上海市嘉定区社区居民和学生合理营养知识健康教育干预效果评估

目的 了解上海市嘉定区居民和学生合理营养知识的知晓水平，找出重点干预内容，评价健康教育干预效果。方法 根据系统抽样与简单随机抽样相结合的方法，分别于干预前、后在嘉定区所有的14个镇、街道各随机选择1个居委（村）、1所学校（小学或中学），随机抽取部分人群进行问卷调查；健康教育采取点、面结合，广泛宣传的方式。结果 基线调查结果显示居民和学生合理营养知识总知晓率达到80．2％，其中大多数有关合理营养的基础知识和相关知识、中国居民膳食指南和平衡膳食宝塔知识的知晓率均超过50％，但对合理膳食和营养不良的概念等部分知识的知晓率较低；干预后调查对象在平均得分、总知晓率和各类知识的知晓率上均有显著提高，总知晓率达到88．5％。结论 合理营养知识健康教育效果明显，但要真正改变人们的饮食行为，实现由知识的获得、态度的转变到行为实践的飞跃，仍需要进行长期广泛而持续的营养教育工作。     

An evaluation of a community dietetics intervention on the management of malnutrition for healthcare professionals

Background: Healthcare professionals working in the community setting have limited knowledge of the evidence‐based management of malnutrition. The present study aimed to evaluate a community dietetics intervention, which included an education programme for healthcare professionals in conjunction with the introduction of a community dietetics service for patients ‘at risk’ of malnutrition. Changes in nutritional knowledge and the reported management of malnourished patients were investigated and the acceptability of the intervention was explored. Methods: An education programme, incorporating ‘Malnutrition Universal Screening Tool (MUST)’ training, was implemented in eight of 10 eligible primary care practices (14 general practitioners and nine practice nurses attended), in seven private nursing homes (20 staff nurses attended) and two health centres (53 community nurses attended) in conjunction with a community dietetics service for patients at risk of malnutrition. Nutritional knowledge was assessed before, immediately after, and 6 months after the intervention using self‐administered, multiple‐choice questionnaires. Reported changes in practice and the acceptability of the education programme were considered using self‐administered questionnaires 6 months after the intervention. Results: A significant increase in nutritional knowledge 6 months after the intervention was observed (P < 0.001). The management of malnutrition was reported to be improved, with 69% (38/55) of healthcare professionals reporting to weigh patients ‘more frequently’, whereas 80% (43/54) reported giving dietary advice to prevent or treat malnutrition. Eighty‐percent (44/55) of healthcare professionals stated that ‘MUST’ was an acceptable nutrition screening tool. Conclusion: An education programme supported by a community dietetics service for patients ‘at risk’ of malnutrition increased the nutritional knowledge and improved the reported management of malnourished patients in the community by healthcare professionals.     

应用SOC模型对农民进行营养干预的研究

目的研究应用行为阶段改变(stages of change,SOC)模型在农村居民中开展营养干预及营养宣教的方法和效果,旨在探索科学高效的适合农村人口的营养干预模式和经验,提高农民营养知识水平和行为,促进健康,降低慢性病相关危险因素水平等。方法采用随机抽样的方法,将天津市某构成相近的两个农村社区18～65岁的农民分成两组,并按照SOC模型将两组研究对象分别划分为5个阶段,干预组给予有针对性的干预措施,对照组仅开展常规的健康教育,为期一年。结果对照组和干预组在干预前后差异有显著性,对于平衡膳食的打算率、行动率和保持率增加了15%～20%,每日体力活动的相信率、行动率和保持率增加了10%～20%,干预组营养知识的知晓率增加了30%。BMI、血压、总胆固醇、同型半胱氨酸、叶酸以及尿钾、尿钠水平在干预组干预前后以及干预组与对照组中均有显著性差异。干预前后干预组人群行为(饮食行为、锻炼行为、健康意识和行为)改变率、健康知识水平及态度改变率、膳食及体力活动行为改变率、干预前后农民体质指标及生物因素的变化均较对照组有所升高,对干预组不同阶段人群对不同干预方式的喜好程度和干预知识的接受程度、干预过程评价等指标进行了分析。结论采用SOC模型在农民中进行营养干预取得良好效果,达到促进知-信-行的连续变化。     

Comparison of nutrition knowledge among health professionals,patients with eating disorders and the general population

Aim: To investigate and compare the level of nutrition knowledge of health professionals, patients with eating disorders and individuals without an eating disorder as controls. Methods: Participants were recruited online through an Australian and New Zealand professional eating disorder organisation and community eating disorder organisations and a university in Australia. Assessment was conducted online using the General Nutrition Knowledge Questionnaire and SCOFF. Demographic data were also collected. Results: Dietitians had greater nutrition knowledge than all other health professionals, except medical doctors. Psychologists and dietitians had similar knowledge for choosing everyday foods. Dietitians had greater nutrition knowledge than eating disorder patients and controls in all areas of nutrition knowledge, while other health professionals had similar knowledge to patients. Patients with eating disorders had greater knowledge of sources of nutrients than controls. Conclusions: Australian health professionals exhibited higher levels of nutrition knowledge than health professionals in previous studies in other countries. However, non‐dietitian health professionals had similar levels of knowledge to individuals with eating disorders. Training and continuing education in nutrition is needed so health professionals can confidently identify when a patient has misleading information about nutrition and either correct the misinformation or refer the patient on to a qualified dietitian.     

Reduced Morbidity Motivated Adoption of Infant and Young Child Feeding Practices after Nutrition Education Intervention in Rural Malawi

This study assessed caregivers’ knowledge and practices and factors that influence the adoption of improved infant and young child feeding (IYCF) practices after nutrition education in Kasungu and Mzimba districts among 198 caregivers. Mixed-methods convergent-parallel design, including knowledge tests, focus group discussions, and in-depth interviews in the intervention areas, was used to collect quantitative and qualitative data. Data were analyzed using count regression and content analysis, which showed that knowledge increased among caregivers after nutrition education. The knowledge about diet diversification for young children as well as about hygienic practices when preparing food and during feeding improved in addition. Enhanced health among children motivated caregivers to apply improved IYCF practices. The study was based on the caregivers’ reports. Long-term effects of exposure to nutrition education are unknown. However, the nutrition education that focused on the child’s health benefits motivated mothers to adopt improved IYCF practices.     

Evaluating rural nurses for preparation in implementing nutrition interventions.

With the increase in wellness programs, earlier hospital discharges, higher health care costs, and more home health care, rural nurses are required to generalize their practices and draw from a more extensive knowledge base. The purpose of this study was to examine nursing interventions, specifically nutrition education practices, based on nutrition knowledge that is used in health promotion. A stratified random sample of rural nurses from hospitals, nursing homes, and community health agencies in North Dakota was invited to participate in this study. Data were obtained via questionnaires. The questionnaire consisted of two parts: the first analyzing demographic data and the second analyzing nutrition knowledge. Nutrition information requests were received by 90.9 percent of the practicing registered nurses. The community/public health nurses had the highest nutrition knowledge scores while medical-surgical hospital nurses had the lowest nutrition knowledge scores. With nutrition information and education being a frequently sought intervention by the rural health client, it would seem that registered nurses should be highly prepared and knowledgeable to meet these clients' needs.     

Sustainability of a Multi-Component Education Program (ABC of Healthy Eating) after Three Months and Nine Months: The Socioeconomic Context in Improving Nutrition Knowledge in Polish Teenagers

The study aimed to evaluate the sustainability of a multi-component education (ABC-HEat) program related to healthy nutrition and lifestyle after three months and nine months and to assess the socioeconomic context in improving teenage nutrition knowledge. The study was designed as a clustered, controlled, education-based intervention. A sample was chosen and allocated into either an educated group (under intervention) or a control group (outside of intervention). The study covered 464 11–12-year-old students (educated/control 319/145). In the educated group, data were collected three times: before education, after three months and after nine months to measure the short- and the long-term effects of education, respectively. In the control group, data were collected in parallel. Changes in nutrition knowledge score (NKS, points) by sex, residence, family affluence scale (FAS) were the main outcome measures. The increase in the NKS was significantly higher in the educated group than in the control group—three months after education on average by 1.4 to 2.7 points (all p < 0.001) in the total sample and all subgroups, and nine months after education in rural residents by 2.2 points (p < 0.001) and in the total sample by 0.4 (p < 0.05). In the educated group, the chance of no increase in the NKS was higher in urban than rural residents after three months and nine months (adjusted odds ratios [OR] and 95% Confidence Intervals [95% CI]: 3.63, 1.80–7.31 and 2.99, 1.60–5.59, respectively, both p < 0.001) using the increase in the NKS by ≥4 points as a reference. The multi-component education program improved the nutrition knowledge of teenagers in the short term regardless of socioeconomic variables, but in the long term this effect was visible only in rural residents. It suggests that a special path of nutrition education addressed to urban teens may be required.     

社区高血压及营养KAP健康教育效果分析

目的 评价高血压及营养健教对社区高血压人群的干预效果。方法 在上海某社区随机抽取370名年龄为35-75岁高血压病人作为高血压及营养知识。态度及行为（KAP）调查的基线人群,其中干预组176人,对照组194人。结果 经一年的社区干预后,对两组人群进行高血压及营养知识,态度及行为复查,干预组对营养知识的掌握优于对照组;干预组对中国居民膳食指南的知晓率在干预后也明显提高;在改善不良膳食行为方面,干预组行为改善率高于对照组,两组相比有显著性差异。结论 社区高血压及营养知识健康教育对高血压人群提高高血压及营养知识水平是有效的和可行的。     

成都市小学生营养知识水平调查分析

目的 调查成都市小学生膳食营养与健康知识知晓情况,为开展营养健康教育提供科学依据.方法 采用分层随机整群抽样的方法抽取成都市2所小学的958名学生进行问卷调查.结果 成都市小学生营养知识知晓率为84.53％,良好行为形成率为77.83％,学生获得营养知识的主要途径是家长、学校和广播电视.结论 无论是营养健康知识或行为,成都市小学生都存在一定的问题,但他们有改善自己膳食结构的愿望,应当进一步加强对小学生的营养知识健康教育.     

What Do People Know about Food,Nutrition and Health?—General Nutrition Knowledge in the Austrian Population

Background: Only limited information is available on the nutrition knowledge of the general Austrian population and how this relates to the nutrition knowledge of health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers. Methods: Adolescents and adults at the age of 14–75 years (n = 1000), medical doctors (n = 307), pharmacists (n = 295), nutritionists (n = 124), dieticians (n = 160) and school teachers (n = 873) completed an online survey using a German version of the General Nutrition Knowledge Questionnaire-Revised (GNKQ-R) including self-reported data on sex, age, BMI, and health status. Adolescent and adult participants were recruited by a research agency to be representative for the Austrian population for age, sex, and education. A convenience sample was used for health professionals (medical doctors, pharmacists, nutritionist, dieticians) and school teachers. All participants completed a computer-assisted web-based interviewing (CAWI) survey. Results: Total scores for nutrition knowledge of the general population (61.4%) were significantly lower than scores from all other groups (medical doctors 81.3%, pharmacists 83.0%, dieticians 87.5%, nutritionists 85.6%, school teachers 74.5%). The main drivers for better nutritional knowledge were female sex, higher age, and higher level of education, while BMI classification and self-reported health status had no impact. In regard to single questions, the most striking result was the misclassification of sugar as the nutrient with the most calories by 41.4% of the general population while only 29.0% correctly identified fat to be the nutrient with the most calories. Conclusions: The nutritional knowledge of the general population should be significantly improved in order to lay a basis for better dietary behavior. In view of the relatively low scores of teachers, their nutrition education should be improved in order to enable transfer of sound education in schools.     

A Formative Evaluation in Maternal and Child Health Practice: The Partners for Life Nutrition Education Program for Pregnant Women

Objectives: This paper describes the formative evaluation of the Partners For Life Program that was developed to change dietary behavior of low income pregnant women in the Mississippi Delta region. Methods: A diverse group of nutrition/health professionals, adapted the Expanded Food and Nutrition Education Program's (EFNEP) methodology for pregnant patients in the local Women, Infants, and Children program who were receiving maternity care at the county health department. Formative evaluation activities included gathering data to determine 1) whether a new nutrition curriculum, modeled after EFNEP could be created, 2) whether peer educators could be recruited and trained to deliver the intervention, 3) whether pregnant women could be recruited to participate in the new program, 4) whether a pilot test of the new intervention would produce short-term impact in nutrition knowledge and dietary behavior, and 5) reactions of pregnant women on the usability of the new program. Data were gathered through use of the Program Implementation Index, focus groups, and a retrospective record review. Pilot test assessments included tests of nutrition knowledge and self-reported changes in dietary behavior. Results: The formative evaluation demonstrated both positive and negative outcomes. Positive data included 1) successful recruitment and training of the peer educators to deliver the intervention; 2) successful recruitment of the targeted population for the pilot study; 3) complete information on project questionnaires and measuring forms; and 4) among those who completed the program, a statistically significant improvement in nutrition knowledge and dietary behavior. Two negative aspects in this formative study were 1) the Program Implementation Index quantitatively showed that the program experienced problems retaining participants it recruited and 2) deviation of the timeframe for intervention delivery. Program length was identified as the primary reason for participant attrition. Conclusions: It is important for program developers to use results from formative evaluations to make changes in problem areas prior to implementation of a full-scale impact evaluation.     

非医学生营养知识、态度和饮食行为调查

目的了解非医学生营养知识、营养态度和饮食行为,为进一步的营养健康教育和营养干预提供参考依据。方法选取河南省某高校非医学专业学生328名,采用发放调查问卷的形式进行营养知识及饮食行为的现场调查。结果非医学专业大学生营养知识得分较低,男女无差异,膳食不合理比例较高(58%),原因是习惯按口味选择食物和缺乏营养知识,牛奶、鸡蛋和肉食摄入较少,学生饮食消费水平多集中在300元~400元。结论应从加强营养教育和提高学校餐饮质量等方面着手,提高学生的身体素质。     

Establishing an innovative model of nutrition and dietetic care for a mental health service through collaboration with non-nutrition healthcare workers

Aim:  To describe the process of the development of the Web-based resources to extend nutrition care to mental health patients through existing non-nutrition mental healthcare professionals (case-managers).
Methods:  A formative approach was used to identify nutrition-related issues faced by both patients and staff through a synthesis of literature review, professional experience and clinical observations. Decision-making tools to assist case-managers in selecting resources were developed to guide case-managers' choice of effective evidence-based health education materials on the hospital intranet. Practical training was provided for case-managers during their orientation to the new website and the tools and resources it housed.
Results:  A Web-based nutrition site was created on the Royal Brisbane and Women's Hospital intranet. The website consisted of a Nutrition Referral Action Plan (a patient support triaging flowchart), a Nutrition Support Action Plan (action-based nutrition support tool to guide resource selection) and thirteen action-based nutrition education resources.
Conclusion:  By maximising established patient contact through existing health professionals, a Web-based approach to nutrition service delivery was an innovative method for delivering patient information. This collaborative action-based strategy has the potential to raise the nutrition profile in mental health and extend nutrition services to at-risk patients not previously receiving nutrition care.     

阜阳市中小学生发育和营养状况及其健康教育干预

目的 :了解阜阳市中小学生生长发育和营养状况 ,采取针对性健康教育干预措施。方法 :随机抽取全市城乡 7～ 17岁在校学生 3795 5人。准确测量身高、体重 ,以百分位数法评价身高、体重发育等级 ;以身高标准体重法评价现时营养状况 ;本站学校卫生科 1993年～ 1995年连续监测三年。健康教育干预措施为讲课、广播、宣传栏及发放自编宣传册。结果 :经过健康教育干预 ,两年后 ,全市城乡中小学生身高发育上等的人数由原来的 15 .16 %上升到 2 1.5 9% ;体重发育上等的人数由 14.2 4%上升到 17.76 %。营养不良率由原来的 17.2 2 %下降到 12 .2 0 %。营养卫生知识水平有不同程度提高。结论 :加强健康教育、普及营养卫生知识、指导合理膳食、提高学生自我保健意识是保证中小学生身体健康的有效措施。     

Sustained benefits of a community dietetics intervention designed to improve oral nutritional supplement prescribing practices

Background: Healthcare professionals working in the community do not always prescribe oral nutritional supplements (ONS) according to best practice guidelines for the management of malnutrition. The present study aimed to determine the impact of a community dietetics intervention on ONS prescribing practices and expenditure 1 year later. Methods: The intervention involved general practitioners (GPs), practice nurses, nurses in local nursing homes and community nurses. It comprised an education programme together with the provision of a new community dietetics service. Changes in health care professionals’ nutrition care practices were determined by examining community dietetics records. ONS prescribing volume and expenditure on ONS were assessed using data from the Primary Care Reimbursement Service of the Irish Health Service Executive. Results: Seven out of 10 principal GPs participated in the nutrition education programme. One year later, screening for malnutrition risk was better, dietary advice was provided more often, referral to the community dietetics service improved and ONS were prescribed for a greater proportion of patients at ‘high risk’ of malnutrition than before (88% versus 37%; P < 0.001). There was a trend towards fewer patients being prescribed ONS (18% reduction; P = 0.074) and there was no significant change in expenditure on ONS by participating GPs (3% reduction; P = 0.499), despite a 28% increase nationally by GPs on ONS. Conclusions: The community dietetics intervention improved ONS prescribing practices by GPs and nurses, in accordance with best practice guidelines, without increasing expenditure on ONS during the year after intervention.     

Nutrition Knowledge and Associated Behavior Changes in a Holistic,Short-term Nutrition Education Intervention with Low-income Women

ObjectiveTo assess the impact of a short-term nutrition intervention using education on a comprehensive array of nutrition and health topics in low-income women.DesignPre- and postintervention surveys; 1 study condition (intervention group); experiential learning; pilot testing of education sessions.SettingCommunity centers, homeless shelters, or University of Minnesota, in Minneapolis–St Paul metropolitan area.ParticipantsEthnically diverse, low-income women (n = 118), 23–45 years of age.InterventionThree educational sessions providing a comprehensive curriculum of nutrition and health education via experiential and interactive lectures, activities, and demonstrations. One week to implement knowledge and behavioral changes, and pre- and postsurvey sessions to collect anthropometric data and evaluate changes in knowledge and behavior.Main Outcome MeasuresHealth benefits of all food groups; identification of healthful foods; shopping, cooking, and gardening; and energy balance.AnalysisPaired t tests, Pearson correlations.ResultsPostintervention increases in nutrition knowledge and favorable nutrition behavioral changes (P < .05).Conclusions and ImplicationsA short-term nutrition intervention using comprehensive nutrition and health education through experiential and interactive lessons, activities, and demonstrations has the capacity to increase nutrition knowledge and favorably change nutrition behaviors in a sample of low-income women.     

云南省傣族地区0～17个月婴幼儿营养健康教育阶段评估

目的探讨云南少数民族贫困地区儿童营养不良有效干预措施，为改善西部贫困地区儿童营养状况提供示范。方法开发适合当地社区的健康教育声像材料、图形材料，利用社区干部和乡村医生，在农村社区开展了参与式营养教育活动，营养教育活动一年后对活动效果进行阶段评估。结果研究地区孕产期妇女不良饮食习惯得到有效改变，婴幼儿正确喂养知识得到普及，婴幼儿正确喂养方法在当地社区家庭得到正确应用。结论开发适合本地文化的健康教育材料，开展社区健康教育活动改变了家庭儿童喂养知识和行为。     

A pilot study to examine the effects of a nutrition intervention on nutrition knowledge, behaviors, and efficacy expectations in middle school children

BACKGROUND: This was a pilot study to determine the impact of the Michigan Model (MM) Nutrition Curriculum on nutrition knowledge, efficacy expectations, and eating behaviors in middle school students. METHODS: The study was conducted in a large metropolitan setting and approved by the Institutional Review Board. The participants for this study were divided into an intervention group (n = 407) and a control group (n = 169). An MM instructor trained health teachers in the use of the curriculum, and the teacher subsequently taught the curriculum to students in the intervention group. A valid and reliable questionnaire was used to determine pre-post differences. It consisted of 3 subscales assessing eating habits, nutrition knowledge, and efficacy expectations toward healthy eating. Subscale scores were analyzed using a 2 groups (intervention vs control) x 2 times (pre vs post) analysis of variance. RESULTS: The intervention group increased their nutrition knowledge at post. There was also a significant main effect for groups in the subscales "Eating Behaviors" and "Efficacy Expectations Regarding Healthy Eating." Subsequent post hoc analysis revealed that the intervention group was significantly more likely to eat fruits and vegetables and less likely to eat junk food than the control group. Students in the intervention group also felt more confident that they could eat healthy. CONCLUSIONS: The results of this pilot study suggest that the MM Nutrition Curriculum delivered by trained professionals resulted in significant positive changes in both nutrition knowledge and behaviors in middle school children. Further research needs to be conducted to determine the long-term impact.     

Developing a tool for health professionals involved in producing and evaluating nutrition education leaflets

Introduction Nutrition education leaflets are widely used by dietitians and many dietitians are also involved in their production. However, there does not appear to be a suitable tool to assist health professionals to produce or evaluate nutrition education leaflets. There are Guidelines available that are either specifically concerned with nutrition but for all educational materials or specifically for use with leaflets, but not necessarily to do with nutrition. The aim of this study was to develop a tool suitable to assist health professionals when producing and evaluating nutrition education leaflets.
Methods Patients and dietitians were surveyed by self-completion questionnaire to determine their opinions of the importance of various criteria which might be applied to nutrition education leaflets were.
Results The research revealed significant differences in the opinions of dietitians and patients for seven of 11 criteria.
Conclusion The evaluation tool developed was based on the patients' ranking of all the criteria. Its reliability was assessed amongst a group of dietitians in Dorset but its wider use and acceptability should be looked at. The tool is likely to be appropriate as a checklist for health professionals producing new nutrition education leaflets or as a framework for evaluating existing nutrition education leaflets.     

“儿童与儿童”模式在小学生营养教育中的应用研究

目的:探讨以“儿童与儿童(Child-to-Child,CTC)”方法作为载体开展学校营养教育的可行性及效果。方法:采用对照实验研究设计,在山西大同、浙江绍兴对3000余名小学生进行营养教育干预研究。结果:两地实验学校学生营养知识及格率均明显提高,对营养与健康的态度、饮食行为均获得改善,同时参与营养教育的行为显著提高(P<0.01)。结论:应用CTC方法进行学校营养教育具有明显效果和优势。