A health promotion intervention on nutrition and physical activity in secondary school students in an urban region

Objective: The aim of this study is to determine the level of knowledge and behaviors of secondary school 7th grade students on nutrition and physical activity, to improve the knowledge, attitudes and behaviors of students through health education and other intervention methods and to evaluate the effect of intervention. Material and Method: This study is an intervention study carried out with 210 seventh grade students, in a control and an intervention school which have similar features in Manisa, in the second half of the academic year 2017-2018. Data were collected with data collection forms prepared for students (72 questions) and parents (38 questions), by scanning the literature by the researcher. The dependent variables of the study are the nutrition knowledge index consisting of 21 questions, the nutrition attitude index consisting of 12 questions, the physical activity knowledge index consisting of 7 questions, the physical activity attitude index consisting of 6 questions and the behavioral variables. Nutritional behavior was evaluated by regular meal consumption, consumption of vegetables, fruits and sugar sweetened drinks. Physical activity behavior was evaluated with adequate physical activity and sedentary behavior. In addition students' height and weight were measured. The intervention methods applied to the students in the intervention school were health education, distribution of family bulletin-hand brochures, inter-class sports competitions, step-aerobic lessons, racecourse races, distribution of pedometers, walking activity and parental education. At the end of the semester, questionnaire and anthropometric measurements were repeated for students. As descriptives, number, percentage, mean, standard deviation, median, minimum and maximum values; in analytical statistics Chi-square test, Fisher's exact test, Student's t test, Mann-Whitney U test, McNemar test, Paired Samples t test and Wilcoxon signed rank test were used. Results: At the beginning of the study, no statistically significant difference was found on other variables between intervention and control groups except the place where lunch was eaten in school days, mode and duration of transportation to school (p>0.05). After the intervention, the knowledge and attitude scores on nutrition and physical activity of the students in the intervention group increased (p<0.05); in the control group, nutritional knowledge score was decreased (p=0.015) and physical activity knowledge and attitudes scores remained similar (p> 0.05). There was no statistically significant change in the nutrition and physical activity behaviors of the students in both groups (p> 0.05). Also, body mass index values were decreased in the intervention group (p=0.009) and no difference was observed in the control group (p=0.762). Conclusion: In this research, it was seen that intervention methods applied to secondary school students for a semester significantly improved their knowledge and attitudes about nutrition and physical activity, decreased body mass index, and were not statistically effective on behavioral variables despite positive changes. Keywords: healthy eating, physical activity, adolescent, intervention, health education