TY - JOUR AU - Wyse, Rebecca AU - Delaney, Tessa AU - Stacey, Fiona AU - Zoetemeyer, Rachel AU - Lecathelinais, Christophe AU - Lamont, Hannah AU - Ball, Kylie AU - Campbell, Karen AU - Rissel, Chris AU - Attia, John AU - Wiggers, John AU - young, Sze Lin AU - Oldmeadow, Christopher AU - Sutherland, Rachel AU - Nathan, Nicole AU - Reilly, Kathryn AU - wolenden，Luke PY - 2021 DA - 201/9/7 TI -多策略行为干预提高小学生网络食堂午餐订单营养质量的有效性(点击& Crunch):JO - J Med Internet Res SP - e26054 VL - 23 IS - 9kw -助推KW -选择架构KW -干预KW -在线食堂KW -在线点菜系统KW -数字干预KW -学校儿童KW -学校食品服务KW -食堂KW -菜单标签AB -背景:学校食品网点代表公共卫生营养干预的关键设置。最近网络订餐系统的普及为支持从学校购买健康食品提供了一个独特的机会。在这些常规使用的系统中嵌入基于证据的选择架构策略提供了同时影响许多用户购买决策的机会，并值得进行调查。目的:本研究旨在评估通过网络学校食堂午餐订餐系统实施的多策略行为干预在降低小学生网络午餐订餐中能量、饱和脂肪、糖和钠含量方面的有效性。方法:本研究采用平行组、队列、聚类随机对照试验设计，选取澳大利亚17所小学的2207名学生。采用基于网络的食堂午餐订购系统的学校被随机分配接受多策略行为干预，其中包括嵌入在网络系统中的选择架构策略(n=9所学校)或仅采用标准的网络订购系统(n=8所对照学校)。在基线(2018年第2学期)和12个月后(2019年第2学期)自动收集的学生购买数据用于评估试验结果。主要试验结果包括学生午餐订单的平均能量(kJ)、饱和脂肪(g)、糖(g)和钠(mg)含量。 Secondary outcomes included the proportion of all web-based lunch order items classified as everyday, occasional, and caution (based on the New South Wales Healthy School Canteen Strategy) and canteen revenue. Results: From baseline to follow-up, the intervention lunch orders had significantly lower energy content (−69.4 kJ, 95% CI −119.6 to −19.1; P=.01) and saturated fat content (−0.6 g, 95% CI −0.9 to −0.4; P<.001) than the control lunch orders, but they did not have significantly lower sugar or sodium content. There was also a small significant between-group difference in the percentage of energy from saturated fat (−0.9%, 95% CI −1.4% to −0.5%; P<.001) but not in the percentage of energy from sugar (+1.1%, 95% CI 0.2% to 1.9%; P=.02). Relative to control schools, intervention schools had significantly greater odds of having everyday items purchased (odds ratio [OR] 1.7, 95% CI 1.5-2.0; P<.001), corresponding to a 9.8% increase in everyday items, and lower odds of having occasional items purchased (OR 0.7, 95% CI 0.6-0.8; P<.001), corresponding to a 7.7% decrease in occasional items); however, there was no change in the odds of having caution (least healthy) items purchased (OR 0.8, 95% CI 0.7-1.0; P=.05). Furthermore, there was no change in schools’ revenue between groups. Conclusions: Given the evidence of small statistically significant improvements in the energy and saturated fat content, acceptability, and wide reach, this intervention has the potential to influence dietary choices at a population level, and further research is warranted to determine its impact when implemented at scale. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12618000855224; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375075. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2019-030538 SN - 1438-8871 UR - //www.mybigtv.com/2021/9/e26054 UR - https://doi.org/10.2196/26054 UR - http://www.ncbi.nlm.nih.gov/pubmed/34491207 DO - 10.2196/26054 ID - info:doi/10.2196/26054 ER -