Impact of a pilot school-based nutrition intervention on the dietary knowledge, attitude, and behavior of Syrian refugee children in West Bekaa, Lebanon -

Abstract

Background: The Syrian refugee crisis is one of the most currently challenging protracted humanitarian crises worldwide. Refugee children are among the most vulnerable groups that may suffer from the adverse consequences of this crisis leading to increased risk of poverty, food insecurity and inadequate dietary intakes. Establishing healthy eating habits and attitudes among school-aged children is essential to effective growth and development. Schools offer a convenient setting to promote healthy eating. Limited studies explored the impact of nutrition interventions on refugee children’s eating behaviors in protracted crises. Also, the nutritional status of school-aged refugee children has not been adequately documented in the scientific literature. Aim: To evaluate the impact of a 6-month school nutrition intervention on change in dietary knowledge, attitude and behavior (KAB) of Syrian refugee children in an under-served region Lebanon. Methods: A non-randomized, controlled before-after (CBA) pilot study was conducted on 10-14-year-old Syrian refugee children (n=180) recruited from three elementary schools in the Bekaa, Lebanon (120 in intervention schools and 60 in control school). Children in the intervention group received classroom-based nutrition educational sessions delivered by trained teachers and enhanced school snacks prepared by trained kitchen employees within the schools whereas children in the control group received their usual school curriculum and a standard snack prepared on-site. At baseline, socio-demographic, household food security and coping strategies of children’s households were collected by trained nutritionists through one-on-one interviews with mothers at a private classroom setting within the selected schools. The nutrition knowledge, attitude and behavior of children were also assessed using a 30-item questionnaire at baseline and post-intervention. In addition, the anthropometric measurements and dietary intake of children were assessed pre-and post- the nutrition