title: To assess the effects of nutritional intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz.
abstract: BACKGROUND
  The present study was carried out to assess the effects of community nutrition intervention based on advocacy approach on malnutrition status among school-aged children in Shiraz, Iran.
  
  
  METHODS
  This case-control nutritional intervention has been done between 2008 and 2009 on 2897 primary and secondary school boys and girls (7-13 years old) based on advocacy approach in Shiraz, Iran. The project provided nutritious snacks in public schools over a 2-year period along with advocacy oriented actions in order to implement and promote nutritional intervention. For evaluation of effectiveness of the intervention growth monitoring indices of pre- and post-intervention were statistically compared.
  
  
  RESULTS
  The frequency of subjects with body mass index lower than 5% decreased significantly after intervention among girls (P = 0.02). However, there were no significant changes among boys or total population. The mean of all anthropometric indices changed significantly after intervention both among girls and boys as well as in total population. The pre- and post-test education assessment in both groups showed that the student's average knowledge score has been significantly increased from 12.5 ± 3.2 to 16.8 ± 4.3 (P < 0.0001).
  
  
  CONCLUSIONS
  This study demonstrates the potential success and scalability of school feeding programs in Iran. Community nutrition intervention based on the advocacy process model is effective on reducing the prevalence of underweight specifically among female school aged children.
authors.affiliation: HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Joulaei
authors.affiliation: Department of Health Policy and Management, School of Health Sciences, Jackson State University, USA.
authors.forename: Emeka
authors.initials: E
authors.lastname: Nwagwu
authors.affiliation: Fars NIOC, Health Organization, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Aliasghar
authors.initials: A
authors.lastname: Nasihatkon
authors.affiliation: Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Azadbahkt
authors.affiliation: Department of community Nutrition, Deputy for Health, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Razieh
authors.initials: R
authors.lastname: Shenavar
authors.affiliation: Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Keshtkar
authors.affiliation: Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Seyed Mehdi
authors.initials: SM
authors.lastname: Ahmadi
keywords: Malnutrition; public health advocacy; school age children