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      School Lunch Programs and Nutritional Education Improve Knowledge, Attitudes, and Practices and Reduce the Prevalence of Anemia: A Pre-Post Intervention Study in an Indonesian Islamic Boarding School

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      Nutrients
      MDPI AG

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          Abstract

          Indonesians face serious health issues that arise from malnutrition, particularly in children who are under unfavorable dietary environments. The present study established a school meal program consisting of dietary and educational interventions and evaluated its impact on promoting continuous improvement in dietary behavior among junior and senior high school students in Indonesia. A total of 319 students belonging to an Islamic Boarding School participated in the pre-post intervention study for 9 months. All participants were assessed based on their Knowledge, Attitude, and Practice (KAP). A subgroup of 115 participants who were anemic and underweight was examined for dietary intake, nutrition status, and hemoglobin level. The KAP test scores for both nutrition and hygiene showed a significant increase for all students and the undernutrition group post-intervention. Protein, iron, and vitamin C intake significantly improved. Although there were no significant improvements in nutrition status, there was a significant increase in the hemoglobin level and a reduction in the prevalence of anemia from 42.6% to 21.7%. Thus, school meal program that combines dietary and educational interventions may effectively improve anemia in undernourished students as well as enhance the knowledge, attitudes, and practices related to health, nutrition, and hygiene in junior and senior high school students.

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          Effect of a school-based nutrition education program on adolescents’ nutrition-related knowledge, attitudes and behaviour in rural areas of China

          This study aimed at examining the effect of the nutrition education program on adolescents' knowledge, attitudes and behaviour in relation to nutrition in rural China.
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            Knowledge, attitude, and practice of healthcare professionals toward clinically applying graduated compression stockings: results of a Chinese web-based survey

            This study had three objectives: (1) to investigate healthcare professionals’ knowledge, attitude, and practice toward clinically applying graduated compression stockings, (2) to analyze the influencing factors, and (3) to provide data to support departments that develop health policies. A self-administered web-based survey was completed by 1,444 healthcare professionals, including physicians and nurses from 15tertiary hospitals and four secondary hospitals from 10 provinces in China. Reliability analysis and exploratory factor analysis were used to evaluate the researcher-designed questionnaire’s reliability and validity. The formal questionnaire, which included demographic data (eight items), knowledge (ten items), attitudes (four items), and clinical practice patterns (six items), was distributed among healthcare professionals. The relationships and mechanisms among the variables were explored using descriptive statistical analysis, Pearson’s correlation coefficients, and multiple linear regression analysis. Of the 1,444 respondents, 31.2% had good knowledge of clinically applying graduated compression stockings, 83.5% had a positive attitude toward clinically applying them, and 30.4% of respondents exhibited normative behavior when applying them. The multiple linear regression analysis indicated that training was an important factor influencing the knowledge, attitude, and practice toward clinically applying graduated compression stockings. The healthcare professionals’ attitude toward clinically applying graduated compression stockings was positive, but the related knowledge was poor, and the code of behavior was deficient. Medical institutions should improve training for clinically applying graduated compression stockings among healthcare professionals and standardize the use of graduated compression stockings to facilitate the prevention of hospital-acquired venous thromboembolism.
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              Impacts of school feeding on educational and health outcomes of school-age children and adolescents in low- and middle-income countries: A systematic review and meta-analysis

              Background School feeding programs are ubiquitous in low- and middle-income countries (LMICs) and may have critical implications for the health and education of school-age children and adolescents. This systematic review aimed to assess the impacts of school feeding on educational and health outcomes of children and adolescents in LMICs. Methods Interventional studies on the effects of school feeding on nutritional and health outcomes of children and adolescents receiving primary or secondary education in LMICs were included. MEDLINE, EMBASE, CINAHL, the Cochrane Library, and grey literature were searched (through December 2019) to identify eligible studies. We included randomized controlled trials and controlled before-after studies on school feeding conducted in LMICs among children and adolescents aged 6 to 19 who received primary or secondary education. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment. Meta-analyses were performed for outcomes available in three or more independent studies. Subgroup analyses were conducted by study design and school feeding modality whenever possible. Results Fifty-seven articles met the inclusion criteria for the review, including 44 randomized controlled trials and 13 controlled before-after studies; 19 articles were included in the meta-analysis. School feeding resulted in a significant increase in height (mean difference = 0.32 cm; confidence interval (CI) = 0.03, 0.61; P = 0.032) and weight (mean difference: 0.58 kg; 95% 95% CI = 0.22, 0.93; P = 0.001) over 12 months, compared to those in the control groups. School feeding also resulted in a significant increase in the percentage of school days attended (2.6%; 95% CI = 1.2%, 3.9%; P < 0.001). Conclusions School feeding is an important approach to improving the health and education outcomes of children and adolescents living in LMICs. More well-designed research is needed to establish further the effectiveness of school feeding for nutritional outcomes and academic achievement. Registration PROSPERO ID: CRD42020159003.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                NUTRHU
                Nutrients
                Nutrients
                MDPI AG
                2072-6643
                February 2023
                February 20 2023
                : 15
                : 4
                : 1055
                Article
                10.3390/nu15041055
                9962024
                36839412
                ce65740a-5999-47a6-a3e2-51845f1aeb9c
                © 2023

                https://creativecommons.org/licenses/by/4.0/

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