title: Effect of integrated school-based nutrition education on optimal dietary practices and nutritional status of school adolescents in Southwest of Ethiopia: a quasi-experimental study.
abstract: BACKGROUND
  Malnutrition and infection are major barriers to educational access and achievement in low-income countries and also work in conjunction with each other in deteriorating wellness and productivity of school adolescents.
  
  
  METHODS
  A quasi-experimental design was used to evaluate the effectiveness of school-based nutrition education using a peer-led approach, health promotion through school media and health clubs. Data were collected at baseline, midline and end line from sampled participants. To account for the effect of time trend, the difference was measured using a repeated measure analysis. Variables that have p≤0.25 in the bivariate analyses were entered into multivariables to determine the independent effect of interventions.
  
  
  RESULTS
  There is a significant difference in food variety between food secure and insecure households (p<0.01). A significant improvement of animal source dietary intake was observed among intervention schools (p<0.001) that was significantly associated with an intervention [adjusted odds ratio (AOR)=0.26, confidence interval (CI): 0.16, 0.42], male gender (AOR=0.48, CI: 0.31, 0.73) and household economic status (AOR=1.69, CI: 1.01, 2.84). The control group had high body mass index (BMI) at baseline, but a significant improvement was observed among the intervention schools, which positively associated with male gender (AOR=4.13, CI: 2.38, 7.15) and having a middle-income family (AOR=2.93, CI: 1.92, 6.15).
  
  
  CONCLUSIONS
  This study showed that by integrating a dietary intervention into school-based activities, there might be significant improvements in dietary intake of primary school adolescents. Therefore, school-based nutrition education programs should be a part of comprehensive school health programs to reach the students and potentially their families.
authors.affiliation: .
authors.forename: Dessalegn
authors.initials: D
authors.lastname: Tamiru
authors.affiliation: .
authors.forename: Alemayehu
authors.initials: A
authors.lastname: Argaw
authors.affiliation: .
authors.forename: Mulusew
authors.initials: M
authors.lastname: Gerbaba
authors.affiliation: .
authors.forename: Girmay
authors.initials: G
authors.lastname: Ayana
authors.affiliation: .
authors.forename: Aderajew
authors.initials: A
authors.lastname: Nigussie
authors.affiliation: .
authors.forename: Tefera
authors.initials: T
authors.lastname: Belachew
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D004032:Diet; D005002:Ethiopia; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D010379:Peer Group; D012572:School Health Services; D061108:Social Media
keywords: Jimma; adolescent; education; nutrition; school