背景:学校饮食环境是儿童和青少年营养的关键界面,并且需要了解有关加拿大学校食物环境的现有文献,以确定公平差距和机会,并授权决策者计划未来的行动。
目的:关于加拿大学校食品和营养干预的文献,政策,programs,并对其对饮食和营养状况的影响进行了综合评价。
方法:为使用的每个数据库开发了搜索策略(Medline,Embase,PsycINFO,ERIC,Cochrane协作,加拿大电子图书馆,BiblioMap),结合自由文本和受控词汇,对于1990年至2021年发表的文章。还搜索了未发表的数据和灰色文献。
方法:采用观察性或干预性研究设计的定量和定性研究,reviews,或在加拿大学校进行的项目评估,参与者年龄在5-19.9岁之间。2名研究者使用标准化工具独立提取关键研究特征和偏倚风险。
方法:共纳入298篇文章(n=192篇同行评议,106篇来自灰色文献)。主要在安大略省进行(n=52),不列颠哥伦比亚省(n=43),和新斯科舍省(n=28)。二十四项干预措施,5个未评估的项目,1项政策涉及土著居民。总的来说,86篇文章衡量和报告了有效性结果,包括膳食摄入;人体测量学;知识,态度,和实践;和身体活动。文献在很大程度上仍然是异质的,主要集中在使用主观评估来推断营养变化的营养教育计划上。实施和可持续性的关键促进者是社区参与,而关键障碍是员工能力,获得资源和资金,始终如一的领导。
结论:这篇综述提供了对加拿大学校食品和营养干预措施的见解,programs,和政策,并发现重要的证据差距,需要仔细审查,以便将来进行评估。各国政府必须创造支持性环境,通过公平的政策和方案优化儿童和青少年的营养。
背景:PROSPERO注册号。CRD42022303255。
BACKGROUND: The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action.
OBJECTIVE: Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review.
METHODS: A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched.
METHODS: Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool.
METHODS: A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership.
CONCLUSIONS: This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs.
BACKGROUND: PROSPERO registration no. CRD42022303255.