PURPOSE
Multi-country study to explore the school community’s environment and its influence on social norms, beliefs, perceptions, motivations, and behaviours on healthy eating, nutrition, and physical activity in school-aged children and their families.
BACKGROUND AND CONTEXT
Latin America and the Caribbean is one of the regions with the highest rates of overweight and obesity in the world. The 2023 Thematic Report on Childhood Overweight in LAC showed that this condition affects more than four million children under five years of age and almost 50 million children and adolescents aged 5 to 19 years. The UNICEF Nutrition Strategy (2020-2030) recognizes the role of five systems, namely food, health, education, social protection and water, sanitation and hygiene (WASH), as well as social norms, in preventing childhood overweight. UNICEF LACRO has been engaged in overweight and obesity prevention work since 2016.
To better understand the evidence base behind overweight and obesity prevention, in 2021 UNICEF LACRO and INCAP commissioned the study "The role of schools in preventing overweight and obesity among students in Latin America and the Caribbean", which showed that only 10 countries in Latin America and the Caribbean (LAC) have regulatory instruments that address at least three of four effective actions.1 Additionally, UNICEF LACRO also commissioned the study "Social norms, nutrition and body image" in 2021-2022, which found that adults, community dynamics, and gender norms all influence children’s dietary practices.
School-aged children and adolescents and their families in urban and rural areas are highly exposed to social, environmental, and physiological factors influencing their decision-making regarding food choices and physical activities. Eating behaviour is strongly influenced by social context. Research shows that what and how much people choose to eat is influenced by perceptions of the eating habits of others, as well as also shared cultural expectations and environmental cues.2 As social creatures, children, adolescents and adults tend to conform to these norms because they find it rewarding to do so. Therefore, to encourage healthier eating habits, social norm-based behavioural interventions have been shown to be effective.
Building on the previous studies done by UNICEF and an existing evidence base from other organizations and researchers, and to gain more information about how school environments affect social norms around the practice of healthy eating and physical activity, UNICEF LACRO will commission a new, complementary study, to explore the school community’s current environment, which influences social norms, beliefs, perceptions, motivations, and behaviours on healthy eating and physical activity, as well as the kinds of interventions or measures that would be needed for the actions taken at the school level to influence parents/ caregivers' behaviour at home in a positive manner.
OBJECTIVES & SCOPE OF WORK
Objectives
Under the overall guidance of the regional Nutrition Specialist in coordination with the SBC (Social and Behavioural Change), Adolescent Development, and Education regional teams, the institution will undertake a desk review and field research regarding the influence of school community environments on children’s food-related behaviors and physical activity practices. This includes:
· Identifying perceived barriers and facilitators to implement regulatory frameworks and national strategies for promoting healthy eating and physical activity in schools.
· Analysing drivers, barriers, and facilitators faced by schools, school communities (teachers, principals, school staff, parents/caregivers), and school-aged children regarding their food environment, food practices, and physical activity, including social norms and environmental factors.
· Explaining the underlying factors influencing social, cultural, and gender dynamics in school-age children and adolescents food choices, practices and physical activity.
· Identifying strategies that can influence behaviour change on healthy lifestyles in a positive manner.
Scope of work
The institution will work closely with the regional Nutrition Specialist and Food Systems Specialist, the Social Behavioral Change Specialist, the Adolescent Health Specialist and the Food Systems Specialist and relevant UNICEF Country Office colleagues, to conduct the following tasks to achieve the deliverables:
1. Develop a research protocol and workplan: This study will have two components 1) regional desk review from all counties in LAC region, with special emphasis in Brazil, Chile, Colombia, Mexico, Panama, and Peru and 2) field research in three countries (Chile, Mexico and Peru) in coordination with UNICEF Country Offices. The protocol draft should include title, introduction, research objectives, ethical considerations, methodology (including local country coordination), data collection tools (including local adaptation), data collection tools, references workplan, timeline, etc. This will be reviewed by UNICEF LACRO and the research team must make changes accordingly.
2. Ethical approval: The research team must submit the study for ethics committee(s) review and approval. The costs for ethical approval should be included in the financial proposal.
3. Desk Review of existing documentation focusing on LAC region (with emphasis in Brazil, Chile, Colombia, Mexico, Panama and Peru) reports, national surveys, scientific articles, and other publications regarding:
a. Regulatory frameworks, policies, programmes and strategies in LAC to promote healthy eating and physical activity in the school environment.
b. Social norms (according to UNICEF’s behavioral drivers’ model around diet and body weight in the LAC region, including subregional differences).
c. Social, environmental, and physiological factors, including cultural expectation and motivations influencing the decision-making regarding food choices, eating behavior and physical activities in school-aged children and their families in urban and rural areas, considering gender disparities.
d. Impact of school environments on social norms around healthy eating and physical activity.
e. Other key aspects identified as essential for the study. This will be defined based on key information found during the desk review that is considered relevant by the research team to explore further.
4. Development of the data collection methodology and study protocol. This should include the recompilation of existing assessment tools (incl. cultural adaptation) and/or development of culturally adapted data collection tools (i.e. focus groups guides and semi-structured interviews). It should also include methods that ensure the meaningful participation of adolescents and youth from diverse backgrounds, ages, and gender.
5. Data collection: Conduct interviews and other innovative/feasible research methods, as needed, in close coordination with COs, to key informants such school students, teachers, caregivers, active partners, relevant governmental counterparts and others identified as relevant. This includes travel and accommodation costs to Chile, Mexico and Peru.
6. Analyse the data collected using adequate tools for qualitative (SenseMaker, NVIVO) and/or quantitative (R, SPSS or STATA) data.
7. Draft report with key findings and recommendations and finalize it after receiving inputs from UNICEF.
8. Final report of the project including executive summary, keywords, introduction, methodology, ethical considerations, results, conclusions, discussion, recommendations at regional and country level, acknowledgements, author’s contribution, declaration of conflict of interest, references (following UNICEF’S guidelines for publications). In addition, include recommendations for youth engagement, including key messages targeting children and adolescents, based on the study results. It also includes support and follow up during translation and publication of the report.
9. Policy brief. Develop one regional policy brief with a summary of the findings and recommendations. The research team will provide support and follow up during the translation and publication process.
10. Dissemination activities: Support the dissemination and presentation of the findings in relevant fora and events at regional and country level, including through the development of a PowerPoint presentation.
11. Follow up and reporting: The research team will engage in regular meetings with the UNICEF LACRO team to provide updates on the study's progress and to collaboratively assess and refine the research approach as needed.
12. Submission and publication of scientific journal: scientific publications, both in Spanish and English. Follow-up to comments and recommendations during publication process.
