Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
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School-based nutrition education improves breakfast-related personal influences and behavior of Indonesian adolescents: a cluster randomized controlled study

  • Indriasari, Rahayu (Department of Nutrition Science, Faculty of Public Health, Hasanuddin University) ;
  • Nadjamuddin, Ulfah (Department of Nutrition Science, Faculty of Public Health, Hasanuddin University) ;
  • Arsyad, Dian Sidik (Department of Epidemiology, Faculty of Public Health, Hasanuddin University) ;
  • Iswarawanti, Dwi Nastiti (Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia)
  • Received : 2019.12.20
  • Accepted : 2020.09.23
  • Published : 2021.10.01
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Abstract

BACKGROUND/OBJECTIVES: Many adolescents in developing countries skip breakfast. Innovative nutrition education (NE) strategies are needed to enhance knowledge and skills related to the breakfasts of adolescents in a low socioeconomic setting. The objective was to evaluate short- and long-term effects of a multi-strategy, school-based NE intervention on adolescents' breakfast-related personal influences and behaviors. SUBJECTS/METHODS: An intervention study with a cluster randomized controlled trial design was conducted in 4 senior high schools in Makassar, Indonesia. The multi-strategy NE intervention was delivered for 3 months. Data were collected using a self-administered questionnaire and a 3-day breakfast recall (face-to-face interview). Wilcoxon, McNemar, and Mann-Whitney tests were used to determine intra- and intergroup differences. RESULTS: Unlike knowledge, improvement was observed in attitude and self-efficacy scores in the intervention groups (IGs) (P < 0.01); however, no significant changes were observed in the control group (CG). More students showed improved motivation in the IG than in the CG (P > 0.05). Changes in breakfast frequency and macronutrient intake from breakfast were greater in the IG than in the CG (P < 0.05). CONCLUSIONS: A multi-strategy NE intervention is effective in producing positive changes in breakfast-related attitude, self-efficacy, and motivation of adolescents from a low-middle socioeconomic setting. The intervention improved breakfast frequency and nutrient intake. This intervention has promise for sustaining the observed changes over the long-term.

Keywords

Acknowledgement

This research was funded by grants from Indonesian Ministry of Education and Culture through Southeast Asian Minister of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional (PKGR) Universitas Indonesia (055F/RECFON-SK/III/2017).

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