This study evaluates the school feeding programme at Magog Primary School. It sets out as its objective to find out how the programme operates and its potential impact on school children, including challenges, if any, and recommends solutions to mitigate the challenges. It was motivated by the need to provide information which could be used as a basis to ensure that the nutritional and educational objectives of the National School Nutritional Programme are achieved. A review of literature demonstrated that, within the developmental framework, the point of view of civil society, government and the academia on the school feeding programmes are a valuable strategy to intervene in the nutritional and cognitive development of learners. It also made it evident that there are diverse views as to whether the School Feeding Programme is achieving its intended objectives. The findings of this study suggest that, although the programme has the potential to improve nutrition and health, enrolment, attendance and cognitive development, there are still some challenges and areas that need to be addressed and improved. These challenges arise as a result of lack of effective monitoring and evaluation, geographical location of the schools and other implementation flaws. The consequences are that the objectives of the National School Nutritional Programme are placed at risk. / Development Studies / M. A. (Development Studies)

The objectives of the study were to determine infant and young child feeding (IYCF) knowledge of Household Health Promoters (HHPs) and examine its relationship with demographic characteristics. Quantitative, non-experimental descriptive design was used. Seventy-one randomly selected HHPs participated in the study. A structured questionnaire was used to collect the data. The results showed that the mean IYCF knowledge score was 77.8% (N=71). The knowledge of the respondents was not uniform across the components of IYCF which ranged between 19.72% for duration of breastfeeding to 100% for colostrums feeding. None of the socio-demographic characteristic was significantly associated to the mean knowledge score. The study identified that refresher training should be provided to the HHPs on IYCF with emphasis on the aspects of IYCF with scores below the mean / Health Studies

Esta dissertação tem como objetivo compreender o funcionamento das famílias com crianças acometidas pela obesidade na instalação e manutenção da doença, na perspectiva dos pais. Nesta circunstância, foram considerados os sentimentos e dificuldades expressos pelas mães frente à obesidade dos filhos; estratégias utilizadas para enfrentar o problema e indicadores no contexto familiar que pudessem estar contribuindo para a manutenção do quadro de obesidade infantil. O trabalho está dividido em três artigos, sendo um teórico e dois empíricos. O primeiro apresenta um breve histórico da necessidade humana de alimentação que mostrou as mudanças ocorridas que culminaram na proliferação da obesidade e, nesse cenário, as transformações que a família enfrenta para adaptar-se ao meio permeado de tantas ofertas e constantes modificações, em articulação com a Teoria Sistêmica. O segundo artigo identifica no contexto familiar à luz da Teoria Sistêmica, os indicadores da dinâmica familiar que podem estar contribuindo para a instalação e a manutenção da obesidade na infância. O terceiro artigo considera elementos presentes na história familiar das crianças com obesidade, os sentimentos expressos pelas famílias e as consequências físicas e psíquicas da evolução da doença. A pesquisa é de natureza qualitativa levando em consideração a experiência dos participantes em relação ao tema. Foram entrevistadas seis mães e uma avó de crianças, na faixa etária entre 8 a 10 anos incompletos, que se encontravam em atendimento no ambulatório de Obesidade Infantil do Instituto de Medicina Integral Professor Fernando Figueira (IMIP), na cidade do Recife. Utilizamos uma entrevista com roteiro previamente estabelecido e, posteriormente, os resultados foram discutidos com base na análise de conteúdo temática. Os resultados indicaram que todos os membros do sistema estão implicados na instalação da obesidade, através da rejeição materna, compensada por superproteção alimentar, conflitos conjugais, interferência das avós na alimentação dos netos, o que demonstra confusão na hierarquia. As dificuldades de intercâmbio com o meio demonstraram que as famílias consomem alimentos com alto teor de gordura; a falta de coesão acerca das normas alimentares e de limites à criança são elementos que podem estar contribuindo para a manutenção da obesidade na infância / This dissertation aims to understand the functioning of families with children affected by obesity in the installation and maintenance of the disease from the perspective of parents. In this circumstance, we considered the feelings expressed by mothers and difficulties facing the obesity of children, strategies used to address the problem in the family context and indicators that could be contributing to the maintenance of the obese children. The work is divided in three articles, one theoretical and two empirical. The first presents a brief history of the human need to feed that showed the changes that led to the proliferation of obesity and, in this scenario, the changes that the family faces in adapting to the environment permeated with so many offers and constant changes, in conjunction with Systemic Theory. The second article identifies the family context under the light of the Systemic Theory, indicators of family dynamics that may be contributing to the installation and maintenance of obesity in childhood. The third article considers elements in the family history of children with obesity, the sentiments expressed by the families and the physical and psychological consequences of disease progression. The research is qualitative in nature, taking into account the experience of participating in the issue. Six mothers were interviewed and a grandmother of children, aged between 8-10 years old, who were in the outpatient clinic of Childhood Obesity Institute of Medicine Professor Fernando Figueira (IMIP) in the city of Recife. We used an interview with previously established questions, and subsequently the results were discussed based on thematic content analysis. The results indicated that all members of the system are involved in the installation of obesity, through the maternal rejection, overprotection offset by food, marital conflicts, and interference from the grandparents in the feeding of grandchildren, which shows confusion in the hierarchy. The difficulties of exchange with the environment showed that families consume of food with high contents of fat, lack of cohesion about food standards and limits are the child elements that may be contributing to the maintenance of childhood obesity

The purpose of this study was to explore the extent to which a School Nutrition Programme can catalyse community-based environmental learning and promote food security in the school and the community. This is an interpretive case study of a junior secondary school in the rural Eastern Cape province of South Africa. The school is located in an area characterised by high levels of poverty and under-nutrition. The school’s food garden, a central focus of this study, contributes to the School Nutrition Programme, which falls under the National School Nutrition Programme (NSNP). The aim of the NSNP is to alleviate poverty in public schools. This case study was conducted by means of questionnaires, semi-structured interviews, and document analysis and field observations. The data set was analysed, firstly, to ascertain if the School Nutrition Programme functions as a community of practise (Wenger, 1998). Thereafter, the data set was analysed to identify the knowledge related to food security and environmental sustainability that is learned and shared in the School Nutrition Programme, and also how such learning took place. The study found that the School’s Nutrition Programme was indeed operating as a community of practice and that it created a platform for sharing explicit and tacit knowledge and skills related to food security and environmental sustainability. The case study also revealed the contextual and experience-based nature of knowledge related to food cultivation.

Made available in DSpace on 2017-06-01T18:08:33Z (GMT). No. of bitstreams: 1 dissertacao_priscila_machado.pdf: 1416795 bytes, checksum: d4a42ab07fac0090b7a9e111146b7e04 (MD5) Previous issue date: 2011-02-15 / This dissertation aims to understand the functioning of families with children affected by obesity in the installation and maintenance of the disease from the perspective of parents. In this circumstance, we considered the feelings expressed by mothers and difficulties facing the obesity of children, strategies used to address the problem in the family context and indicators that could be contributing to the maintenance of the obese children. The work is divided in three articles, one theoretical and two empirical. The first presents a brief history of the human need to feed that showed the changes that led to the proliferation of obesity and, in this scenario, the changes that the family faces in adapting to the environment permeated with so many offers and constant changes, in conjunction with Systemic Theory. The second article identifies the family context under the light of the Systemic Theory, indicators of family dynamics that may be contributing to the installation and maintenance of obesity in childhood. The third article considers elements in the family history of children with obesity, the sentiments expressed by the families and the physical and psychological consequences of disease progression. The research is qualitative in nature, taking into account the experience of participating in the issue. Six mothers were interviewed and a grandmother of children, aged between 8-10 years old, who were in the outpatient clinic of Childhood Obesity Institute of Medicine Professor Fernando Figueira (IMIP) in the city of Recife. We used an interview with previously established questions, and subsequently the results were discussed based on thematic content analysis. The results indicated that all members of the system are involved in the installation of obesity, through the maternal rejection, overprotection offset by food, marital conflicts, and interference from the grandparents in the feeding of grandchildren, which shows confusion in the hierarchy. The difficulties of exchange with the environment showed that families consume of food with high contents of fat, lack of cohesion about food standards and limits are the child elements that may be contributing to the maintenance of childhood obesity / Esta dissertação tem como objetivo compreender o funcionamento das famílias com crianças acometidas pela obesidade na instalação e manutenção da doença, na perspectiva dos pais. Nesta circunstância, foram considerados os sentimentos e dificuldades expressos pelas mães frente à obesidade dos filhos; estratégias utilizadas para enfrentar o problema e indicadores no contexto familiar que pudessem estar contribuindo para a manutenção do quadro de obesidade infantil. O trabalho está dividido em três artigos, sendo um teórico e dois empíricos. O primeiro apresenta um breve histórico da necessidade humana de alimentação que mostrou as mudanças ocorridas que culminaram na proliferação da obesidade e, nesse cenário, as transformações que a família enfrenta para adaptar-se ao meio permeado de tantas ofertas e constantes modificações, em articulação com a Teoria Sistêmica. O segundo artigo identifica no contexto familiar à luz da Teoria Sistêmica, os indicadores da dinâmica familiar que podem estar contribuindo para a instalação e a manutenção da obesidade na infância. O terceiro artigo considera elementos presentes na história familiar das crianças com obesidade, os sentimentos expressos pelas famílias e as consequências físicas e psíquicas da evolução da doença. A pesquisa é de natureza qualitativa levando em consideração a experiência dos participantes em relação ao tema. Foram entrevistadas seis mães e uma avó de crianças, na faixa etária entre 8 a 10 anos incompletos, que se encontravam em atendimento no ambulatório de Obesidade Infantil do Instituto de Medicina Integral Professor Fernando Figueira (IMIP), na cidade do Recife. Utilizamos uma entrevista com roteiro previamente estabelecido e, posteriormente, os resultados foram discutidos com base na análise de conteúdo temática. Os resultados indicaram que todos os membros do sistema estão implicados na instalação da obesidade, através da rejeição materna, compensada por superproteção alimentar, conflitos conjugais, interferência das avós na alimentação dos netos, o que demonstra confusão na hierarquia. As dificuldades de intercâmbio com o meio demonstraram que as famílias consomem alimentos com alto teor de gordura; a falta de coesão acerca das normas alimentares e de limites à criança são elementos que podem estar contribuindo para a manutenção da obesidade na infância

MCur / Department of Advanced Nursing Science / Background: Globally, malnutrition among children is one of the most challenging and critical public health problem, and it remains one of the most common causes of morbidity and mortality among children under the age of 5 years. There is no exception for the Vhembe District. Purpose: The study determined the perceptions of young mothers regarding causes of malnutrition in children under the age of 5 years in the Vhembe District, of the Limpopo Province. Methodology: This study used qualitative, exploratory, descriptive and contextual design to collect data among young mothers regarding causes of malnutrition in children under 5 years. Twelve young mothers were sampled using probability, simple random sampling at selected hospitals population. In-depth individual interviews were used to collect data and analysed using Tesch’s steps. Measures to ensure trustworthiness and ethical consideration were adhered to throughout the study. Results: Three themes emerged from the analysed data, namely: Young mothers’ perceived causes of malnutrition, young mother’s beliefs about malnutrition, and health care seeking actions for a malnourished child. Recommendations: This study recommend a strategies to integrate young mothers into the health promotion regarding their understanding and experiences about malnutrition. Policies on child nutrition should be reviewed regularly in the Vhembe District for prevention and management of malnutrition in children under 5. / NRF

PhDRDV / Institute for Rural Development / Many countries provide food to school children through school feeding programmes (SFPs). This is designed to alleviate short-term hunger and encourage learners to attend school. Many children in South Africa attend school hungry and lack general knowledge of nutrition, which negatively affects their learning abilities. Not much research attention has been paid to the potential of SFPs to improve learners‟ knowledge of nutrition. Nor has there been significant effort to stimulate local production of food involving community members, which might contribute to the development of rural areas. In the current study, the degree to which SFPs have alleviated hunger, promoted nutrition education, and enhanced the development of rural communities in Blouberg Local Municipality (BLM) was investigated. Data were collected from 11 primary schools in BLM where the South African Department of Basic Education implemented SFPs. At each school, quantitative data were collected from learners aged from 10 to 15 years using a structured, pre-tested and validated questionnaire. Qualitative data were collected through individual in-depth interviews and focus group discussions with learners, teaching staff, community members and government officials involved in the implementation of SFPs. Document analysis, direct observation, and taking notes, photographs, Venn and seasonal -diagraming were used to collect data. Descriptive statistics, crosstabulation and binary logistic regression were used to analyse quantitative data. Qualitative data obtained in the form of interview transcripts and field notes were analysed using thematic content analysis. An inductive approach was followed. This entails coding the data and observing emerging patterns, culminating in organising the results into common themes. A composite index was used as a measure of the quality of SFPs. Perceived benefits of SFPs were assessed based on a validated and standardised 5-point ordinal scale. It was observed that 80 % school children who participated in the study were satisfied with the quality of the SFPs provided to them. The results confirmed those obtained through focus group discussions and individual interviews. Overall satisfaction with the quality of the SFP in BLM significantly and positively depended on the following knowledge, in descending order of importance: fewer sugary foods should be consumed; fewer fatty foods should be consumed and eating various foods helps in proper growth and development. Four predictor variables significantly influenced satisfaction with SFPs. These were: knowledge that a variety of food types is helpful for growth and development [OR = 3.72; P < 0.001; 95% C.I. = 1.77, 7.83]; knowledge that eating too much fatty food is harmful [OR = 2.93; P < 0.001; 95% C.I. = 1.83, 4.68]; knowledge that eating too much sugary food is harmful [OR = 2.18; P < 0.001; 95% C.I. = 1.45, 3.29]; and knowledge that eating too much sweet food is harmful because it can make people fat [OR = 1.58; P < 0.05; 95% C.I. = 1.01, 2.50]. All participants agreed that SFPs alleviated hunger and benefited the learners and their families. Although the participants cited numerous other benefits accrued through SFPs, there were challenges that should be addressed. The involvement of community members in the SFPs was reported to be minimal such as cooking and serving food and working in the school gardens. This could be maximised because SFPs presented an opportunity for local food production and rural community development. Non-delivery of food by suppliers and the negative impact it had on learners was the major challenge. This observation implied that the SFPs constituted a readily available market, which the rural communities could exploit to improve their income, create jobs and enhance the rural economy. Therefore, SFPs and school gardens should be integrated with nutrition education to improve the learners‟ level of nutrition knowledge and reinforce the consumption of healthy foods. Although initially, the SFP had a community development component, this seemed to be overlooked. A framework that underscores strong partnerships among government departments, NGOs and the private sector in implementing community and/or rural development initiatives was developed. The framework is based on strong partnerships between key stakeholders, policy support, investments in resources and infrastructure for rural development and capacity building. / NRF

by Au-Yeung Kit Mei. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves 219-232). / Abstracts in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii / Abstract (Chinese Version) --- p.v / Table of Contents --- p.vii / List of Figures --- p.xiii / List of Tables --- p.xv / List of Abbreviations --- p.xxviii / Chapter CHAPTER ONE: --- INTRODUCTION / Chapter 1.1 --- Health-related Transition in Hong Kong and Their Implications --- p.1 / Chapter 1.2 --- "Eating Habits, Lifestyle and Health of Hong Kong Children" --- p.1 / Chapter 1.2.1 --- Affluent Diet --- p.1 / Chapter 1.2.2 --- Poor Diet Habits --- p.2 / Chapter 1.2.2.1 --- Low Breastfeeding Rate --- p.2 / Chapter 1.2.2.2 --- Breakfast Skipping --- p.4 / Chapter 1.2.2.3 --- Increased Eating Out --- p.5 / Chapter 1.2.2.4 --- Quality of School Lunch --- p.6 / Chapter 1.2.2.5 --- Snacking Habits --- p.7 / Chapter 1.2.3 --- Physical Inactivity --- p.8 / Chapter 1.2.4 --- Childhood Obesity Prevalence and Trend --- p.9 / Chapter 1.2.5 --- Health Implications and Consequences --- p.10 / Chapter 1.2.6 --- Children's Eating and Physical Activity Habit Formation --- p.13 / Chapter 1.2.6.1 --- Parental Influences --- p.13 / Chapter 1.2.6.2 --- Influence of School Environment and Healthy Food Availability --- p.14 / Chapter 1.2.6.3 --- Media Influences --- p.15 / Chapter 1.3 --- Prevention Rather than Management --- p.15 / Chapter 1.3.1 --- Good Habit Establishment is Essential When Young --- p.16 / Chapter 1.3.2 --- Need for Comprehensive Health or Nutrition Education --- p.17 / Chapter 1.3.3 --- Brief Review of Nutrition Education Research in Other Nations --- p.17 / Chapter 1.3.4 --- Nutrition / Health Education in Hong Kong --- p.21 / Chapter 1.3.4.1 --- Government and Community Promotion --- p.21 / Chapter 1.3.4.2 --- Nutrition and Physical Activity in Primary School Syllabus --- p.22 / Chapter 1.3.4.3 --- Barriers --- p.23 / Chapter 1.4 --- Rationale of This Study --- p.24 / Chapter 1.4.1 --- Project Background: Multidisciplinary Advisory Committee Composition --- p.24 / Chapter 1.4.2 --- Objectives of this Project --- p.24 / Chapter 1.4.3 --- Theoretical Framework --- p.25 / Chapter 1.4.4 --- Research Design and Hypothesis --- p.26 / Chapter CHAPTER TWO: --- METHODOLOGY / Chapter 2.1 --- Target Subjects --- p.27 / Chapter 2.2 --- Sample --- p.27 / Chapter 2.2.1 --- Gaining Access To Subjects --- p.27 / Chapter 2.2.2 --- Sample Selection --- p.29 / Chapter 2.3 --- Questionnaires Development and Data Collection --- p.30 / Chapter 2.3.1 --- Questionnaire Design --- p.30 / Chapter 2.3.1.1 --- Students' Questionnaire --- p.31 / Chapter 2.3.1.2 --- Parents' Questionnaire --- p.32 / Chapter 2.3.1.3 --- Pre-testing --- p.32 / Chapter 2.3.1.4 --- Student Helper Training --- p.33 / Chapter 2.3.1.5 --- Reliability and validity of measures --- p.33 / Chapter 2.4 --- Intervention --- p.34 / Chapter 2.4.1 --- Intervention Activities and Curriculum Design --- p.34 / Chapter 2.4.2 --- Intervention Materials Development and Pre-testing --- p.39 / Chapter 2.5 --- Evaluation --- p.39 / Chapter 2.5.1 --- Outcome Evaluation --- p.39 / Chapter 2.5.1.1 --- Data Management --- p.39 / Chapter 2.5.1.2 --- Statistics --- p.40 / Chapter 2.5.1.3 --- "Knowledge,Attitude and Behavior Scores of Students" --- p.40 / Chapter 2.5.2 --- Process Evaluation of Program Materials and Activities During the Intervention --- p.41 / Chapter 2.6 --- Ethics --- p.44 / Chapter CHAPTER THREE: --- RESULTS / Chapter 3.1 --- Response Rate --- p.45 / Chapter 3.2 --- Baseline Characteristics of Students and Parents in Pre-intervention Survey --- p.46 / Chapter 3.2.1 --- General Sociodemographic Characteristics --- p.46 / Chapter 3.2.2 --- Breastfeeding --- p.58 / Chapter 3.2.3 --- Healthy Diet Pyramid and General Healthy Eating Awareness --- p.63 / Chapter 3.2.4 --- Healthy Breakfast --- p.67 / Chapter 3.2.5 --- Healthy Eating Out --- p.73 / Chapter 3.2.6 --- Healthy School Lunch --- p.79 / Chapter 3.2.7 --- Healthy Snacking --- p.82 / Chapter 3.2.8 --- Family Dietary Habits --- p.88 / Chapter 3.2.9 --- Physical Activity --- p.97 / Chapter 3.2.10 --- Summary Profile of the Subjects at Pre-intervention Survey --- p.109 / Chapter 3.3 --- Outcome Evaluation --- p.114 / Chapter 3.3.1 --- General Sociodemographic Characteristics of Students and Parents in Post-intervention survey --- p.114 / Chapter 3.3.2 --- Breastfeeding --- p.117 / Chapter 3.3.3 --- Healthy Diet Pyramid and General Healthy Eating Awareness --- p.122 / Chapter 3.3.4 --- Healthy Breakfast --- p.125 / Chapter 3.3.5 --- Healthy Eating Out --- p.130 / Chapter 3.3.6 --- Healthy School Lunch --- p.134 / Chapter 3.3.7 --- Healthy Snacking --- p.138 / Chapter 3.3.8 --- Family Dietary Habits --- p.144 / Chapter 3.3.9 --- Physical Activity --- p.150 / Chapter 3.3.10 --- "Changes in Students' Knowledge, Attitudes and Behavior With Respect to Healthy Eating and Physical Activity" --- p.157 / Chapter 3.3.11 --- Summary Profile of the Subjects at Post-intervention Survey --- p.162 / Chapter 3.4 --- Parents' Evaluation of Program Materials and Activities --- p.166 / Chapter 3.5 --- Teachers' Evaluation of Program Materials and Activities --- p.174 / Chapter 3.5.1 --- Breastfeeding Evaluation --- p.175 / Chapter 3.5.2 --- Program Evaluation: Other FUN-IN-SEVEN Themes --- p.181 / Chapter CHAPTER FOUR: --- DISCUSSION / Chapter 4.1 --- Implication of Findings --- p.193 / Chapter 4.2 --- Strengths and Limitations of the Study --- p.210 / Chapter 4.3 --- Major Difficulties Encountered in Launching Nutrition Promotion in Schools --- p.213 / Chapter 4.4 --- Implications and Recommendations for Meeting the Challenges to Improving Hong Kong Primary Students Nutrition and Physical Activity Habits --- p.214 / Chapter CHAPTER FIVE: --- CONCLUSION --- p.218 / References --- p.219 / Appendices / Chapter AI --- Students' questionnaire (Chinese version) --- p.233 / Chapter AII --- Students' questionnaire (English version) --- p.238 / Chapter BI --- Visual aids (Chinese version) --- p.251 / Chapter BII --- Visual aids (English version) --- p.258 / Chapter CI --- Parents' questionnaire (Chinese version) --- p.265 / Chapter CII --- Parents' questionnaire (English version) --- p.273 / Chapter DI --- Introductory letter (Chinese version) --- p.281 / Chapter DII --- Introductory letter (English version) --- p.283 / Chapter EI --- Consent form (Chinese version) --- p.285 / Chapter EII --- Consent form (English version) --- p.286 / Chapter F --- Principal/teacher questionnaire --- p.287 / Chapter G --- Background information of the partner schools --- p.289 / Chapter H --- Summary of materials and activities of FUN-IN-SEVEN Programme (Chinese version) --- p.291 / Chapter KI --- "Programme materials, pamphlets/brochures and photographs of some activities" --- p.292 / Chapter LI --- Parents' evaluation (Chinese version) --- p.370 / Chapter LII --- Parents' evaluation (English version) --- p.372 / Chapter MI --- Teachers' breastfeeding evaluation (Chinese version) --- p.373 / Chapter MII --- Teachers' breastfeeding evaluation (English version) --- p.375 / Chapter NI --- Teachers' programme evaluation (Chinese version) --- p.377 / Chapter NII --- Teachers' programme evaluation (English version) --- p.381 / Chapter P --- Socioeconomic background information of partner schools --- p.385

Text in English / This study aimed at exploring Barriers to compliance with exclusive breastfeeding and timely introduction of complementary feeding practices in Ofla District, Tigray Region in Ethiopia. A quantitative exploratory descriptive study was conducted to explore and describe the barriers that restrict mothers /caregivers to comply with exclusive breast feeding practice until six months and with introduction of solid, semi-solid and soft foods at six months in Ofla District. Data were collected using structured questionnaire, from a total of 112 samples of which 75 mothers and care givers with children aged 0-5 months and 38 children aged 6-8 months participated. The data were entered into a computer and analysed though the Statistical Package for Social Sciences (SPSS) software. The findings revealed that there are barriers related Doer mothers and Non-Doer mothers perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues for actions, perceived social acceptability and positive and negative attitudes towards exclusive breastfeeding and initiation of complementary feeding. On the other hand, the participant’s perception of both groups with regard to perception of Divine (God’s) Will on two child feeding practices was insignificantly the same. Both groups perceived that children could get sometimes malnourished because of spiritual or supernatural causes. / Health Studies / M.A. (Public Health)

by Wan Cheuk Wing. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (leaves p. 166-183). / Abstracts in English and Chinese. / Acknowledgements --- p.i / Abstract --- p.ii-iii / Abstract (Chinese Version) --- p.iv / Table of Contents --- p.v-xi / List of Figures --- p.xii / List of Tables --- p.xiii-xxiii / List of Abbreviations --- p.xxiiv / Chapter CHAPTER ONE: --- INTRODUCTION / Chapter 1.1 --- "Socioeconomic, dietary and epidemiological transformation" --- p.1 / Chapter 1.1.1 --- Low breastfeeding rate --- p.3 / Chapter 1.1.2 --- Breakfast skipping --- p.6 / Chapter 1.1.3 --- Popularity of eating out --- p.8 / Chapter 1.1.4 --- Lack of school lunch surveillance or policy --- p.10 / Chapter 1.1.5 --- Frequent unhealthy snack consumption --- p.11 / Chapter 1.1.6 --- Physical inactivity --- p.12 / Chapter 1.2 --- "Childhood and Adolescent obesity determinants, trends and consequences" --- p.13 / Chapter 1.3 --- "Physiological, psychosocial and economic determinants of childhood and adolescent obesity" --- p.16 / Chapter 1.4 --- Adolescence - Critical period of habit development --- p.17 / Chapter 1.4.1 --- "Factors affecting eating and physical activity patterns: peers, television and the school environment" --- p.18 / Chapter 1.5 --- The education system in Hong Kong and United States --- p.20 / Chapter 1.5.1 --- Principles of effective nutrition curriculum development --- p.23 / Chapter 1.6 --- Study Design and Theoretical Approach of study --- p.23 / Chapter CHAPTER TWO: --- METHODOLOGY / Chapter 2.1 --- Target Population Determination --- p.28 / Chapter 2.2 --- Recruitment & Geographical Distribution of Schools --- p.28 / Chapter 2.2.1 --- Familiarization with School Background --- p.30 / Chapter 2.3 --- Focus groups --- p.31 / Chapter 2.4 --- "Questionnaire Development, Instrument Design and Pre-testing" --- p.32 / Chapter 2.4.1 --- Questionnaire Development --- p.32 / Chapter 2.4.2 --- Socio-demographic --- p.33 / Chapter 2.4.3 --- Breastfeeding --- p.33 / Chapter 2.4.4 --- "Dietary - Healthy Diet Pyramid, Healthy Breakfast, Healthy Lunch, Healthy Snack, Healthy Eating Out" --- p.33 / Chapter 2.4.5 --- Physical Activity --- p.34 / Chapter 2.4.6 --- Pretesting --- p.35 / Chapter 2.4.7 --- Sampling Method --- p.35 / Chapter 2.4.8 --- Student Helpers Training --- p.36 / Chapter 2.4.9 --- Data Collection --- p.37 / Chapter 2.4.10 --- Fun-In-Seven Logo --- p.37 / Chapter 2.5 --- Intervention Program --- p.38 / Chapter 2.5.1 --- Planning the Intervention Programs - Health Committee Establishment --- p.38 / Chapter 2.5.2 --- "Intervention Activities, Curriculum Design and Implementation" --- p.39 / Chapter 2.6 --- Evaluations --- p.45 / Chapter 2.6.1 --- Process Evaluation --- p.45 / Chapter 2.6.2 --- Outcome Evaluation --- p.45 / Chapter 2.7 --- Data Management --- p.46 / Chapter 2.7.1 --- Data Processing --- p.46 / Chapter 2.7.2 --- Statistics --- p.46 / Chapter 2.7.3 --- Data Analysis --- p.47 / Chapter CHAPTER THREE: --- RESULTS / Chapter 3.1 --- Participation rate of the study --- p.52 / Chapter 3.2 --- Pre-intervention survey results --- p.52 / Chapter 3.2.1 --- General sociodemographic characteristics of students --- p.52 / Chapter 3.2.2 --- Self-evaluated nutrition scores --- p.53 / Chapter 3.2.3 --- Breastfeeding --- p.55 / Chapter 3.2.4 --- Healthy Diet Pyramid --- p.61 / Chapter 3.2.5 --- Healthy breakfast awareness and practices --- p.64 / Chapter 3.2.6 --- "Eating out knowledge, attitudes and practices" --- p.68 / Chapter 3.2.7 --- Healthy Lunch --- p.73 / Chapter 3.2.8 --- Snack patterns --- p.77 / Chapter 3.2.9 --- Physical Activity --- p.81 / Chapter 3.2.10 --- Summary Profile of the Secondary Students in the Pre-intervention Survey --- p.92 / Chapter 3.3 --- Outcome evaluation --- p.95 / Chapter 3.4 --- Post-intervention Survey --- p.95 / Chapter 3.4.1 --- General sociodemographic characteristics of students --- p.95 / Chapter 3.4.2 --- Changes in self-rated nutrition knowledge --- p.96 / Chapter 3.4.3 --- Intervention effects on of breastfeeding knowledge and attitudes --- p.97 / Chapter 3.4.4 --- Healthy Diet Pyramid and healthy eating awareness --- p.104 / Chapter 3.4.5 --- Breakfast --- p.109 / Chapter 3.4.6 --- Eating Out --- p.113 / Chapter 3.4.7 --- Lunch --- p.117 / Chapter 3.4.8 --- Snacking --- p.121 / Chapter 3.4.9 --- Physical Activity --- p.128 / Chapter 3.4.10 --- "Changes in students' knowledge, attitude, and behavior after the intervention programme" --- p.140 / Chapter 3.5 --- Summary Profile of the Secondary Students in the Post-intervention Survey --- p.145 / Chapter CHAPTER FOUR: --- DISCUSSION / Chapter 4.1 --- Impacts of Fun-in-Seven programmes --- p.150 / Chapter 4.1.1 --- Breastfeeding --- p.150 / Chapter 4.1.2 --- Healthy Diet Pyramid --- p.151 / Chapter 4.1.3 --- Healthy Breakfast --- p.152 / Chapter 4.1.4 --- Lunch --- p.153 / Chapter 4.1.5 --- Snacking --- p.155 / Chapter 4.1.6 --- Physical Activity --- p.156 / Chapter 4.2 --- Strengths of the intervention programme --- p.157 / Chapter 4.3 --- Limitations and problems encountered --- p.159 / Chapter 4.4 --- Recommendations for further improvement --- p.161 / Chapter CHAPTER FIVE: --- CONCLUSION --- p.165 / References --- p.166-180 / Appendices / Chapter A --- Questionnaire for Teacher/Principal (English version) --- p.181-183 / Chapter B --- Secondary School Background Information (English version) --- p.184-195 / Chapter CI --- Questionnaire (Chinese version) --- p.196-209 / Chapter CII --- Questionnaire (English version) --- p.210-224 / Chapter D --- Pamphlets for seven themes (Chinese and English versions) --- p.225-257 / Chapter E --- Worksheets & Certificates (Chinese and English versions) --- p.258-283 / Chapter F --- Activities photos (English version) --- p.284-288 / Chapter G --- Summary of materials and activities of each theme in Fun-in-Seven (Chinese version) --- p.289 / Chapter HI --- Breastfeeding and Physical Activity Process Evaluation Questionnaire (Chinese version) --- p.290-291 / Chapter HII --- Breastfeeding and Healthy Diet Pyramid Process Evaluation Questionnaire (English version) --- p.292-294 / Chapter JI --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (Chinese version) - School 1" --- p.295-299 / Chapter JII --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (English version)" --- p.300-305 / Chapter KI --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (Chinese version) - School 2" --- p.306-309 / Chapter KII --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (English version) ´ؤ School 2" --- p.310-313 / Chapter LI --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (Chinese version) ´ؤ School 3" --- p.314-317 / Chapter LII --- "Physical Activity, Breakfast, Lunch, Eat Out, Snack Outcome Evaluation (English version) ´ؤ School 3" --- p.318-322 / Chapter MI --- Teacher's Outcome Evaluation Form (Chinese version) ´ؤ School --- p.323-324 / Chapter MII --- Teacher's Outcome Evaluation Form (English version) 一 School --- p.325-327 / Chapter NI --- Teacher's Outcome Evaluation Form (Chinese version) ´ؤ School --- p.328-329 / Chapter NII --- Teacher's Outcome Evaluation Form (English version) - School --- p.330-332 / Chapter PI --- Teacher's Outcome Evaluation Form (Chinese version) - School --- p.333-334 / Chapter PII --- Teacher's Outcome Evaluation Form (English version) 一 School --- p.335-337 / Chapter QI --- Health Ambassador's Outcome Evaluation Form (Chinese version) --- p.338-339 / Chapter QII --- Health Ambassador's Outcome Evaluation Form (English version) --- p.340-341