Background: School canteens represent an opportune setting in which to deliver public health nutrition strategies because of their wide reach and frequent use by children. Online school-canteen ordering systems, where students order and pay for their lunch online, provide an avenue to improve healthy canteen purchases through the application of consumer-behavior strategies that have an impact on purchasing decisions.Objective: We assessed the efficacy of a consumer-behavior intervention implemented in an online school-canteen ordering system in reducing the energy, saturated fat, sugar, and sodium contents of primary student lunch orders.Design: A cluster-randomized controlled trial was conducted that involved 2714 students (aged 5-12 y) from 10 primary schools in New South Wales, Australia, who were currently using an online canteen ordering system. Schools were randomized in a 1:1 ratio to receive either the intervention (enhanced system) or the control (standard online ordering only). The intervention included consumer-behavior strategies that were integrated into the online ordering system (targeting menu labeling, healthy food availability, placement, and prompting).Results: Mean energy (difference: -567.25 kJ; 95% CI: -697.95, -436.55 kJ; P < 0.001), saturated fat (difference: -2.37 g; 95% CI: -3.08, -1.67 g; P < 0.001), and sodium (difference: -227.56 mg; 95% CI: -334.93, -120.19 mg; P < 0.001) contents per student lunch order were significantly lower in the intervention group than in the control group at follow-up. No significant differences were observed for sugar (difference: 1.16 g; 95% CI: -0.50, 2.83 g; P = 0.17).Conclusions: The study provides strong evidence supporting the effectiveness of a consumer-behavior intervention using an existing online canteen infrastructure to improve purchasing behavior from primary school canteens. Such an intervention may represent an appealing policy option as part of a broader government strategy to improve child public health nutrition. This trial was registered at www.anzctr.org.au as ACTRN12616000499482.

中文翻译：

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消费者行为干预的集群随机对照试验，以改善从在线食堂购买健康食品。

背景：学校食堂是提供公共卫生营养策略的合适场所，因为它们覆盖面广且儿童经常使用。在线学校食堂订购系统，学生在线订购和支付午餐费用，通过应用对购买决策有影响的消费者行为策略，提供了一种改善健康食堂购买的途径。目标：我们评估了消费者的功效- 在学校食堂在线订购系统中实施的行为干预，以降低小学生午餐订单的能量、饱和脂肪、糖和钠含量。设计：进行了一项涉及 2714 名学生（5-12 岁）的整群随机对照试验y) 来自澳大利亚新南威尔士州的 10 所小学，目前正在使用在线食堂点餐系统的人。学校以 1:1 的比例随机接受干预（增强系统）或控制（仅标准在线订购）。干预措施包括整合到在线订购系统中的消费者行为策略（针对菜单标签、健康食品供应、放置和提示）。结果：平均能量（差异：-567.25 kJ；95% CI：-697.95，-436.55 kJ；P < 0.001）、饱和脂肪（差异：-2.37 g；95% CI：-3.08、-1.67 g；P < 0.001）和钠（差异：-227.56 mg；95% CI：-334.93、-120.19 mg; P < 0.001) 干预组每份学生午餐订单的含量在随访中显着低于对照组。对于糖，未观察到显着差异（差异：1.16 g；95% CI：-0.50，2.83 g；P = 0。17). 结论：该研究提供了强有力的证据支持消费者行为干预的有效性，使用现有的在线食堂基础设施来改善小学食堂的购买行为。这种干预可能代表一种有吸引力的政策选择，作为更广泛的政府改善儿童公共卫生营养战略的一部分。该试验在 www.anzctr.org.au 上注册为 ACTRN12616000499482。