| Due to nutrition transition, the prevalence of childhood obesity is increasing significantly worldwide especially in affluent developing countries such as Kuwait. Obesity is associated with adverse chronic health conditions and financial burdens which provides an incentive for prevention. The objective of the study was to examine the effectiveness of a multi-component school-based nutrition intervention designed to improve healthy eating knowledge, attitudes, self efficacy and dietary behaviors among fourth and fifth graders in Kuwait. The Let's Eat Smart program was based on the social cognitive theory and used short interactive lessons, DVD sessions, posters, food models and parental letters to promote a healthy lifestyle message among fourth and fifth graders. Let's Eat Smart was delivered to 110 students in the English Playgroup and Primary School. Surveys and 3-day food-records were collected on pre- and post-intervention. Surveys assessed nutrition knowledge, attitudes, dietary behaviors and self efficacy while diet records were analyzed to examined intake of food groups. Additionally, program evolutions were collected on post-intervention. A paired t-test was used to analyze the change from pre- to post-intervention. Eighty four students completed all requirements of the program and were included in the quantitative analysis, while 95 students were included in the qualitative analysis of the program evaluation. After the intervention, students reported high levels of knowledge (p < .0001), positive attitude toward a healthy lifestyle (p < .04) and higher levels of self efficacy toward healthy eating (p < .01). There was no significant change in dietary practices assessed in the survey except for fast food consumption where there was a significant decrease in consumption after the intervention (p < .001). Diet-records analysis showed a significant increase in fruits intake (p < .02) and vegetables intake (p < .001) after the intervention. The overall students' evaluation of the program was positive as 90.5% were satisfied and would like to have more nutrition lessons. Due to its apparent impact on children, Let's Eat Smart is an effective school-based intervention approach to address prevention of childhood obesity in Kuwaiti schools. |
