A School Based Intervention for Combating Food Insecurity and Promoting Healthy Nutrition in a Developed Country Undergoing Economic Crisis: A Qualitative Study
Author: Dalma, A.
Date: 2015-00-00
Type: Journal Articles
Subjects: Foreign Countries,Developed Nations,Intervention,Food,Hunger,Health Promotion,Nutrition,Nutrition Instruction,Economic Climate,Financial Exigency,Disadvantaged Environment,Learning Processes,Teacher Attitudes,Administrator Attitudes,Elementary School Students,Junior High School Students,Program Effectiveness,Educational Benefits,Lunch Programs,Knowledge Level,Focus Groups,Transcripts (Written Records),Qualitative Research,Attendance Patterns,Family Influence,Peer Influence,Parent School Relationship,Trust (Psychology)

Introduction: Aiming at reducing the rates of food insecurity and promoting healthy diet for children and adolescents, we designed and implemented the Program on Food Aid and Promotion of Healthy Nutrition-DIATROFI, a school-based intervention program including the daily provision of a free healthy mid-day meal in disadvantaged areas across Greece. We conducted a qualitative study with educators and school principals, in order to explore their perceptions and attitudes towards the Program, its effects on child malnutrition and learning environment in participated schools with regards to healthy nutrition, and its further social and pedagogical aspects. Significance of the study: This is the first study that explores the social aspects and pedagogical potential of a school-based healthy nutrition intervention in disadvantaged areas of a high-income country, currently undergoing severe economic crisis, as it is realized by educators and school principals who have experienced its implementation. Objective: The study's primary purpose is to explore the effects of a school based healthy nutrition intervention on students' learning as regards to healthy nutrition as well as on social and educational environment of schools in disadvantaged areas. The analysis focuses on educators' and school principals' perceptions of the intervention and the meals themselves, as well as their involvement in and attitudes towards the Program. Methods: 136 schools with 23,044 students participated during the 2012-2013 school year in the DIATROFI Program. Every day, all students of the participating schools received a daily healthy meal, designed by nutrition specialists. Informational materials (brochures, leaflets and games) promoting healthy nutrition were distributed to all students and parents, combined with presentations by health promotion specialists. Focus groups methodology was employed. Eligible participants included elementary and junior high school educators and school principals from the participating schools in the intervention program. 20 focus groups were conducted (April-June 2013), 5 each with educators and school principals respectively in elementary schools, and 5 each with educators and school principals respectively in junior high schools. The 10 schools were randomly selected. The sample consisted of 136 participants in total; 40 educators and 33 school principals in elementary schools and 36 educators and 27 school principals in junior high schools. A discussion guide was developed, in relation to perceptions of and attitudes towards the intervention and its effects on the involved actors and the school environment. Analysis of the transcripts was done using the Krueger's method. Results: Educators and school principals emphasized the social benefits of the program for the families in need. They stressed the multiple benefits of the participation of all students, since it generates peer-influence that enhances students' consumption of the mid-day healthy meals, while influencing positively the school-climate. Both school principals and educators pointed out that due to the participation of all students social stigmatization of the students in need was not only avoided but also reduced, while solidarity and collegiality were strengthened. Educators and school principals mentioned that the program is an important step towards the promotion of healthy nutrition that enhances the pedagogical work in schools. Educators in elementary schools stressed out that the healthy mid-day meals were &quot;the theory in practice&quot;, since they complemented lessons concerning healthy nutrition. Junior high schools' educators other than those teaching Home Economics mentioned their lack of knowledge with regards to healthy nutrition. Moreover, they felt insecure to promote healthy eating to adolescents through valid arguments on the benefits of a healthy diet. School principals and educators in elementary and junior high schools stressed out the importance of family in children's healthy eating habits. Both school principals and educators mentioned their need for nutrition education. Especially, educators in elementary schools and teachers in Home Economics in junior high schools expressed their need for further resources to enhance their work on healthy nutrition. Discussion: Overall, the results suggest that the daily provision of a free healthy mid-day meal to all the students of the participating schools in socioeconomic disadvantaged areas, along with actions that promote healthy nutrition, combat child malnutrition and generate learning opportunities that increase the pedagogical work of school. Yet, in order for the full pedagogical potential to be reached, especially with regards to the promotion of healthy nutrition, collaborative efforts of school principals and educators as well as the support of parents are required. Moreover, the provision of nutrition education, training, and resources for both educators and school principals was deemed of great importance for the successful promotion of healthy nutrition to students.