Nutritional Education Intervention And Effect Evaluation Of Migrant Children Aged 9-12y In A Primary School In Wuhan City

Objective: The purpose of this study is to improve the nutritional knowledge level of 9-12year-old migrant children and their caregivers of third-to-sixth grade in a primary school in Wuhan city,and to establish a correct nutritional health concept and form a good dietary behavior.The present study could provide a scientific basis for improving the nutritional health of the children.Methods: A baseline survey was conducted on all students and caregivers of third-to-sixth grade in a primary school with a high proportion of migrant children in Wuhan in March2017.The content includes physical examination and dietary survey of children(24-hour dietary review method),children and their caregiver’s nutrition KAP(knowledge,attitude,behavior)survey,then stratified random sampling was used to select 8 classes in each of the intervention group and the control group.Intervention methods for children mainly included nutrition education courses and knowledge lectures.The intervention for caregivers mainly included distributing nutrition materials through the head teachers,pushing nutrition knowledge in the class group and giving nutrition knowledge lectures.The intervention activities continued for 2 months,then data was collected after the intervention including children’s dietary surveys,nutrition KAP questionnaires for children and caregivers.The database was established using Epidata3.0 and Excel tables,and SPSS25.0 was used for statistical analysis.The data of migrant children and caregivers were extracted as the research object of this study.The dietary intake of migrant children before and after intervention and between the intervention group and the control group was compared,as well as differences in the nutritional KAP status of migrant children and caregivers.Results: This study investigated a total of 218 migrant children and 196 caregivers in the intervention group;222 migrant children and 181 caregivers in the control group.There were no differences in the sociodemographic characteristics between two groups before the intervention.(1)In the part of KAP of migrant children: the average knowledge score of the intervention group after the intervention was 8.69±1.67,which was higher than that before the intervention(8.05±1.67)(P <0.001)and that of the control group after the intervention(7.84 ± 1.96,P <0.001);the children in the intervention group after the intervention The rate of willingness to acquire nutritional knowledge was 91.3% after the intervention,which was higher than that before the intervention(83.5%,P = 0.002),andhigher than that of the control group after intervention(84.1%,P = 0.004).In terms of children’s picky eating,the proportion of children’s picky eating after intervention in the intervention group(47.7%)was lower than that before the intervention(59.2%,P <0.001),and lower than that of the control group after the intervention(59.9%,P <0.001).(2)In the part of KAP of caregivers: the average value of the nutritional knowledge score of caregivers in the intervention group after intervention was 19.73 ± 5.64,which was higher than that before the intervention(18.52±5.72,P <0.001),and higher than that of the control group after the intervention(19.04±5.59,P <0.001).(3)In terms of dietary intake of children: the intakes of energy,three major macronutrients,calcium,vitamin A,and vitamin C in the intervention group after intervention were higher than that before the intervention,the differences were statistically significant.(P <0.001);in terms of dietary structure,the food intakes of cereals and miscellaneous beans,vegetables,livestock and poultry meat,eggs,soybeans and dairy products in the intervention group after intervention were higher than that before the intervention and that of the control group after the intervention(P <0.001).(4)Analysis of influencing factors: the analysis about the nutritional intervention effect of children and caregivers with different characteristics of the intervention group showed that age and gender were the main factors affecting the intervention effect of children’s nutritional knowledge scores,while caregiver status,age,parental education level were important factors affecting the intervention effect of the knowledge score of caregivers.Multivariate analysis showed that the effects of children’s age and gender on the intervention of nutritional total scores were statistically significant(P<0.05).Conclusion: Nutritional education interventions have significantly improved the nutritional knowledge of the migrant children and their caregivers,the nutrition-related attitudes and behaviors have improved too,but there is still much room for improvement.In terms of nutrient intake status,the energy,protein,and carbohydrate compliance rates have increased significantly after intervention,but the phenomenon of severely insufficient intake of some micronutrients still exists.After the intervention,the food compliance rate of most diet types also increased.Nutritional status improvement is a process that requires long-term persistence.The short-term nutrition education interventions in this study have limited effects,but there is still a certain degree of improvement in the nutritional KAP and dietary status of children in the present study.