Feeding in full-time public schools: Do students adhere and accept?

ABSTRACT Objective Identifying adherence to, and acceptance of school feeding, and analyzing the factors associated with non-adherence/non-acceptance in full-time public schools in Goiânia, Goiás, Brazil. Methods Cross-sectional study with students of both sexes aged 6-14 years. Issues regarding the consumption of meals, food distribution, food eaten outside the school and socioeconomic data, including nutritional assessment of students, were investigated. Adherence to meals was defined as the consumption of school meals four to five times/week, and acceptance was defined as meal approval, using the facial hedonic scale. Results A total of 359 students participated in this study and it was observed that adherence was high for lunch (95%) and afternoon snacks (78%), and low for morning snacks (44%). Acceptance did not reach the required minimum percentage of 85% for any of the meals. Factors associated with non-adherence were the presence of >4 people in a household, having meals in a refectory, the meal location being considered uncomfortable and a negative evaluation of utensils used in eating meals. Factors associated with non-acceptance were age >10 years, female sex, the negative evaluation of utensils used in eating meals and inadequate food temperature. Conclusion Lunch and afternoon snacks showed the highest adherence, but the stipulated acceptance was not reached. Non-adherence and non-acceptance were mainly associated with aspects related to school feeding. This study allowed the evaluation of feeding in full-time public schools, in order to influence its improvement.

摘要
研究目的：识别巴西戈亚斯州戈亚尼亚市全日制公立学校学生对学校供餐（school feeding）的依从性与接受度，并分析与不依从、不接受供餐相关的影响因素。
研究方法：本研究为横断面研究，纳入6~14岁的男女学生作为研究对象。调查内容涵盖学生餐食摄入情况、食物分发流程、校外进食行为以及社会经济相关数据，同时包含学生营养状况评估。本研究将餐食依从性定义为每周食用4~5次学校供餐，将供餐接受度定义为通过面部愉悦量表（facial hedonic scale）判定的餐食认可程度。
研究结果：本研究共纳入359名学生。结果显示，学生对午餐（95%）和午后加餐（78%）的依从性较高，而对晨间加餐（44%）的依从性较低；所有餐食的接受度均未达到85%的最低预设标准。与依从性不佳相关的因素包括：家庭常住人口超过4人、在学校食堂就餐、就餐环境被认定为不适宜，以及对就餐所用餐具存在负面评价。与接受度不佳相关的因素包括：年龄超过10岁、女性性别、对就餐所用餐具存在负面评价，以及餐食温度不适宜。
研究结论：学生对午餐和午后加餐的依从性最高，但所有餐食均未达到预设的接受度标准。依从性不佳与接受度不佳主要与学校供餐相关的多方面因素相关。本研究对全日制公立学校的供餐情况开展评估，旨在为供餐体系的优化提供参考依据。