Multicomponent intervention on adherence to school meals: results from a quasi-experimental study

This study aimed to verify the impact of a multicomponent intervention on adherence to school meals. This is a quasi-experimental study, conducted during 2019 with students from 4th to 9th grade of three public schools in the rural area of Sumidouro, Rio de Janeiro, Brazil: i) control group, ii) experimental group 1 (environmental modifications and addition of a self-service system) and iii) experimental group 2 (environmental modifications, addition of a self-service system and new culinary preparations in the menu based on gastronomic techniques). The weekly frequency of school meals consumption was assessed by a question included in a self-completed questionnaire applied at three moments (baseline, 1st follow-up [after 5 months of intervention], and 2nd follow-up [after 8 months of intervention]). Students who reported a frequency of consumption of≥3 times a week were considered adherent to school meals, as defined by the Brazilian Institute of Geography and Statistics in national surveys carried out with schoolchildren. The variation rate in adherence to school meals in each school was evaluated via generalized linear models. An increase in adherence was observed in participants from experimental group 2 throughout the follow-up period (RR = 1.14; p = .03), going from 60.7% at baseline to 68% at the end of the study, and reduced adherence among participants in the control group (RR = 0.88; p = .02), going from 73.9% to 64.1%. Variation in adherence was different between experimental groups 1 and 2, in relation to the control group (RR = 1.20; p = .02 and RR = 1.30; p < .001, respectively). Interventions based on environmental changes combined with implementing gastronomic techniques in the menu increased adherence to school meals.