TY - JOUR AU - Wyse, Rebecca AU - Delaney, Tessa AU - Stacey, Fiona AU - Lecathelinais, Christophe AU - Ball, Kylie AU - Zoetemeyer, Rachel AU - Lamont, Hannah AU - Sutherland, Rachel AU - Nathan, Nicole AU - Wiggers, John H AU - Wolfenden, Luke PY - 2021 DA - 2021/11/29 TI -多策略行为干预提高小学学生在线午餐营养质量的长期有效性:18个月的随访的点击和紧缩集群随机对照试验乔- J地中海互联网Res SP - e31734六世- 23 - 11千瓦孩子饮食KW——消费者行为KW -干预KW -个随机对照试验KW -公共卫生营养KW -肥胖KW -学校KW -学校食堂KW -长期随访KW -选择架构KW -公共卫生KW -营养KW -儿童KW -饮食KW -电子健康KW -学校午餐AB -背景:学校的食品服务，包括自助餐厅和食堂，是改善儿童营养的理想场所。在线食堂点餐系统越来越普遍，提供了独特的机会来传递选择架构策略，促使用户选择更健康的食品。尽管有短期有效性的证据，但很少有证据表明选择架构干预的长期有效性，特别是那些在线交付的。目的:本研究确定在现有的在线学校午餐订购系统中嵌入多策略行为干预(点击& Crunch)对基线后18个月小学生午餐订购的能量、饱和脂肪、糖和钠含量的长期有效性。方法:该集群随机对照试验(RCT)包括来自澳大利亚新南威尔士州17所学校的2207名学生(5-12岁)。学校随机接受多策略行为干预或对照(通常仅在线订购)。干预策略持续14-16.5个月，直至随访数据收集结束。试验主要结果(即，学生在线午餐订单的平均总能量、饱和脂肪、糖和钠含量)和次要结果(即，在线午餐订单中被分类为日常、偶尔和谨慎的项目的比例)在8周的基线期间和18个月的随访期间进行评估。 Results: In all, 16 schools (94%) participated in the 18-month follow-up. Over time, from baseline to follow-up, relative to control orders, intervention orders had significantly lower energy (–74.1 kJ; 95% CI [–124.7, –23.4]; P=.006) and saturated fat (–0.4 g; 95% CI [–0.7, –0.1]; P=.003) but no significant differences in sugar or sodium content. Relative to control schools, the odds of purchasing everyday items increased significantly (odds ratio [OR] 1.2; 95% CI [1.1, 1.4]; P=.009, corresponding to a +3.8% change) and the odds of purchasing caution items significantly decreased among intervention schools (OR 0.7, 95% CI [0.6, 0.9]; P=.002, corresponding to a –2.6% change). There was no between-group difference over time in canteen revenue. Conclusions: This is the first study to investigate the sustained effect of a choice architecture intervention delivered via an online canteen ordering systems in schools. The findings suggest that there are intervention effects up to 18-months postbaseline in terms of decreased energy and saturated fat content and changes in the relative proportions of healthy and unhealthy food purchased for student lunches. As such, this intervention approach may hold promise as a population health behavior change strategy within schools and may have implications for the use of online food-ordering systems more generally; however, more research is required. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618000855224; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375075 SN - 1438-8871 UR - //www.mybigtv.com/2021/11/e31734 UR - https://doi.org/10.2196/31734 DO - 10.2196/31734 ID - info:doi/10.2196/31734 ER -