Kathelijne Bessems

Appreciation and implementation of the Krachtvoer healthy diet promotion programme for 12- to 14- year-old students of prevocational schools

BackgroundKrachtvoer is a school-based healthy diet programme, developed in 2001 and revised in 2007 to meet the needs of particular segments of the target population as well as a wider target group. The main aims of the present process evaluation of the revised programme were to examine student and teacher appreciation of the programme, completeness of and adherence to its implementation, and relations between appreciation and completeness of implementation.MethodsData were collected among 22 teachers and 1117 students of 13 schools, using student evaluation forms, teacher logbooks, telephone interviews, and classroom observations.ResultsResults indicate favourable levels of teacher and student appreciation for the programme in general and the revised elements. Girls, first-year students and students with more favourable dietary intakes particularly appreciated individual programme elements. Levels of completeness of implementation were high, but several teachers did not adhere to the intended implementation period. Some moderately strong relations were found between teacher appreciation and completeness of implementation scores.ConclusionWe conclude that the revisions have resulted in a programme that was appreciated well, also by the extended target group, and was implemented with a high degree of completeness. Teacher appreciation proved potentially important for completeness of implementation. We identified several aspects requiring improvement, indicating the importance of continued programme updates and repeated evaluation.

Healthier food choices as a result of the revised healthy diet programme Krachtvoer for students of prevocational schools

BackgroundKrachtvoer is a Dutch healthy diet programme for prevocational schools, developed in 2001 and revised for a broader target group in 2007, based on the findings of an evaluation of the first version. The goal of this study was to report on the short- and longer-term total and subgroup effects of the revised programme on students’ fruit, fruit juice, breakfast, and snack consumption.MethodsSchools were randomized to the experimental condition, teaching the Krachtvoer programme, or to the control condition teaching the regular nutrition lessons. Self-reported consumption of fruit, fruit juice, breakfast and snacks was measured at baseline directly before programme implementation, one to four weeks after finishing programme implementation, and after six months. Mixed linear and logistic regression analyses were conducted.ResultsIn total 1117 students of 13 experimental schools and 758 students of 11 control schools participated in the study. Short- and longer-term favourable intervention effects were found on fruit consumption (mean difference between experimental and control group 0.15 servings at both posttests). Regarding fruit juice consumption, only short-term favourable effects were revealed (mean difference between experimental and control group 0.05 glasses). Intervention effects on breakfast intakes were limited. No changes in snack frequency were reported, but students made healthier snack choices as a result of the programme. Some favourable as well as unfavourable effects occurred in subgroups of students.ConclusionsThe effects on fruit consumption and snack choices justify the current nationwide dissemination of the programme. Achieving changes in breakfast consumption may, however, require other strategies.

Examining the relationship between completeness of teachers' implementation of the Krachtvoer healthy diet programme and changes in students' dietary intakes.

OBJECTIVE The goal of the current study was to examine if the completeness of programme implementation and the completeness of implementation of specific programme elements of the Dutch school-based healthy diet promotion programme Krachtvoer are related to short- and longer-term changes in students’ fruit, sweets and breakfast intakes. DESIGN Data on students’ dietary intakes were collected 1–4 weeks and 6 months after programme implementation. Teachers filled in a logbook on programme implementation after each lesson. The relationships between changes in students’ dietary intakes and completeness of implementation of the programme and of specific programme elements were tested using mixed linear regression analyses. SETTING Thirteen Dutch prevocational schools. SUBJECTS Eight hundred and seventy-six of the 1117 participating students and eighteen of the twenty-two participating teachers. RESULTS Completeness of programme implementation was positively related to an increase in fruit consumption in the short term. Completeness of implementation of food exposure activities and a practical lesson on advertisements were related to an increase in fruit consumption in the short as well as the longer term. No such relationships were found for sweets and breakfast consumption. CONCLUSIONS Our results indicate that efforts should be made to help teachers implement the programme as fully as possible.

Restrictive rules of Dutch mothers regarding their children's dietary intake between meals

The use of restrictive food rules by parents has been found to be associated with dietary intake in their children. The aim of this study was to explore the use of restrictive rules of Dutch mothers regarding their childs food intake between main meals in detail, to generate necessary input for setting priorities for further research and intervention development. A cross-sectional questionnaire study on nine restrictive rules was completed by 359 mothers of primary school children aged 4-12years. Mothers reported to use an average of 4.1 (SD 2.1) out of nine restrictive food rules and all rules measured in this study were used. The rules mothers reported to use most were not eating shortly before meals, not eating certain foods too often and not eating too much of certain foods. The rules varied according to different foods, but particularly applied to the intake of potato chips, nuts and savory snacks, candy and chocolate. Mothers of a younger age, lower educated mothers and mothers with a higher BMI were less likely to use (certain) restrictive rules. This study showed that mothers use a large variety of rules, particularly to restrict the intake of unhealthy foods and reported on several subgroups that were less likely to use (certain) rules. Our results direct further research and inform the development of interventions.

Evaluatie van een online actieplanprogramma over fruit, ontbijt en tussendoortjes voor leerlingen van het VMBO

AbstractEvaluation of an online action planning program on fruit, breakfast and snack consumption for students of prevocational schools To turn behavioral change intentions into actual behavioral change, an online action plan program about fruit, snacks and breakfast intake was developed for the Krachtvoer program for prevocational school students. This paper describes the content of the action planning program and the results of an evaluation study among 539 students concerning the usage of the program and implementation of action plans in practice. Further, program appreciation by teachers and students was assessed. More than 64% of the students completed at least two program modules and 61% made an action plan. About 34% of the student who had prepared an online plan, reported to have implemented the plan successfully in practice, while 65% was partly successful. Program appreciation among students was satisfactory, appreciation among teachers was good. Using pre-structured online action plans seems to work well. The implementation of this postmotivational program element should always be part of a larger program in which elements aimed at changing the premotivational phase of behavior change are included as well.