评比等多种方式开展营养教育,可以提高学生的营养知识水平、改善饮食行为,并促进学生健康。开展营养教育两年的效果要好于一年。建议全面普及学生营养教育,提高学生的营养素养;学校应将营养教育工作纳入到日常教学计划,对学生进行系统全面的营养教育;强化对教师的营养知识、技能的培训;营养教育是一个长期的任务,需要不断坚持。
[Abstract]:Background With the development of social economy and the improvement of people's living standards, nutrition-related diseases have an increasingly prominent impact on human health. Nutritional status in childhood not only affects their mental and physical development, but also affects their health status and labor productivity in adulthood. At present, primary and secondary school students still lack nutritional knowledge, do not eat breakfast, often eat unhealthy snacks and other issues. Through nutrition education, children can understand the concept of a reasonable diet, guide children to increase milk, eggs, meat, vegetables and fruits intake. Nutrition education formula In order to explore a suitable nutrition education model for rural primary schools in China, nine schools in Pingquan County, Hubei Wufeng County and Longyang District of Yunnan Province were set up from September 2014 to July 2016. Objective 1. To evaluate the effect of nutritional education on nutritional knowledge, attitude and behavior of primary school students. 2. To provide basic data and scientific advice for rural primary school nutritional education and accumulate experience. 3. Summarize the nutrition education model that can be popularized in rural primary schools in China. The research object is a two-year intervention study. The method of multi-stage stratified random cluster sampling is used for sampling. From September 2014 to July 2016, a teacher-student model of nutrition education was carried out in selected schools. All students in the school were selected as the subjects of education. All the nutrition teachers and the school's nutrition education leaders (hereinafter referred to as "school leaders") were assessed. In September 2014, June 2015 and June 2016, nutrition teachers and students were surveyed with questionnaires on nutrition knowledge, and school leaders were interviewed. The sample size of students was 1500 according to the sampling formula. Results 1 Nutrition education in primary schools started in two rounds of this study. Each round is a school year, from September 2014 to July 2015 for the first round, from 2015. From September to July 2016, the second round was held. Nutrition courses were taught once every two weeks, mostly in local classes, hygiene and general knowledge classes or safety classes. Rural pupils'correct answers to 10 nutritional knowledge points, such as health concept, protein source, calcium source, prevention of iron deficiency anemia, food composition of nutritional breakfast, choice of drinks, non-substitution of vegetables and fruits, nutritional characteristics of coarse grains, less pickles and pickles, and reasonable choice of snacks, were significantly improved. The average score of nutritional knowledge increased year by year in the past two years, and the growth rate in the second year was higher than that in the first year. The frequency of milk drinking, meat eating and eggs eating per week increased from 4.8, 3.8, and 4 to 5.3, 5.2, and 4.6, respectively, at baseline survey. There was significant difference before and after intervention (P 0.05). The proportion of drinking at least one glass of milk per day increased by 9.7 percentage points, and the proportion of eating at least one meat per day increased. The percentage of eating at least one egg per day increased by 9.7 percentage points, and the frequency of milk, meat and eggs per week increased year by year in the second year than in the first year. Nutrition education showed that the frequency of breakfast and the types of breakfast food in rural primary school students increased significantly, the frequency of breakfast increased from 6.3 times a week to 6.6 times a week in the baseline survey, and the types of breakfast food increased from 1.4 to 2 categories on average in the baseline survey. There was statistical significance before and after the intervention (P 0.05). The number of snacks per day decreased significantly, from 1.2 to 1.1 in the baseline survey. There was a statistically significant difference before and after the intervention (P 0.05). During the two years, the cumulative decline of 3.7 percentage points, the first year dropped by 7.8 percentage points, and in the second year, repeated, increased by 4.1 percentage points. There was a significant difference between the two groups (P 0.05). Among them, the cumulative percentage of daily sports activity time greater than or equal to 60 minutes increased by 9.6 percentage points, and the cumulative percentage of daily playing time longer than 30 minutes increased by 15.4 percentage points. There was no significant difference between before and after the intervention (P 0.05). The daily writing time decreased significantly from 72.5 minutes to 66.9 minutes. There was statistical significance before and after the intervention (P 0.05). The cumulative decrease of the proportion of daily writing time over 120 minutes was 8.1 percentage points, and the decrease in the second year was greater than that in the first year.2.5 nutritional status. After two years of nutritional education, the nutritional status of rural primary school students continued to improve, and more surveys showed that the nutritional status of students returned to normal range. (P 0.001). Conclusion Nutrition education can be carried out by teacher-student model, by training teachers to teach nutrition lessons, by means of student nutrition speech contest and teacher's teaching plan evaluation, etc. It can improve students'nutrition knowledge, dietary behavior and promote students' health. The effect of carrying out nutrition education for two years is better than that for one year. It is suggested that nutrition education should be popularized in an all-round way and students'nutrition quality should be improved; schools should incorporate nutrition education into their daily teaching plans and carry out systematic and comprehensive nutrition education for students; strengthen the training of teachers' nutrition knowledge and skills; nutrition education is a long-term task that needs to be persevered.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R153.2
[Abstract]:Background With the development of social economy and the improvement of people's living standards, nutrition-related diseases have an increasingly prominent impact on human health. Nutritional status in childhood not only affects their mental and physical development, but also affects their health status and labor productivity in adulthood. At present, primary and secondary school students still lack nutritional knowledge, do not eat breakfast, often eat unhealthy snacks and other issues. Through nutrition education, children can understand the concept of a reasonable diet, guide children to increase milk, eggs, meat, vegetables and fruits intake. Nutrition education formula In order to explore a suitable nutrition education model for rural primary schools in China, nine schools in Pingquan County, Hubei Wufeng County and Longyang District of Yunnan Province were set up from September 2014 to July 2016. Objective 1. To evaluate the effect of nutritional education on nutritional knowledge, attitude and behavior of primary school students. 2. To provide basic data and scientific advice for rural primary school nutritional education and accumulate experience. 3. Summarize the nutrition education model that can be popularized in rural primary schools in China. The research object is a two-year intervention study. The method of multi-stage stratified random cluster sampling is used for sampling. From September 2014 to July 2016, a teacher-student model of nutrition education was carried out in selected schools. All students in the school were selected as the subjects of education. All the nutrition teachers and the school's nutrition education leaders (hereinafter referred to as "school leaders") were assessed. In September 2014, June 2015 and June 2016, nutrition teachers and students were surveyed with questionnaires on nutrition knowledge, and school leaders were interviewed. The sample size of students was 1500 according to the sampling formula. Results 1 Nutrition education in primary schools started in two rounds of this study. Each round is a school year, from September 2014 to July 2015 for the first round, from 2015. From September to July 2016, the second round was held. Nutrition courses were taught once every two weeks, mostly in local classes, hygiene and general knowledge classes or safety classes. Rural pupils'correct answers to 10 nutritional knowledge points, such as health concept, protein source, calcium source, prevention of iron deficiency anemia, food composition of nutritional breakfast, choice of drinks, non-substitution of vegetables and fruits, nutritional characteristics of coarse grains, less pickles and pickles, and reasonable choice of snacks, were significantly improved. The average score of nutritional knowledge increased year by year in the past two years, and the growth rate in the second year was higher than that in the first year. The frequency of milk drinking, meat eating and eggs eating per week increased from 4.8, 3.8, and 4 to 5.3, 5.2, and 4.6, respectively, at baseline survey. There was significant difference before and after intervention (P 0.05). The proportion of drinking at least one glass of milk per day increased by 9.7 percentage points, and the proportion of eating at least one meat per day increased. The percentage of eating at least one egg per day increased by 9.7 percentage points, and the frequency of milk, meat and eggs per week increased year by year in the second year than in the first year. Nutrition education showed that the frequency of breakfast and the types of breakfast food in rural primary school students increased significantly, the frequency of breakfast increased from 6.3 times a week to 6.6 times a week in the baseline survey, and the types of breakfast food increased from 1.4 to 2 categories on average in the baseline survey. There was statistical significance before and after the intervention (P 0.05). The number of snacks per day decreased significantly, from 1.2 to 1.1 in the baseline survey. There was a statistically significant difference before and after the intervention (P 0.05). During the two years, the cumulative decline of 3.7 percentage points, the first year dropped by 7.8 percentage points, and in the second year, repeated, increased by 4.1 percentage points. There was a significant difference between the two groups (P 0.05). Among them, the cumulative percentage of daily sports activity time greater than or equal to 60 minutes increased by 9.6 percentage points, and the cumulative percentage of daily playing time longer than 30 minutes increased by 15.4 percentage points. There was no significant difference between before and after the intervention (P 0.05). The daily writing time decreased significantly from 72.5 minutes to 66.9 minutes. There was statistical significance before and after the intervention (P 0.05). The cumulative decrease of the proportion of daily writing time over 120 minutes was 8.1 percentage points, and the decrease in the second year was greater than that in the first year.2.5 nutritional status. After two years of nutritional education, the nutritional status of rural primary school students continued to improve, and more surveys showed that the nutritional status of students returned to normal range. (P 0.001). Conclusion Nutrition education can be carried out by teacher-student model, by training teachers to teach nutrition lessons, by means of student nutrition speech contest and teacher's teaching plan evaluation, etc. It can improve students'nutrition knowledge, dietary behavior and promote students' health. The effect of carrying out nutrition education for two years is better than that for one year. It is suggested that nutrition education should be popularized in an all-round way and students'nutrition quality should be improved; schools should incorporate nutrition education into their daily teaching plans and carry out systematic and comprehensive nutrition education for students; strengthen the training of teachers' nutrition knowledge and skills; nutrition education is a long-term task that needs to be persevered.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R153.2
【参考文献】
相关期刊论文 前10条
1 刘梦苑;宋逸;马军;;中国汉族学生贫血状况及营养状况的关联研究[J];中国儿童保健杂志;2017年01期
2 郭海军;袁帆;栾德春;李晓辉;吴晓e，
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