Primary Outcomes (explanation)
The study will involve 3 data collection rounds: baseline, endline 1 (right after the intervention ends) and endline 2 (six months after endline 1). Baseline data will be used to validate the assumptions, adapt the theories, re-estimate the power, and adjust the pre-analysis plans accordingly. Besides, balance tests will be performed on baseline data to check if randomization has resulted in groups similar in relevant covariates. We will use standard data analysis techniques used in randomization studies to measure the treatment effects (Khandker, B. Koolwal, & Samad, 2009).
Outcome variables for children:
A KAP (knowledge, attitude and practice) questionnaires will be used to measure the knowledge of and attitude towards vegetable and fruit consumption. A FAV consumption frequency question will be included under “Practice”. The questionnaire will be carried out in a face-to-face interview with children.
To measure the consumption of fruits and vegetables at school, research assistants (RA) will observe the children during lunch time/afternoon snacks to fill in the school food diaries. The food diary will not only cover fruits and vegetables, but also other foods, to put fruit and vegetable consumption in the overall context of a diet.
Lunch time: In Dong Anh, all the lunches in schools are provided in food trays with standardized foods (portioned by the school food provider staff). The RAs will hand in the food trays (with stickers to identify the sampled children). After children finish eating, they will collect the identified trays, measure the leftover (or extra food – the RA can see if he/she asks for extra food from the teacher/enumerator; and/or estimate the amount of food she/he was given by another student) and fill in the school food diaries for each children.
Morning break: The RAs will observe if the children pick up the provided food or take the food home and fill in the school food diary.
School food diaries will be done in 2 days of the school week (e.g. Tuesday and Thursday; Wednesday and Friday, Monday and Wednesday).
To measure the consumption of fruits and vegetables at home, children will be instructed by RAs to fill in the home food diary at home themselves (with the parents’ help if necessary). The home food diaries will also be done in 3 days, so that what the children eat during the weekend is also recorded.
Outcome variables for parents:
A KAP survey for parents will be implemented to measure the knowledge and attitude towards fruits and vegetables consumption. The parents will be instructed by RAs to fill in the food diary themselves. The food diaries will also be done in 2 days as per the school food diaries.
The following variables/indicators will be used to assess the knowledge level on FAV:
- The average number of incorrect/”do not know” answers to the questions on FAV
- The proportion of respondents who know the correct amount of recommended FAV
The following variables/indicators will be used to assess the attitude towards FAV:
- The average scores on perceived barriers to FAV consumption
- The score on perceived benefits of FAV consumption
- The proportion of respondents who recognize all the benefits of FAV consumption
- The score on perceived susceptibility to FAV insufficient consumption