Evaluación de cursos en línea, masivos y abiertos de educación en salud y nutrición para prevenir la obesidad / Assessment of massive open online courses for teaching nutrition and preventing obesity

Background: A massive open online course (MOOC) is an online course aimed at unlimited participation and open access via the Web. Aim: To assess the MOOC experience for teaching nutrition, healthy food consumption, physical activity and health promotion to prevent obesity. Material and Methods: Two MOOC courses, (one with two versions), are described with the registration and evaluation instruments such as surveys carried out at the beginning and at the end of the courses. Effective participants in the three versions were 17.456, 11.121 in MOOC1, 2.351 in MOOC1 second version and 3.984 in MOOC2. Their median age was 31 years, 82% were women, 60% were professionals and 12% were foreigners. Results: In the final evaluation of the three courses, 85% to 99% qualified as "very good" or "good" all the surveyed topics. Thirty five percent of participants reported having lack of time, 11% reported problems with internet connectivity and 3.9%, personal or work problems. Conclusions: This is the first experience with MOOC in health and nutrition to prevent obesity in Chile. Considering the good results and positive evaluation of these courses, we estimate that they are an important tool to prevent obesity and chronic diseases in Chile, Latin America and other regions of the world.

[Assessment of massive open online courses for teaching nutrition and preventing obesity]. / Evaluación de cursos en línea, masivos y abiertos de educación en salud y nutrición para prevenir la obesidad.

BACKGROUND: A massive open online course (MOOC) is an online course aimed at unlimited participation and open access via the Web. AIM: To assess the MOOC experience for teaching nutrition, healthy food consumption, physical activity and health promotion to prevent obesity. MATERIAL AND METHODS: Two MOOC courses, (one with two versions), are described with the registration and evaluation instruments such as surveys carried out at the beginning and at the end of the courses. Effective participants in the three versions were 17.456, 11.121 in MOOC1, 2.351 in MOOC1 second version and 3.984 in MOOC2. Their median age was 31 years, 82% were women, 60% were professionals and 12% were foreigners. RESULTS: In the final evaluation of the three courses, 85% to 99% qualified as "very good" or "good" all the surveyed topics. Thirty five percent of participants reported having lack of time, 11% reported problems with internet connectivity and 3.9%, personal or work problems. CONCLUSIONS: This is the first experience with MOOC in health and nutrition to prevent obesity in Chile. Considering the good results and positive evaluation of these courses, we estimate that they are an important tool to prevent obesity and chronic diseases in Chile, Latin America and other regions of the world.

[Impact of a teachers' program on food habits and culinary skills in Chilean public schools]. / Efecto de un programa para profesores sobre cambio de hábitos alimentarios y habilidades culinarias en escuelas públicas de Chile.

INTRODUCTION: Objective: to evaluate a healthy food program for teachers and their educational transfer through an action plan for 3rd to 5th primary students, to improve their food habits and culinary skills. Methodology: a four months quasi-experimental prospective study was carried out, with qualitative measurements to teachers (n = 43) and pre- and post-intervention quantitative measurements for students (n = 302) in three public schools compared with a control group in other three schools (n = 265) in La Reina county, Santiago, Chile. The teachers received on-line training and at the end of the program they designed an action plan to be implemented at the three intervened schools. Results: half of the students reported that they had dinner at night. A high percentage had breakfast and lunch twice a day. At the end of the study, the number of students who had lunch twice a day was reduced to a half. Also, the group significantly increased the water and fruits consumption, instead of snacks. In culinary skills, they learned how to prepare healthy sandwiches. As a result, the level of obesity in both groups decreased significantly. The teachers increased water consumption, limited the number of meals to three per day, and decreased the fast food eating. Conclusion: the healthy food training improved the food habits of teachers and students. The support of the headmaster and the staff of the school is required to organize activities to promote healthy food.

INTRODUCCIÓN: Objetivo: evaluar un programa de alimentación saludable para docentes y su transferencia educativa a través de un plan de acción a alumnos de 3º a 5º básico para mejorar sus hábitos alimentarios y habilidades culinarias. Metodología: estudio cuasi-experimental prospectivo de cuatro meses de duración, con mediciones cualitativas a profesores (n = 43) y cuantitativas pre- y postintervención en alumnos (n = 302) de tres colegios municipales, comparados con un grupo control de otros tres colegios (n = 265) en la comuna de La Reina, Santiago de Chile. Los profesores recibieron una capacitación on-line y al final del curso elaboraron un plan de acción que aplicaron en los colegios intervenidos. Resultados: en hábitos y consumo alimentarios, la mitad de los niños refirió que cenaba en la noche y un alto porcentaje desayunaba y almorzaba dos veces. Los que almorzaban dos veces disminuyeron a la mitad al final de la intervención. En el grupo intervenido aumentó significativamente la fruta como colación y en ambos grupos, la ingesta de agua. En habilidades culinarias, el grupo intervenido mejoró la preparación de sándwich. En ambos grupos disminuyó significativamente la obesidad. En los profesores mejoraron el consumo de agua y el hábito de comer tres veces al día y disminuyó la ingesta de comida rápida. Conclusión: la capacitación en alimentación saludable para profesores mejora sus hábitos alimentarios, los cuales se transfieren a sus alumnos. Para ello se debe contar con el apoyo de la dirección de la escuela y con equipos docentes interesados en organizar actividades de promoción de alimentación saludable.

Teachers' self-perception of their dietary behavior and needs to teach healthy eating habits in the school.

Through focus groups, we explored 22 third- to fifth-grade teachers' perceptions about their eating habits, including barriers and facilitators to healthy eating. It also explored teachers' thoughts about how to teach students healthy eating habits. The information was transcribed and treated using the content analysis technique. Results were evaluated using the concept of majority and minority group and presented in a sequential way: teachers' perceptions about eating habits, barriers to healthy eating, teacher's culinary habits, abilities to teach students healthy eating habits through Information and Communication Technologies, and cooking activities. Teachers' eating habits were poor, with lack of time, money, and will to improve. They had culinary habits skills and the desire to instruct and guide their students in eating healthier food. They need a program with Information and Communication Technologies and cooking workshops to apply in the classroom.

The contribution of distance education to health promotion in Chile.

The objective of this paper is to present the distance education's contribution to developing health promotion in Chile, through evaluation of a postgraduate certificate program for professionals, and a training course for nurse technicians working in primary healthcare, with an 8-month follow-up after program completion. The program methodology was participatory, interactive and reflective, with mentoring support, exercises, group work and discussions as well as content pertinent to the needs of practice. The evaluation was quali-quantitative with an analysis of the student profile, the implementation process, outcomes at the end of the training and impacts on workplace changes. The results showed a high rate of student approval (87 and 76%), good academic performance and a high level of satisfaction with the methodology and knowledge delivered. The participants' final projects were adapted to local work places realities and were implemented by 62.6% of technicians and 43% of professionals, in addition to changes in work practices that favor health promotion. The level of fulfillment of participants' expectations was very high and the most frequent barriers to implementing the final project were lack of time and personnel, along with minimal support from management and low prioritization of health promotion. This study shows the effectiveness of a distance training model for professionals and technicians that can reach the most remote parts of the country, where there is no access to presencial training, with an educational program centered on work activities and current health challenges.

Diagnóstico de la situación alimentaria y nutricional de niños de tercero a quinto año básico de la comuna de la Reina, Santiago de Chile / Food and nutrition diagnosis of third to fifth grade school-age children from the La Reina neighborhood, Santiago de Chile

RESUMEN Se describe el estado nutricional, consumo, hábitos alimentarios y habilidades culinarias en alumnos de tercero a quinto año básico de colegios municipales de la comuna de La Reina, Santiago, Chile, para proponer intervenciones que conduzcan hacia una alimentación saludable. El estudio es descriptivo, de corte transversal en 617 niños, 349 hombres y 268 mujeres de tercero (n=193), cuarto (n=202) y quinto básico (n=222). El 30,3% de los niños tenía obesidad, mayor que el 24,2% reportado por la Junta Nacional de Auxilio Escolar y Becas (JUNAEB) en primero básico el 2015. Al 66,2% de los niños les gusta cocinar, pero sólo un 20,0% mezcla y aliña verduras, hace sándwich y pela o pica fruta 4 a 5 días en la semana. Todos los niños (100%) toman once, pero sólo un 60,9% cena en la noche. Un 20,7% toma doble desayuno y un 35,7% come doble almuerzo. Casi todos (97%) llevaban dinero o colación de la casa. El 78,4% llevaba golosinas dulces, 60,0% fruta, 50,0% lácteos y 48,4% bebidas o jugos azucarados y un 45,0% lleva $500 a $1.000 por día al colegio. Existe la necesidad de educar en hábitos de alimentación saludable a los alumnos, incorporando padres con apoyo del Ministerio de Educación, para tener una política de Estado en prevención de la obesidad infantil.

ABSTRACT This article describes the nutritional status, food consumption, dietary behavior and culinary skills of third to fifth grade public school students from the La Reina neighborhood, Santiago de Chile, in order to propose healthy eating interventions. This is a cross-sectional, descriptive study in 617 children (349 males and 268 females) from third (n= 193), fourth (n= 202) and fifth grade (n= 222). Obesity prevalence was 30.3%, greater than the 24.2% reported by National Board of Scholarships and Grants in first grade in 2015. Most of the children reported liking cooking (66.2%), but just 20.0% cooked mixed or seasoned vegetables, made sandwiches, or peeled or cut 4 or 5 days per week. All children (100%) ate a late snack in the afternoon, but only 60.9% ate dinner at night. A second breakfast was eaten by 20.7% of the children and a second lunch by 35.7%. Almost all children (97%) brought money or a snack from home: 78.4% brought candies, 60.0% fruit, 50.0% dairy products and 48.4% soft drinks or juices with sugar, and 45.0% money (500 to 1000 Chilean pesos). It is necessary to educate children in healthy eating habits, with participation of parents and support from the Ministry of Education to prevent children obesity.

El riesgo de los que cuidan el riesgo: FINDRISK en personal de blanco

Introducción: el cuestionario FINDRISK permite evaluar la probabilidad de desarrollar diabetes mellitus (DM) a 10 años. Objetivo: determinar la probabilidad de desarrollar DM a 10 años en el personal de salud, teniendo en cuenta el estilo de vida y su carga familiar utilizando el cuestionario FINDRISK. Materiales y métodos: estudio prospectivo, descriptivo, de corte trasversal, realizado en 100 individuos, personal de blanco del Hospital de Clínicas, desde el 1 de septiembre de 2015 a 31 de octubre de 2015. Resultados: la muestra fue mayoritariamente del sexo femenino (77%), predominantemente joven (73%), 19% tienen padres y/o hermanos con DM. Tenían peso normal 32%, sobrepeso 27%, obesidad GI 24% y obesidad GII 17%. Solo realizan actividad física 30,4%. La mitad consumen frutas y verduras todos los días. Solo 6% presentaban antecedentes de hiperglicemia. El 43% presenta riesgo muy elevado por circunferencia abdominal. Solo 16% consumen regularmente medicamentos para la hipertensión arterial. Aplicando el cuestionario de FINDRISK la media global fue de 14,4 ± 4,4 (rango 7 -24) siendo similar en ambos sexos (p 0,6). En la valoración del riesgo, presentaban FINDRISK riesgo alto casi la mitad (47%) de los funcionarios, seguido de 31% riesgo ligeramente elevado, riesgo moderado 11% y riesgo muy alto 11%. En el análisis bivariado, utilizando como punto de corte de 15 del FINDRISK, encontramos que 38% de los funcionarios tienen nivel de riesgo alto. Conclusión: más de un tercio del personal de blanco tiene un alto nivel de riesgo de desarrollar DM en su evolución si no se toman medidas preventivas para evitarlo. Se deberían tomar medidas para disminuir la aparición de casos nuevos o retardar el inicio de la DM.

Introduction: FINDRISK questionnaire evaluates the probability of developing mellitus (DM) within 10 years. Objective: To determine the probability of developing DM within 10 years in healthcare personnel, considering lifestyle and family burden using the FINDRISK questionnaire. Material and methods: Cross-sectional descriptive prospective study performed in 100 individuals, healthcare personnel of the Hospital de Clínicas from September 1 to October 3, 2015. Results: The sample population was mostly women (77%), predominantly young (73%), 19% has parents and/or brothers/sisters with DM. Thirty two percent had normal weigh, 27% was overweight, 24% had GI obesity and 17% GII obesity. Only 30.4% made physical activity. Half eats fruits and vegetables every day. Only 6% had history of hyperglycemia and 43% presented a very high risk by abdominal circumference. Only 16% used regularly drugs for arterial hypertension. Applying the FINDRISK questionnaire, the global mean was 14.4 ± 4.4 (range 7 - 24) being similar in both genders (p = 0.6). In the risk assessment, almost half (47%) of the employees presented high risk followed by slightly high risk (31%), moderate risk (11%) and very high risk (11%). In the bivariate analysis using 15 of FINDRISK as a cut-off point, it was found that 38% of the employees had high risk levels. Conclusion: More than a third of the healthcare personnel had high risk level of developing DM in their evolution if preventive measures are not taken to avoid it. Measures should be taken to reduce the appearance of new cases or delay the beginning of DM.

[Assessment of a nutrition education intervention among construction workers]. / Evaluación de una intervención educativa nutricional en trabajadores de la construcción para prevenir enfermedades crónicas no transmisibles en Chile.

BACKGROUND: Unhealthy lifestyles and overweight are common among blue collar workers. AIM: To evaluate a nutrition education intervention in construction workers to prevent chronic diseases. MATERIAL AND METHODS: One hundred forty two participants were randomly assigned to an experimental group (n = 69) and or a control group (n = 73). The experimental group received nutrition education consisting in individual lifestyle counseling, group workshop, group counseling in healthy lifestyles, and environmental intervention. At baseline and after one year of intervention, clinical evaluations consisting in laboratory determinations, anthropometry and nutritional assessment evaluation were carried out. RESULTS: The experimental group experienced a significant decrease in waist circumference, total cholesterol, triglycerides, and an increase in HDL cholesterol. A significant reduction in total calorie intake, especially at the evening snack was observed during week-days. The same reduction in total calories occurred at dinner during the week-end. A significant increase was observed in the consumption of fruits, vegetables and fish. In the control group there was a significant increase in weight, waist circumference, body mass index, glucose and insulin, without changes in total calorie intake or healthy food consumption. High soft drink consumption did not change in both groups. CONCLUSIONS: In construction workers, integral nutrition intervention at the individual, group and environmental level had an impact in nutritional and biochemical indicators.

Evaluación de una intervención educativa nutricional en trabajadores de la construcción para prevenir enfermedades crónicas no transmisibles en Chile / Assessment of a nutrition education intervention among construction workers

Background: Unhealthy lifestyles and overweight are common among blue collar workers. Aim: To evaluate a nutrition education intervention in construction workers to prevent chronic diseases. Material and Methods: One hundred forty two participants were randomly assigned to an experimental group (n = 69) and or a control group (n = 73). The experimental group received nutrition education consisting in individual lifestyle counseling, group workshop, group counseling in healthy lifestyles, and environmental intervention. At baseline and after one year of intervention, clinical evaluations consisting in laboratory determinations, anthropometry and nutritional assessment evaluation were carried out. Results: The experimental group experienced a significant decrease in waist circumference, total cholesterol, triglycerides, and an increase in HDL cholesterol. A significant reduction in total calorie intake, especially at the evening snack was observed during week-days. The same reduction in total calories occurred at dinner during the week-end. A significant increase was observed in the consumption of fruits, vegetables and fish. In the control group there was a significant increase in weight, waist circumference, body mass index, glucose and insulin, without changes in total calorie intake or healthy food consumption. High soft drink consumption did not change in both groups. Conclusions: In construction workers, integral nutrition intervention at the individual, group and environmental level had an impact in nutritional and biochemical indicators.

[Validity of an instrument for assessing food consumption, food habits and cooking skills in 8-11 years old students]. / VALIDACIÓN DE UN INSTRUMENTO PARA EVALUAR CONSUMO, HÁBITOS Y PRÁCTICAS ALIMENTARIAS EN ESCOLARES DE 8 A 11 AÑOS.

INTRODUCTION: An instrument to measure food knowledge, food consumption, cooking skills, food habits and food expenses at school is necessary to assess changes in food practices. OBJECTIVE: To validate an instrument to measure changes in food knowledge, food consumption, cooking skills, food habits and food expenses in Chilean school children 8 - 11 years from third to fifth grade. METHODS: A validation of a questionnaire with 42 questions was conducted in two stages: the first to assess temporal stability, concordance and internal consistency in 45 children. The second one to apply the survey, modified with the results of the first stage, in 90 children assessing internal consistency. RESULTS: The first survey with 42 questions showed a reasonable temporal stability, concordance and internal consistency for cooking skills, habits and food expenditure at school. Internal consistency was good for food consumption, but not so good for food knowledge. In the final validation with 90 children, there was good consistency for food consumption but bad for food knowledge. Besides, children with cooking skills ate more healthy food and those who expended more money at school, consumed less healthy food. CONCLUSIONS: Food knowledge questions were eliminated from the instrument, which was elaborated with 28 questions about food consumption, cooking skills, food habits and food expenses at school. This instrument is useful to assess changes in food and nutrition education interventions in 8 -11 years children, in particular to measure cooking skills and food expenses at school.

Introducción: Para medir cambios en prácticas alimentarias, se requieren instrumentos que midan conocimiento, consumo, habilidades culinarias, hábitos y gastos en alimentos en las escuelas. Objetivo: Validar un instrumento que permita medir cambios en conocimiento, consumo, habilidades culinarias, hábitos y gastos en niños de 8 a 11 años, de tercero a quinto básico, en escuelas públicas de Chile. Métodos: Se realizó un estudio de validación de un cuestionario de 42 preguntas de conocimiento, consumo, habilidades culinarias, hábitos y gastos en la escuela. Se realizó en dos etapas: la primera en 45 niños para evaluar la estabilidad temporal, concordancia y consistencia interna. La segunda fue aplicar el instrumento modificado con los resultados de la primera etapa en 90 niños para medir consistencia interna. Resultados: El cuestionario aplicado en los 45 niños mostró estabilidad temporal, concordancia y consistencia interna aceptables para habilidades culinarias, hábitos y gastos en la escuela. La consistencia fue buena para frecuencia de consumo, pero mala en conocimiento. En la validación final con 90 niños, se confirmó la buena consistencia para frecuencia de consumo y mala para conocimiento. Se observó que aquellos niños con habilidades culinarias, consumen más alimentos saludables y los que gastan más dinero en la escuela, consumen menos alimentos saludables. Conclusiones: Al instrumento se le quitaron las preguntas de conocimiento, quedando con 28 preguntas de consumo, habilidades culinarias, hábitos y gasto en alimentos en las escuelas. Este instrumento es útil para medir cambios en intervenciones educativas en alimentación y nutrición en niños de 8 a 11 años.

[Feeding habits and lifestyles of male construction workers]. / Estilos de vida, alimentación y estado nutricional en trabajadores de la construcción de la Región Metropolitana de Chile.

BACKGROUND: The less affluent and educated members of the society tend to be less prone to healthy lifestyles. AIM: To describe feeding habits, nutrition, quality of life and working conditions of construction workers comparing two recent surveys, namely the 2009 Chilean National Health Survey (NHS) and the 2010 Work, Employment and Health Survey (WEH). MATERIAL AND METHODS: One hundred ninety male workers aged 43±13 years were surveyed about feeding habits during working days and weekends, smoking and usual physical activity. Weight, height and blood pressure were also measured. RESULTS: In 2010, 82% of workers were overweight or obese compared with 67% rates in the NHS of 2009. The rate of sedentariness was 86% compared with 84% in the NHS of 2009 and 93% in the WEH 2010. Forty one percent smoked and those aged less than 25 years consumed more calories than the other age groups. There was a high intake of carbonated beverages, bread, salted and red meats and a low consumption of fruits, vegetables, legumes and fish. Seventy seven percent had a meal at midafternoon and only 25% ate supper. Lunch had a fixed schedule, was considered good and usually was prepared by a family member. The level of satisfaction with work, family life and life in general was high. The satisfaction with health and physical condition was lower. CONCLUSIONS: The unhealthy lifestyles of these construction workers should alert health authorities.

Evaluación de una intervención de educación nutricional en profesores y alumnos de prebásica y básica de la comuna de los Andes en Chile / Evaluation of a nutrition education intervention in teachers and students in preschool and primary schools in los Andes, Chile

El objetivo del estudio fue evaluar el efecto de un programa de intervención con metodologías educativas innovadoras en alimentación y nutrición en profesores y alumnos de prebásica y básica, para lograr una mejoría en sus conocimientos, ingesta alimentaria y estado nutricional. Se realizó un estudio cuasi experimental en que se evaluó conocimiento, consumo alimentario y estado nutricional al inicio y término de la intervención educativa. La muestra quedó constituida por 25 profesores y 465 alumnos de Los Andes y 352 estudiantes controles de San Felipe. La intervención consistió en 9 sesiones educativas para los profesores en temas de alimentación saludable durante 5 meses, con transferencia de conocimientos a sus alumnos. Hubo una mejoría significativa en conocimiento y una disminución en el consumo de alimentos poco saludables en los alumnos de los profesores que recibieron la capacitación, con respecto al grupo control, sin cambios significativos en el estado nutricional de ambos grupos. En conclusión, la intervención en los profesores mejoró el conocimiento e ingesta de alimentos saludables en sus alumnos, sin modificar el estado nutricional por su corta duración. Si esta estrategia se mantiene en el tiempo y se incorpora al currículo escolar, puede lograr resultados en el largo plazo, incorporando a los padres en esta tarea.

The objective of the study was to assess the impact of a nutrition education program for teachers to improve food knowledge, food consumption and the nutritional status of their pre basic and basic students. A quasi-experimental study was carried out, with a pre-post evaluation of food knowledge, food consumption and nutritional status. The sample was 25 teachers and 465 students in Los Andes, with 352 students as control group in San Felipe. The nutrition intervention consisted in 9 interactive workshops for teachers during 5 months, transferring the information to the students. In the experimental group there was a significant improvement in food knowledge and a decrease in non-healthy food consumption in students, compared with the control group, without changes in nutritional status. In conclusion, the intervention in teachers improved food knowledge and healthy food consumption in students. As a consequence of the short period of intervention, the nutritional status did not change. If these strategies are maintained over time and incorporated to the school curricula could achieve more significant results, in particular if parents are incorporated in school nutrition education programs.

Estilos de vida, alimentación y estado nutricional en trabajadores de la construcción de la Región Metropolitana de Chile / Feeding habits and lifestyles of male construction workers

Background: The less affluent and educated members of the society tend to be less prone to healthy lifestyles. Aim: To describe feeding habits, nutrition, quality of life and working conditions of construction workers comparing two recent surveys, namely the 2009 Chilean National Health Survey (NHS) and the 2010 Work, Employment and Health Survey (WEH). Material and Methods: One hundred ninety male workers aged 43 ± 13 years were surveyed about feeding habits during working days and weekends, smoking and usual physical activity. Weight, height and blood pressure were also measured. Results: In 2010, 82% of workers were overweight or obese compared with 67% rates in the NHS of 2009. The rate of sedentariness was 86% compared with 84% in the NHS of 2009 and 93% in the WEH 2010. Forty one percent smoked and those aged less than 25 years consumed more calories than the other age groups. There was a high intake of carbonated beverages, bread, salted and red meats and a low consumption of fruits, vegetables, legumes and fish. Seventy seven percent had a meal at midafternoon and only 25% ate supper. Lunch had a fixed schedule, was considered good and usually was prepared by a family member. The level of satisfaction with work, family life and life in general was high. The satisfaction with health and physical condition was lower. Conclusions: The unhealthy lifestyles of these construction workers should alert health authorities.

[Evaluation of an online health promotion Diploma]. / Evaluación de un programa de educación a distancia en Promoción de Salud para la Atención Primaria en Chile.

BACKGROUND: Health promotion in Chile is essential, considering its current epidemiologic status where chronic diseases are predominant. AIM: To report the evaluation of an on-line Diploma in health promotion for Primary Health Care professionals. MATERIAL AND METHODS: Two hundred sixty four professionals from all regions of the country (40% rural and 60% urban) took the Diploma. It lasted 8 months with 248 academic hours distributed in 5 modules with a total of 15 units. The program was evaluated with four surveys answered by the students (general description of participants, mid-term, final and follow-up). RESULTS: Students were highly satisfied with the program and especially with its interactive methodology which included tutorials, individual and group assignments, online discussions and a final project. The drawbacks were time restrictions and limited internet access. Ninety percent of students completed the course with an overall mean grade of 5.57 (out of a 1-7 scale). The follow-up survey showed that students implemented the new health promotion knowledge acquired, and put in practice their final assignment in their local counties. Also, most students improved their working conditions. CONCLUSIONS: The on-line interactive and participative methodology applied in this Diploma had positive results and the evaluation model can be applied in other health promotion on-line education programs.

[Impact of a nutrition education intervention in teachers, preschool and basic school-age children in Valparaiso region in Chile]. / Efecto de una intervención educativa en alimentación saludable en profesores y niños preescolares y escolares de la región de Valparaíso, Chile.

OBJECTIVE: To assess the impact of a nutrition education program for teachers in the nutritional status, food knowledge and food consumption of their pre basic and basic students, and in the controls. MATERIALS AND METHODS: A nutrition education intervention was conducted in pre basic and basic teachers in a school year, with a pre-post evaluation of their students, compared with a control group. Subjects were 817 students (389 men and 428 women) from pre kindergarten to the second grade. The 465 students of the intervened group were distributed in two schools (Liceo 1 = 283; Liceo 2 = 182) and 352 in the control school. The nutrition intervention consisted in 9 interactive workshops for teachers with the utilization of Information and Communication Technologies (ICT). The pre post evaluation consisted in a nutritional status assessment, and a food and nutrition survey with questions related with food knowledge and food consumption, at the beginning and at the end of the school year. RESULTS: There were no significant differences in nutritional status between the beginning and the end of the intervention. In one of the experimental schools (Liceo 2) there was a significant decrease in obesity, in women and in the age-group 7-9 years. In the experimental group there was a significant improvement in food knowledge and a decrease in non-healthy food consumption. In the control group, consumption of non-healthy food was stable, with a decrease in fruits and vegetables consumption. CONCLUSIONS: As it was demonstrated in similar studies, a short interactive nutrition education intervention with utilization of ICT in pre basic and basic teachers can produce positive changes in nutritional status of their students, improving food knowledge and healthy food consumption and decreasing non-healthy food consumption, compared with the control group. However, a strategy to incorporate parents in school nutrition education programs is still a pending issue.

Objetivo: Evaluar el efecto del programa educativo realizado en profesores, en el estado nutricional, conocimiento y consumo de alimentos saludables de alumnos de prekinder a segundo básico intervenidos y sus controles. Material y Método: Se trata de una intervención en educación nutricional en profesores de prebásica y básica, durante un año escolar, con una evaluación antes y después de sus alumnos, comparado con un grupo control. La muestra quedó constituida por 817 alumnos (389 hombres y 428 mujeres) de prekinder, kínder, 1º y 2º básico, 465 en los dos colegios intervenidos (Liceo 1 = 283 y Liceo 2 = 182) y 352 en el control. La intervención consistió en 9 talleres participativos y con uso de Tecnologías de la Información y Comunicación (TIC) a los profesores y en una evaluación de estado nutricional y encuesta de conocimiento y consumo de sus alumnos, al inicio y final del año académico. Resultados: En estado nutricional no se produjeron diferencias significativas entre el inicio y final de la intervención. En uno de los colegios intervenidos se observó una disminución significativa de la obesidad, en mujeres y en el grupo de 7 a 9 años. En los colegios intervenidos hubo una mejoría significativa en conocimiento y disminución en el consumo de alimentos poco saludables con respecto al control, en el cual se mantuvo la alimentación poco saludable y disminuyó el consumo de verduras y legumbres. Conclusiones: Al igual que en otros estudios, queda demostrado que una intervención educativa participativa, con uso de TIC y de corta duración en profesores y alumnos de prebásica y básica, puede producir cambios positivos en el estado nutricional, mejorando significativamente el conocimiento y consumo de alimentos saludables y disminuyendo el consumo de alimentos no saludables, lo que no sucede en el grupo control. Sin embargo, queda pendiente una estrategia de como implicar a los padres en esta tarea.

Evaluación de un programa de educación a distancia en Promoción de Salud para la Atención Primaria en Chile / Evaluation of an online health promotion Diploma

Background: Health promotion in Chile is essential, considering its current epidemiologic status where chronic diseases are predominant. Aim: To report the evaluation of an on-line Diploma in health promotion for Primary Health Care professionals. Material and Methods: Two hundred sixty four professionals from all regions of the country (40% rural and 60% urban) took the Diploma. It lasted 8 months with 248 academic hours distributed in 5 modules with a total of 15 units. The program was evaluated with four surveys answered by the students (general description of participants, mid-term, final and follow-up). Results: Students were highly satisfied with the program and especially with its interactive methodology which included tutorials, individual and group assignments, online discussions and a final project. The drawbacks were time restrictions and limited internet access. Ninety percent of students completed the course with an overall mean grade of 5.57 (out of a 1-7 scale). The follow-up survey showed that students implemented the new health promotion knowledge acquired, and put in practice their final assignment in their local counties. Also, most students improved their working conditions. Conclusions: The on-line interactive and participative methodology applied in this Diploma had positive results and the evaluation model can be applied in other health promotion on-line education programs.

[Evaluation of a nutrition education intervention in teachers and students in pre-school and primary schools in los Andes, Chile]. / Evaluación de una intervención de educación nutricional en profesores y alumnos de prebásica y básica de la comuna de los Andes en Chile.

The objective of the study was to assess the impact of a nutrition education program for teachers to improve food knowledge, food consumption and the nutritional status of their pre basic and basic students. A quasi-experimental study was carried out, with a pre-post evaluation of food knowledge, food consumption and nutritional status. The sample was 25 teachers and 465 students in Los Andes, with 352 students as control group in San Felipe. The nutrition intervention consisted in 9 interactive workshops for teachers during 5 months, transferring the information to the students. In the experimental group there was a significant improvement in food knowledge and a decrease in non-healthy food consumption in students, compared with the control group, without changes in nutritional status. In conclusion, the intervention in teachers improved food knowledge and healthy food consumption in students. As a consequence of the short period of intervention, the nutritional status did not change. If these strategies are maintained over time and incorporated to the school curricula could achieve more significant results, in particular if parents are incorporated in school nutrition education programs.

[Effect of a nutrition education intervention on consumption of fruits, vegetables and fish in families of prescholers and scholers]. / Efecto de una intervención educativa sobre el consumo de frutas, verduras y pescado en familias de niños preescolares y escolares.

The objective of this study was to assess the impact of a nutrition education intervention on fruits, vegetables and fish consumption in pre-school and school age children families, through a three months education intervention with a pre-post evaluation in 27 intervened families and 32 controls from public schools in Santiago, Chile. A food-frequency questionnaire on fruits, vegetables and fish, and a survey on food and nutrition knowledge, attitudes and practices were applied to children and their parents. The intervention consisted in six 90 minutes cooking workshops, including the utilization of videos and photovoice for those who cooked in the families. Results showed a significant more consumption of fruits, vegetables and fish in the intervened than in the control group (test de Kolmogorov-Smirnov, test de Wilcoxon, p < 0.05). Comparing pre-post consumption by group, significance differences were for the intervened group in all cases. (test de Wilcoxon for paired samples, p < 0.05). In parents, fruit consumption increased 135.8 g, vegetables 19.5 g, and fish 10,2 g per day. In children, the increase in fruits was 92.1 g, vegetables 65.9, and fish 5.2 g per day. All the intervened families (n = 22) introduced a significant healthy food improvement at home. Results showed that it is possible to change food habits in families with the implementation of a nutrition education intervention including cooking workshops, videos and photovoice.

Efecto de una intervención educativa sobre el consumo de frutas, verduras y pescado en familias de niños preescolares y escolares / Effect of a nutrition education intervention on consumption of fruits, vegetables and fish in families of prescholers and scholers

El objetivo del estudio fue evaluar el efecto de una intervención educativa sobre el consumo de frutas, verduras y pescado en familias de niños preescolares y escolares mediante una intervención de tres meses y una evaluación antes y después, en 27 familias intervenidas y 32 controles, de colegios municipales de una comuna de Santiago, Chile. Al inicio y final de la intervención se aplicó a cada niño y su padre una encuesta de frecuencia de consumo de frutas, verduras y pescado y de conocimientos, actitudes y prácticas de alimentación familiar. La intervención consistió en seis talleres de cocina de 90 minutos cada uno para los encargados de la preparación de alimentos en el hogar, utilizando además video y fotografía participativa. Los resultados mostraron un mayor consumo de frutas, verduras y pescado en el grupo intervenido (test de Kolmogorov-Smirnov, test de Wilcoxon, p<0,05). Al comparar el consumo pre-post por grupo, las diferencias resultaron significativas para el intervenido en todos los casos (test de Wilcoxon para muestras pareadas, p<0,05). En los padres, el consumo de frutas aumentó en 135,8 g, el de verduras en 19,5 g y el de pescado en 10,2 g diarios. En los niños, las frutas aumentaron 92,1 g, las verduras 65,9 g y el pescado 5,2 g al día. Todas las familias intervenidas (n=22) incorporaron algún cambio significativo en la alimentación saludable de su hogar. Los resultados muestran que es posible realizar cambios en los hábitos alimentarios de las familias, con la implementación de una intervención educativa que incluya talleres de cocina y materiales audiovisuales.

The objective of this study was to assess the impact of a nutrition education intervention on fruits, vegetables and fish consumption in pre-school and school age children families, through a three months education intervention with a pre-post evaluation in 27 intervened families and 32 controls from public schools in Santiago, Chile. A food-frequency questionnaire on fruits, vegetables and fish, and a survey on food and nutrition knowledge, attitudes and practices were applied to children and their parents. The intervention consisted in six 90 minutes cooking workshops, including the utilization of videos and photovoice for those who cooked in the families. Results showed a significant more consumption of fruits, vegetables and fish in the intervened than in the control group (test de Kolmogorov-Smirnov, test de Wilcoxon, p<0,05). Comparing pre-post consumption by group, significance differences were for the intervened group in all cases. (test de Wilcoxon for paired samples, p<0,05). In parents, fruit consumption increased 135.8 g, vegetables 19.5 g, and fish 10,2 g per day. In children, the increase in fruits was 92.1 g, vegetables 65.9, and fish 5.2 g per day. All the intervened families (n=22) introduced a significant healthy food improvement at home. Results showed that it is possible to change food habits in families with the implementation of a nutrition education intervention including cooking workshops, videos and photovoice.

[Validation of an instrument to measure food practices in Chilean families of school children aged 4-7 years]. / Validación de un instrumento para evaluar prácticas alimentarias en familias chilenas de escolares de 4 a7 años.

INTRODUCTION: It is necessary to assess family food habits in school children to cope with infant obesity. OBJECTIVE: Designing and validation of an instrument to measure food habits and food knowledge in Chilean preschool and school families based on dietary guidelines. METHODS: A pilot study in 30 preschool and school-age parents was carried-out. A questionnaire to measure food habits and food knowledge in parents was elaborated by researchers considering an expert group opinion. This questionnaire was applied twice with a 15 days interval, evaluating temporal stability, internal consistency and inter-personal agreement. Afterwards, the questionnaire was applied to 59 parents calculating the internal consistency of the instrument. RESULTS: The questionnaire had 55 questions in 4 sections. The instrument had questions about food and nutrition information about the families. A good inter-personal agreement resulted for almost all the questions about food and nutrition information (0.5-1.0). The correlation between the first and second test (test-retest) was high (0.6-1.0), as well as the internal consistency (0.75). In the section about frequency consumption in parents and children food consumption at home and school there was a high internal consistency for the two observers (0.85-0.92 and 0.87-0.90). CONCLUSIONS: The instrument is valid and useful to be utilized in preschool and school families intervened with nutrition education, and this methodology can be replied in other studies.

Introducción: Para enfrentar el problema de la obesidad infantil, es necesario evaluar prácticas alimentarias en familias de escolares. Objetivo: Elaborar y validar un instrumento para medir actitudes, conocimientos y hábitos alimentarios en familias chilenas de escolares de prebásica y básica basado en las guías alimentarias. Métodos: Se realizó un estudio piloto en 30 padres de escolares de prebásica y básica. Se diseñó un cuestionario por los investigadores del estudio considerando la opinión de un grupo de expertos, para medir actitudes, conocimientos hábitos alimentarios en los padres de los escolares. Para la validación del cuestionario, se aplicó en 2 ocasiones, con 15 días de intervalo y se evaluó estabilidad temporal, consistencia interna y concordancia inter-observadores. Posteriormente se aplicó a una muestra de 59 padres y se calculó la consistencia interna del instrumento. Resultados: El cuestionario quedó conformado por 55 preguntas, agrupadas en 4 secciones. Se encontró una buena concordancia inter-observadores para casi todas las preguntas de la sección conocimientos en alimentación y hábitos alimentarios (0,5-1,0). La correlación entre la primera aplicación y la segunda (test-retest) fue elevada (0,6-1,0), así como la consistencia interna (0,75). En la sección frecuencia de consumo del padre y en la de alimentación del niño en el hogar y colegio, la consistencia interna para los dos observadores fue elevada (0,85-0,87; 0,92-0,90; respectivamente). Conclusiones: El instrumento es útil y válido para ser aplicado en familias de escolares de prebásica y básica intervenidas con educación nutricional y esta metodología puede ser replicada en estudios similares.