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Multicomponent intervention on adherence to school meals: results from a quasi-experimental study
Rafael Lavourinha Pinto1, Valéria Troncoso Baltar2, Bárbara da Silva Nalin de Souza3
1Department of Epidemiology, Hesio Cordeiro Social Medicine Institute, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil.
Appetite
|April 22, 2026
Summary
Implementing environmental changes and culinary improvements in school meals significantly boosted student adherence. This intervention increased meal consumption frequency among students, demonstrating the effectiveness of a multicomponent approach.
Area of Science:
- Nutrition Science
- Public Health
- Educational Interventions
Background:
- School meal programs are crucial for student nutrition.
- Adherence to school meals can be influenced by various factors.
- Previous interventions have shown mixed results in improving school meal consumption.
Purpose of the Study:
- To evaluate the impact of a multicomponent intervention on school meal adherence.
- To compare the effectiveness of environmental modifications versus combined environmental and culinary interventions.
- To assess changes in school meal consumption frequency among students.
Main Methods:
- A quasi-experimental study involving three groups: control, environmental modifications with self-service, and environmental modifications with self-service and new culinary preparations.
- Data collected via self-completed questionnaires at baseline, 5 months, and 8 months.
- Generalized linear models used to analyze adherence variation rates.
Main Results:
- Experimental group 2 (environmental and culinary changes) showed increased adherence (RR = 1.14, p = .03).
- The control group exhibited reduced adherence (RR = 0.88, p = .02).
- Both experimental groups showed significantly different adherence variations compared to the control group (RR = 1.20, p = .02 and RR = 1.30, p < .001).
Conclusions:
- Multicomponent interventions combining environmental changes and gastronomic techniques effectively increase school meal adherence.
- Menu innovation and appealing culinary preparations are key to improving student engagement with school meals.
- Targeted environmental and menu strategies can positively impact school nutrition programs.
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