From Policy to Practice: Implementing Nutritional Interventions to Improve Adherence to School Meals in Northeastern Brazil
1
Universidade Estadual do Ceará, Fortaleza, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1529
ABSTRACT
INTRODUCTION:
Brazil faces persistent challenges related to food and nutrition insecurity, marked by the coexistence of malnutrition and increasing childhood obesity. The National School Feeding Program (PNAE) aims to ensure access to healthy meals in public schools; however, adherence to and acceptability of school meals remain critical challenges. The objective of this work was to evaluate the implementation of a multicomponent nutritional intervention and its effects on adherence to and acceptability of the main school meal in the public school system of a municipality in Northeastern Brazil.
METHODS:
This implementation study was conducted with a 5th-grade class at a public elementary and secondary school in Tauá, Ceará. The study was developed in three stages: (1) a diagnostic phase, including focus groups with students and parents; (2) implementation of a multicomponent intervention involving changes in the school food environment, food and nutrition education actions, improvements in the organization and operation of the school food service, and gastronomic interventions; and (3) an evaluation phase based on the Proctor implementation outcomes taxonomy. Quantitative and qualitative data were collected, including plate waste and clean leftovers, nutritional status, socioeconomic characteristics, and lifestyle indicators. Data were analyzed using mixed methods.
RESULTS:
The multicomponent intervention showed a positive impact on both adherence to and acceptability of school meal preparations, particularly those previously reported as less accepted. The actions were well received by students and the school community, were low-cost, sustainable throughout the study period, and directly addressed barriers identified in the diagnostic phase. Active and collaborative engagement of school stakeholders was a key element contributing to the observed improvements.
CONCLUSIONS:
Multicomponent nutritional interventions in the school environment are feasible, effective, and potentially replicable strategies to improve adherence to and acceptability of school meals, contributing to the promotion of adequate and healthy eating in public schools.
Brazil faces persistent challenges related to food and nutrition insecurity, marked by the coexistence of malnutrition and increasing childhood obesity. The National School Feeding Program (PNAE) aims to ensure access to healthy meals in public schools; however, adherence to and acceptability of school meals remain critical challenges. The objective of this work was to evaluate the implementation of a multicomponent nutritional intervention and its effects on adherence to and acceptability of the main school meal in the public school system of a municipality in Northeastern Brazil.
METHODS:
This implementation study was conducted with a 5th-grade class at a public elementary and secondary school in Tauá, Ceará. The study was developed in three stages: (1) a diagnostic phase, including focus groups with students and parents; (2) implementation of a multicomponent intervention involving changes in the school food environment, food and nutrition education actions, improvements in the organization and operation of the school food service, and gastronomic interventions; and (3) an evaluation phase based on the Proctor implementation outcomes taxonomy. Quantitative and qualitative data were collected, including plate waste and clean leftovers, nutritional status, socioeconomic characteristics, and lifestyle indicators. Data were analyzed using mixed methods.
RESULTS:
The multicomponent intervention showed a positive impact on both adherence to and acceptability of school meal preparations, particularly those previously reported as less accepted. The actions were well received by students and the school community, were low-cost, sustainable throughout the study period, and directly addressed barriers identified in the diagnostic phase. Active and collaborative engagement of school stakeholders was a key element contributing to the observed improvements.
CONCLUSIONS:
Multicomponent nutritional interventions in the school environment are feasible, effective, and potentially replicable strategies to improve adherence to and acceptability of school meals, contributing to the promotion of adequate and healthy eating in public schools.
| eISSN: | 2654-1459 |
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