Impact of a school-based nutrition education intervention on students’ knowledge, attitudes, and behaviors in Chiang Mai, Thailand: a quasi-experimental study

The increasing prevalence of childhood obesity in Thailand highlights the need for effective school-based interventions. This study evaluated the impact of a short-term nutrition education intervention on the nutrition knowledge, attitudes, and behaviors (KAB) of students in grades 4-6 in Chiang Mai, Thailand. A quasi-experimental design was implemented in nine public primary schools, comprising four intervention schools (121 students) and five control schools (153 students). The nine-week intervention integrated animated video modules into Health Education, Mathematics, and English lessons. Data on KAB were collected at baseline and at a three-month follow-up after the intervention and analyzed using mixed-effects linear regression models adjusting for clustering at the school level and for student covariates (sex, ethnicity, and daily allowance). Baseline characteristics were comparable between groups, except for age and ethnicity. Knowledge scores increased modestly in both groups, but the difference in change between groups was not significant (adjusted β = 0.21; 95% CI -0.47 to 0.89; p = 0.55). Attitude scores decreased slightly, and behavior scores remained stable, with no significant intervention effects. The short-term, teacher-facilitated intervention modestly improved nutrition knowledge but did not significantly affect overall KAB or dietary patterns. Longer-term, multi-component strategies involving teachers, parents, and supportive school food environments are required to achieve sustained improvements in children’s dietary behaviors.