Healthy Kitchens, Healthy Children: the impact of linking community kitchens to a school food program on children's diet diversity, nutritional status and school performance
| ISRCTN | ISRCTN15931286 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN15931286 |
| Secondary identifying numbers | A 102829 -P 22047 |
- Submission date
- 25/09/2018
- Registration date
- 22/10/2018
- Last edited
- 25/04/2022
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Palestinian refugee children in Lebanon attend schools run by the UN Relief Works Agency for Palestine Refugees (UNRWA). Most schools have a small private food seller selling packaged foods inside the school, with products generally high in fat, sugar and salt. The aim of this study was to investigate the effect of the offering of a subsidised healthy daily school meal at these schools on diet diversity, nutritional status, school attendance and school performance of children.
Who can participate?
Children aged 6 years or older, attending one of four selected elementary schools in two Palestinian camps in Beirut. Children were asked to declare any food allergies they may have in advance of participation.
What does the study involve?
Children attending two intervention schools were offered the option of purchasing a subsidised healthy school meal on a daily basis, in addition to receiving nutrition and health education sessions. Children attending two control schools were offered nutrition and health education sessions only.
What are the possible benefits and risks of participating?
Possible benefits of participating include a potentially improved school meal, and therefore nutrition for children. There are no known risks to participants taking part in this study. Risks of food-borne illness were mitigated by ensuring rigorous food safety standards for the program. Risks of allergies were mitigated by ensuring that children declared allergies in advance.
Where is the study run from?
The study is run from the Center for Research on Population and Health at the American University of Beirut and four schools in two Palestinian camps in Lebanon will participate
When is the study starting and how long is it expected to run for?
September 2013 to December 2017
Who is funding the study?
The Nestle Foundation for the Study of Problems of Nutrition in the World (Switzerland)
Who is the main contact?
Dr Hala Ghattas
hg15@aub.edu.lb
Contact information
Scientific
American University of Beirut
PO Box 11-0236/EPHD, Riad El Solh
Beirut
1107 2020
Lebanon
| Phone | +961 1 350 000 Ext 4679 |
|---|---|
| hg15@aub.edu.lb |
Study information
| Study design | Interventional non-randomised study |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Non randomised study |
| Study setting(s) | School |
| Study type | Other |
| Participant information sheet | Not available in web format, please contact Hala Ghattas (hg15@aub.edu.lb) to request a participant information sheet |
| Scientific title | Healthy Kitchens, Healthy Children: a community-based intervention linking community kitchens to a school food program - the Healthy Children component |
| Study acronym | Healthy Kitchens, Healthy Children- Children's study (HKHC-C) |
| Study objectives | This study aimed to investigate the effect of a two-pronged intervention that employed women through social enterprises (Healthy Kitchens) to deliver a subsidised healthy daily school meal to elementary schoolchildren in Palestinian camps (Healthy Children). We hypothesised that children participating in the Healthy children component of the intervention would have improved dietary diversity, nutritional status, school absenteeism and educational achievements. |
| Ethics approval(s) | 1. American University of Beirut Social and Behavioral Sciences Institutional Review Board (AUB SBS IRB), 20/12/2013, ref: FHS.HG.01 / FHS.HG.02 2. University of Maryland Institutional Review Board (UMD IRB), 02/12/2013, ref: 535188-1 |
| Health condition(s) or problem(s) studied | Children's diet diversity and nutritional status |
| Intervention | This study, Healthy Children, is a component of a wider study called Healthy Kitchens, Healthy Children. The Healthy Schools component is an 8 month, non-randomised school-based intervention, where 2 schools are allocated to receive the intervention and 2 neighbouring schools are allocated to the control group. Intervention schools received a series of 4 interactive health and nutrition classes, and a daily health subsidised snack, made by the women in the Healthy Kitchens component (covering 15% of children's energy requirements and over 30% of iron, folate and Vitamin A requirements), which children purchased at a cost of 0.25 USD/day. Children in the control group received the 4 interactive health and nutrition classes only. |
| Intervention type | Other |
| Primary outcome measure | Schoolchildren’s diet diversity assessed using the Diet Diversity Score (DDS) at the baseline and after 8 months |
| Secondary outcome measures | The following are assessed at the baseline and after 8 months: 1. Nutritional status, assessed by measuring height and weight and recording age and calculating indices such as height-for-age Z-score and BMI-for-age Z-score 2. Haemoglobin, assessed using a Hemocue 3. School absence, assessed by the number of school days missed between the baseline and the end of the study 4. Educational outcomes, including final language and maths grades |
| Overall study start date | 01/09/2013 |
| Completion date | 01/12/2017 |
Eligibility
| Participant type(s) | Other |
|---|---|
| Age group | Child |
| Lower age limit | 6 Years |
| Sex | Both |
| Target number of participants | Between 1200-1500 (at least 300 children in each school) |
| Total final enrolment | 1362 |
| Key inclusion criteria | 1. Child aged over 6 years 2. Registered student in one of four specified UNRWA schools |
| Key exclusion criteria | None - children were asked to declare any food allergies they might have |
| Date of first enrolment | 04/06/2014 |
| Date of final enrolment | 31/05/2016 |
Locations
Countries of recruitment
- Lebanon
Study participating centre
American University of Beirut
Bliss Street
Hamra
Beirut
1107 2020
Lebanon
Sponsor information
Research organisation
Place de la Gare 4 - PO Box 581
Lausanne
CH-1001
Switzerland
| Website | http://www.nestlefoundation.org/e/about.html |
|---|---|
"ROR" |
https://ror.org/021k07d19 |
Funders
Funder type
Research organisation
No information available
Results and Publications
| Intention to publish date | 01/01/2019 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not expected to be made available |
| Publication and dissemination plan | Data and results of the study have been presented at four conferences; some resulting in published abstracts. We have prepared the following for publication: 1. Presenting the protocol and process evaluation of the intervention 2. Presenting the outcomes of the Healthy Children (children's component) of the study 3. Using data from the study, we validated a child food security tool |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are not expected to be made available due to the fact that studies were conducted with vulnerable refugee populations, and data transfer agreements with the collaborating organisations restrict our ability to share these data with third parties. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Abstract results | results presented at 21st International Congress of Nutrition | 01/01/2017 | No | No | |
| Abstract results | results presented at Experimental Biology, Chicago, | 01/04/2017 | No | No | |
| Other publications | Process evaluation | 22/11/2019 | 25/04/2022 | Yes | No |
| Results article | 24/11/2020 | 25/04/2022 | Yes | No |
Editorial Notes
02/11/2018: Internal review.
