title: The implementation and effectiveness of school-based nutrition promotion programmes using a health-promoting schools approach: a systematic review.
abstract: OBJECTIVE
  To evaluate implementation and effectiveness of nutrition promotion programmes using the health-promoting schools (HPS) approach, to indicate areas where further research is needed and to make recommendations for practice in this field.
  
  
  METHODS
  The searched electronic databases included: CINAHL, Cochrane Library, Health Reference Center, Informit Search, MEDLINE, ProQuest, PsycINFO, PubMed, ScienceDirect, Scopus, Social Services Abstracts and Web of Science. Inclusion criteria were: (i) controlled or before-and-after studies evaluating a nutrition intervention and involving the HPS approach, either fully or in part; (ii) provision of information about components and delivery of the intervention; and (iii) report on all evaluated outcomes.
  
  
  METHODS
  Schools.
  
  
  METHODS
  Students, parents and school staff.
  
  
  RESULTS
  All included studies described intervention delivery and six reported on process evaluation. In intervention schools school environment and ethos were more supportive, appropriate curriculum was delivered and parents and/or the community were more engaged and involved. Students participated in interventions at differing levels, but the majority was satisfied with the intervention. The evidence indicates that nutrition promotion programmes using the HPS approach can increase participants' consumption of high-fibre foods, healthier snacks, water, milk, fruit and vegetables. It can also reduce participants' 'breakfast skipping', as well as reduce intakes of red food, low-nutrient dense foods, fatty and cream foods, sweet drinks consumption and eating disorders. It can help to develop hygienic habits and improved food safety behaviours.
  
  
  CONCLUSIONS
  More professional training for teachers in the HPS approach, further qualitative studies, longer intervention periods, improved follow-up evaluations and adequate funding are required for future school-based nutrition promotion programmes.
authors: School of Public Health, Griffith Graduate Centre, South Bank Campus, Griffith University, PO Box 3370, 226 Grey Street, South Bank, South Brisbane, QLD 4101, Australia. dongxu.wang2@griffithuni.edu.au
authors: Dongxu
authors: D
authors: Wang
authors: Donald
authors: D
authors: Stewart
mesh_terms: D003258:Consumer Behavior; D003479:Curriculum; D004032:Diet; D005247:Feeding Behavior; D005518:Food Preferences; D015438:Health Behavior; D006293:Health Promotion / Q000592:standards*; D006801:Humans; D015397:Program Evaluation; D012572:School Health Services; D012574:Schools; D012944:Social Support