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w z wz 16(2) : 206~214, 2011 Korean J Community Nutr 16(2) : 206~214, 2011 DOI:10.5720/kjcn.2011.16.2.206 영양플러스사업효과의지속성에대한연구 - 포항지역을중심으로 - x 1) Á y 1)sw û, w t w A Study of the Sustainability of NutriPlus Program Effect - in Pohang Area - +J)ZF,BOH )P,ZVOH3ZV 1) Nam-gu Community Health Center, Pohang, Gyeongbuk, Korea Department of Food and Nutrition, Pusan National University, Pusan, Korea "CTUSBDU This study was conducted to investigate the effect of the NutriPlus+ Program and to observe how the improved statuses were maintained after the 's termination. The subjects were infants and their parents, who have participated in the NutriPlus+ Program conducted by South Healthcare Center in Po-hang for longer than six months, during the period 2007-2010. The survey was conducted with questionnaires, and scores were tabulated from each question. After the intervention of the, scores representing degrees of nutrition knowledge and nutrition attitude increased. The rate of nutritional risk by anthropometric measurement decreased, and the prevalence rate of anemia was significantly decreased as well. The number of subjects lacking any nutrients, except for iron and vitamin C, decreased, which indicates that the NutriPlus+ Program was effective. After enough time had passed after the intervention's completion; however, the scores of nutrition knowledge and nutrition attitude decreased. The number of subjects with low height and weight (proportional to their age) relatively decreased, and the prevalence rate of anemia increased slightly. The number of subjects lacking in energy and calcium consumption increased as well, which indicates that the effect of the NutriPlus+ Program was not maintained after the 's termination. (Korean J Community Nutr 16(2) : 206~214, 2011) KEY WORD : NutriPlus ProgramÁafter interventionásustainability 서 n # # #vp # p# # p#lq lp # p#kv v# p# tl# pl+kdq#)#ohh#533<>#dq#5343,# # # }l #n # p/# r/# # r# ol # n# r p=#5344 #5o#44p#r rp=#5344 #6o#5;p# r }ˆp=#5344 #7o#37p#}ˆ *This work was supported for two years by Pusan National University Research Grant Corresponding author: Ho Kyung Ryu, Department of Food and Nutrition, Pusan National University, Jangjun-dong, Geumjung-gu, Pusan 609-735, Korea Tel: (051)510-7397, Fax: (051)583-3648 E-mail: hokryu@pusan.ac.kr 론 kv #p 1# #tl #mkrp # k #v p#pe / o # #mok # #l l# # # #n #p#e p#mk p# pp# # # r # p#p # l#tn # kv #p +Nzrq 5338,1# #ok # q# op# q#m # p# p#m #e p /#e~p# #sr # # pv# p# # #e +Prrq#)#Ohh#4<;:> Dkq#)#Olp#4<<7>#Nlp#)#Vklp#4<<8,/#p#e l# #mk p# q # l# rp#npp #qn +Zuljkw# )# Udglfolih# 4<<5># Kdpprqg# # 4<<7># Vlq )#Ohh#5338,1# #ok l#rr #mk # #m k p# p# kt v#plvv#k # kk# 1 p # k#t r#mk r # #o # # #t# q# rp# p# p#zlf# p 1 n l #p #ZLF# p# ˆ l#mk 206

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208Á v z npp#p #Žr m /#eql# #~tp# pp <8shufhqwloh#p p# n# p #Žr m 1# +5,# # #Žrp#o # t# +khprjorelq/#ke,# # l#r/# l#s #e/#e # # #s #erl khprfxh#ke#534#.#khpr0frqwurop# n l# t# # # r mp /#5 # # r l# p# n m 1# Žrp#ZKRp# tp# n mp 45 8< op#44 j2go# /#93 ;7 op#4418 j2go# /#;8 465 op#45 j2go# p# #Žr m 1 +6,#mk ˆs mk ˆ #s #o l#57e # p# n m 1# #s #ok ql #ok # #r # e m# ep#e s l# #r # m 1#r nep# m # e#ed # # n#5p#rl# # np # # e#ed # d #57e # k p#e # p# # m 1#p q #rp# p# ˆp # e# p#mk d# #mk #p # ep # ~rp# p#s m /# v l #r # on#e #e #e vp# #}# n kp# lp#l # p B # n l#mk # p#m # m 1#s #q #FDQ0Sur 613+Frpsxwhu# Dlghg# Qxwulwlrqdo# Dqdo vlv# Surjudp 613,p#pn l#mk # p# m # p#mk tp# q p# l# q l# # p # n #p # # pp# m +Sdun# #5339,1 mko #Žrp# mk l # # p#mk t+ngulv#5338,l# l/#l v# p# n r +Hvwlpdwhg#Hqhuj #Uhtxluhphqwv=#HHU,p#:8( p /# v/# d/#~/# ˆ #D/# /# p ke/# ˆ #F#t# # v # # p# n +Hvwlpdwhg#Dyhudjh#Uhtxluhphqw=#HDU,l# v# # nl#mk sp #Žr m 1 s #q #VSVV#4513N#iru#Zlqgrzv #pn l# m 1# # l# # p # /# # t # m /# l#r # l#s #e/#e # #erp#mkve/#ˆ /# #o /# # /#m k # # rp# # ~# # # r p # p # v m 1# l#r #s #e/#e # # #e rp# qv m# #o p#op # vp# p # pr # r p#pn l# v mp /# #q p#s# p#3138# p# #op #Ž m 1 결 k d ok# qp# p# k#99 +861:(,/#lk#8: +7916(,pl /# l p# l#r #erp# tp #59 o/# l#s #e #68 o/# e # # #86 opl 1 okp#tn#ok q # l #44< +<91:(,p #ok #l # #p # p#k# #pl 1# qp# l# l# p# e# #mk d# ll# 9 o # k# l #67 +5:19(,/# : o#p #45 o#p # l #73 +6518(,/# 46 o#p #4; o#p #69 +5<16(,/# 4< o#p #57 o#p #46 +4319(,p # #9 ol # #57 o vm 1#s l# # # p# 45 o#p #68 +5;18(,/# 46 o#p l #4; o#p #76 +6813(,/# 4< o#p 과 p#78 +6919(, # v m +Wdeoh#4,1 j n m p # v # n l#ok qp#mkvep# l r # l#s #e/#e # # # # #Wdeoh#5 Table 1. The general characteristics of children Variables Items Gender Age (month) Fosterer Duration for G participation Boy 66G(553.7) 1) Girl 57G(546.3) Before 26 1.4 2) After 35 1.6 Follow-up 53 1.8 Mother 119G(596.7) 1) Others 4G(553.3) 6 month 34G(527.6) 1) 7 12 month 40G(532.5) 13 18 month 36G(529.3) 19 24 month 13G(510.6) 12 month 35G(528.5) 1) Duration after the 13 18 month 43G(535.0) G finish of 19 month 45G(536.6) Total 123G(100.0) 1) 1) N (%) 2) Mean SD

xá y Á209 m# 1# o#r#mkver ##:1;<rl # o# ;17:rp #oprp# p # l 1# v # l#s #e p# #;147rp #oprp# p # m +Wdeoh#5,1# m +Wdeoh#6,1# l#r#mk #e #ˆ r # #7<19rl # l#s #e#8515rp #oprp # l 1# v # l#s # #e p# #mk #e # #ˆ #r #7<16rp #oprp # m 1# m Ð m ok qp#mk #e #ˆ #r #43 v# p s # # l#r # l#s #e/#e # # # h m l #eqp#43# ˆp# p#ok# q # l r#4515(l # l#s #e#;1<( #oprp # m Table 2. Changes in parents'/guardians' nutrition knowledge score Questions Before After Follow-up F-value 3) 51. In case of child, it is enough to take nutritions from 3 meals 1) 0.65 0.48 2) 0.73 0.45 0.67 0.47 51.47 52. It requires fish oriented meals than grain and vegetable in child's growth period 53. It is better to drink more than 2 cups of milk daily for the development and health 54. It is better to feed daily at least one among the meat, eggs, and beans for their proper growing up 55. It does not need to feed many kinds because all the vegetables and the fruits have same nutrients 0.74 0.44 a 0.83 0.38 b 0.71 0.46 a 54.79** 0.93 0.25 0.97 0.16 0.97 0.16 51.94 0.98 0.16 0.97 0.18 0.97 0.16 50.10 0.94 0.24 0.98 0.13 0.95 0.22 52.66 56. Cookies and drinks are adequate food for child snack 0.93 0.25 0.97 0.16 0.98 0.13 52.86 57. the foods to prevent child from anemia are meats and eggs 0.77 0.42 a 0.84 0.37 b 0.75 0.44 a 52.52 58. Child can be grown fat since skipping one meal makes him eat more food in the next meal 0.87 0.33 0.94 0.24 0.93 0.25 52.31 59. It is prohibited to give milk for the children of atopic skins 0.86 0.35 0.86 0.35 0.87 0.34 50.03 10. It is important to feed the children in their growth period the iron content food for healthy growth of the bones 0.22 0.41 a 0.37 0.49 b 0.34 0.47 b 54.52* Total 7.89 1.26 a 8.47 1.21 c 8.14 1.05 b 11.61*** 1) Knowledge about nutritionalg (0~1) : Correct answer 1, wrong answer 0 2) Mean SD 3) *: p < 0.05, **: p < 0.01, ***: p < 0.001 by tests of within-subjects effects Table 3. Changes in parents'/guardians' nutrition attitude score Questions Before After Follow-up F-value 3) 51. To think that it is important for child to have good eating habits during childhood 1) 55.8 0.4 a2) 55.9 0.5 b 55.7 0.5 a 52.36 52. To prepare diverse kind of vegetables every meal for child 54.7 0.9 a 55.1 0.8 b 54.8 1.1 a 55.86** 53. To help for child to drink daily more than 2 cups of milk 55.0 1.0 a 55.4 0.7 b 55.0 1.1 a 58.18*** 54. To include every meal with grains, vegetables, and protein food (meats, fishes, eggs, beans) for child to take meal with balanced nutrition 54.6 0.9 a 55.0 0.9 b 54.6 1.2 a 59.34*** 55. To recommend child to play outside if possible 54.5 1.2 a 54.8 1.0 b 54.5 1.1 a 54.91** 56. To prepare 3 meals of the day and snack, which contain rich amount of nutrients, than cookies and soda 54.8 1.0 a 55.1 0.8 b 54.8 1.0 a 56.78** 57. To try for child to eat diverse kinds of foods 54.7 0.9 a 55.1 0.9 b 54.8 1.1 a 56.01** 58. To prepare for child fruits and milks as snack, which contain rich amount of nutrients, than cookies and soda 54.9 0.8 a 55.3 0.8 b 55.0 0.9 a 58.08*** 59. To prepare for child have meals together with family 55.2 0.7 a 55.3 0.8 b 55.1 1.0 c 56.52** 10. To teach for child to wash hands before eat 55.2 0.8 a 55.3 0.9 b 55.0 1.0 c 57.34** Total 49.6 5.3 a 52.2 5.8 b 49.3 7.0 a 16.93*** 1) RangesG (1~6): 6-piont Likert type (high score denote strong agreement) 2) Mean SD 3) **: p < 0.01, ***: p < 0.001 by tests of within-subjects effects

210Á v z /#e # # l #:16( # # mp #oprp# p # pv#kk 1# l #~tp#43# ˆp# p# q # l#r#4319(l # l#s #e#71<( # m p /#e # # #918( #v m 1# /# eq #~t p#43# ˆp# p# q # l#r#<1;(l # l s #e#313( #oprp # mp /#e # # # e#714( #v m 1 l #eqp# pp#<8# ˆp#p p #Žr q # l#r#81:(l # ls #e#71<( #tl e # # #918( #v mp #oprp# p # p v#kk 1# l #~tp# pp#<8# ˆp#p p# q # l#r#616(l # l#s #e#714( #v m / e # # #;1<( #v m 1# eq #~tp# pp <8# ˆp#p p# q # l#r#71<(l # l s #e#;14( #oprp #v m #e # # l ;1<( #k #v mp #opr# p #ll +Wdeoh#7,1 l m l#r # l#s #e/#e # # p#okp# t# #Žr # #o p# #Wdeoh#8m# 1# l#r # l#s #ep# #o p# #8415( l #918( #oprp # mp #e # # # e 4:14( #oprp #v m 1# okp# # # # l#r#44155 j2gol l#s #e#4514: j2go #oprp# p # lp / e # # l #45149 j2go #s #em# p #ll 1# m mk d l#r # l#s #e/#e # # p#mk # # s #okp# pp# l v p# n# l#r 751<(l # l#s #e#4914( #oprp # mp #e # # #681:( #oprp #v m 1# d p nl # l#r#7513(l # l#s #e#4:1<( #op rp # mp /#e # # #6<16( #oprp # # sqp# pp#v m 1# # p#mk p# nl ~rp # l#rl# # l#s #e#mk # sq oprp # # # mp # l#s # # e#v m 1 Table 4. Changes on the growth of children Before After Follow-up χ 2 Height for age 10th percentile 15 (812.2) 1) 11 (888.9) 9 (887.3) 10 94th percentile 101 (882.1) 106 (886.2) 106 (886.2) 95th percentile 7 (885.7) 6 (884.9) 8 (886.5) Weight for age 10th percentile 13 (810.6) 6 (884.9) 8 (886.5) 10 94th percentile 106 (886.2) 112 (891.1) 104 (884.6) 95th percentile 4 (883.3) 5 (884.1) 11 (888.9) Weight for height 10th percentile 12 (889.8) 0 (880.0) 5 (884.1) 10 94th percentile 105 (885.4) 113 (891.9) 107 (887.0) 95th percentile 6 (884.9) 10 (888.1) 11 (888.9) Total 123 (100.0) 123 (100.0) 123 (100.0) 1) NG (%) 2) **: p < 0.01 by chi-square test 82.045 87.512 14.699** 2) Table 5. Changes in anemia prevalence and hemoglobin concentration Anemia prevalence Before After Follow-up χ 2 Normal 60G(648.8) 1) 115G(693.5) 102G(682.9) Anemia 63G(651.2) 8G(666.5) 21G(617.1) 71.790*** 3) Total 123G(100.0) 123G(100.0) 123G(100.0) Hemoglobin concentration Before After Follow-up F-value Hb (g/dl) 11.22 1.39 a2) 12.17 1.01 b 12.16 1.02 b 30.40*** 4) 1) NG (%) 2) HemoglobinG (Hb) concentration 3) ***: p < 0.001 by chi-square test 4) ***: p < 0.001 by tests of within-subjects effects

xá y Á211 Table 6. Changes of nutrient intakes (N=112) Before After Follow-up Normal 1) Deficiency 2) Normal Deficiency Normal Deficiency χ 24) Energy 64 (57.1) 3) 48 (42.9) 94 (83.9) 18 (16.1) 72 (64.3) 40 (35.7) 19.956*** Protein 104 (92.9) 8 (67.1) 111 (99.1) 1 (60.9) 110 (98.2) 2 (61.8) 68.083* Calcium 65 (58.0) 47 (42.0) 92 (82.1) 20 (17.9) 68 (60.7) 44 (39.3) 17.678*** Iron 70 (62.5) 42 (37.5) 82 (73.2) 30 (26.8) 77 (68.8) 35 (31.3) 62.989 Vitamin A 81 (72.3) 31 (27.7) 99 (88.4) 13 (11.6) 97 (86.6) 15 (13.4) 12.007** Riboflavin 80 (71.4) 32 (28.6) 101 (90.2) 11 (69.8) 93 (83.0) 19 (17.0) 13.331** Niacin 62 (55.4) 50 (44.6) 85 (75.9) 27 (24.1) 90 (80.4) 22 (19.6) 19.161*** Vitamin C 72 (64.3) 40 (35.7) 82 (73.2) 30 (26.8) 85 (75.9) 27 (24.1) 64.029 1) Normal: over 75% of EER or over EAR (KDRIs, 2005) 2) Deficiency: under 75% of EER or under EAR (KDRIs, 2005) 3) NG (%) 4) *: p < 0.05, **: p < 0.01, ***: p < 0.001 by chi-square test 고 ok qp#mkve#r # l#rl# # l#s e#oprp# p # l 1#p #Sdun# +533<,p# l m# p # v # n l#s # #ok q p#mkvep#oprp# p # l # m#p 1#\lp+533;,p#49t # k#mk o# p e # #mkvep#op # l # m /#Vrq# +533;,p# Ž l# op# p#e # op# v#kp# s p#r# #mkvep# # #e p#op # p #v # # p # ˆ # m 1#Nlp# +533<,p# pl #5; p# p #mk o p#45t# k#ee # #mkve#r #v m # m /#Fkrl+533<,p#l l #t l p# p mk op#ee# # #ed p# #llp #mkve r #oprp # kr # m 1#p #l p#mk op#mkvep# p # #ppp# lt #pp # #n# p#l l # p # # p# p # ˆ +Urvdqghu# )# Vlpv# 4<;4># Qhzhoo# 4<;8>#Euxvk# #4<;9>#Ndqj# #4<<5,1# v # l#s #e#v # l #mkve#r #e # # l#oprp# p # m 1#p #9 o#p p#t rp#mk# o# l#mkvep#v m # l#s #e# t # #lp #mkvep# # p# ˆ 1#p #Ndqj# +4<<5,p#l l #p rp#mkl# #mkvep# op# p#v l # op# v#kp# s # op# p#e p#r #oprp # kp /# o# p# #4 op#v # n# # p#oprp# p #ll # m# d # p 1# #Nlp# +533:, p# # p#e # o# # # o# #v l# #l l # o#r # o# l# #pl /#5 o v # op# #ov #e p#v l# #m 찰 kve#r #r l#7 op#v # op# #p #p # m # m #p # p 1# ok qp#mk #e #ˆ #r # l#rl# l#s #e#oprp # l#mk op# rpl pp# lt 1#p #Nlp# +5338,p#l l #t p p #e kp#tep # #5 ol# #mk op#mkve #ed p# e /#e # # v # p #v #e # # d # #t rp#mk# op#e #ˆ # eˆ # p # 1# l#s # #e p# l# #mk #e #ˆ #r #oprp # m 1#p # l#t#t rp#m k o #e p #mk #e # #ˆ # l # lp#t # l#pr#e p# # l # ˆ # #v eˆv# # p # l#v 1#Ndqj# +4<<5,p#;e #mk op# # o#v l #ˆ p # r#m #4 op#v # l # op #p #lp ˆ # #v eˆv# # l# #l m# d # # ˆ 1# qv # l #l #eq/#l #~t/#eq #~tp#43# ˆp# p# q # l#rl# # l#s #e# m /#l #eqp# nl #e # l # t # l#mk d# lp# #pv m 1#Sdun# +533<,p#okp#l #eq/#l #~t p#43# ˆp# p# q #mk d# l#s #e oprp # m # l# #l m# d # # ˆ 1# # lv o#mkr} l # #533< #mk d# l# # #5343 #mk d lp#tn l #okp#e~ l# #mko # oq ##6<13:(l #5;148( # m /#mokp e~ l#p #mko # oq #6<1:6(l #5;134( #oprp # m # #p 1#p #mk d# lp# #t rp#mk o #e p#mko npp#tlt# p # #l p# # # t 1#

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xá y Á213 +5336,p#l l # k l# # d# sp#e p# #p 1#p#e p# d# p# # kp # #p lvv#kk# q#qk/# p# # # # p# l# p# ˆ +Vplwk# #4<;<,1 #o m#~ p# # v # p#v e t # p# v # v# # rp#m # }p +Khdqh # #5333,/# # d# # # # v eˆ +Ydolqdnl# # 4<<7># Zhowhq# 4<<7,#mk d# l#s #el #okp# # d# p#o l#r # rp#no# #vo# p# rp# }# p#e # p # 1# 요약및결론 p # #mok # r# p #p #mko l } # n#mk k# l# /#p#e p#mk p# p#sn # 1# #l #p #mk r #o # p #r p# p # #mk d lp# # q #mk p# l vl# # # Š /#mk d# l#s #e# #mk ˆ #e p # l# rp #ov #p v #s m 1#533: l #5343 #4o v# e# l # #m k d# ll#9 o#p # l # lp#s # #p r p# #okm#ok q#456 p# p # l#r/# l#s #e/#e # # p#mk# ˆ # m 1# #l # #nk # p # 1 41# qp#mk d# lp# l p# #9 o # #57 o vm 1#ok# qp# p# k#861:(/ lk#7916(m /# o p# l#r#59 o/# l#s #e 68 o/#e # # #s erl#86 opl 1# 51#mk d# lp# #mk d# l#r # l s #e/#e # # # # #mkve#r # l r#:1;<rl # l#s #e#;17:rp #oprp #v mp /#e # # #;147rp #oprp # m 1# 61#mkˆ #r # l#r#7<19rl # l#s #e#8515 rp #oprp #v mp /#e # # #7<16rp oprp # kr 1# 71#e~ # # ~rp #o np# oq # l#r l# # l#s #e# m /#p #e # # l # p # ˆ v #kk 1# 81# #o p# l#r#8415(l # l#s #e#918( #oprp # mv #e # # #4:14( # e#o prp #v m 1# 91#mk # # sqpp# ls e# l v p# n 751<(l #4914( /# d p#7513(l #4:1<( /# p# p#mk l #oprp # mp #e # # l #mk p# q # l v p# n#681:( oprp #v m /# d p# nl #6<16( #op rp #v m 1 rp #mk d# lp#ok qp#mkve# ˆ l# rrp#m p# ~ /#okp# q # # #o /#e ˆ # eˆ# p # ˆ 1# #m k d# l#s # #v rp# #lp#e p# # p# l # # # lrp #q rp# lp #o # l#s # #v rp#mk o # # qp# # n # p # 1# v l #r p#t # op#p l#rk v/#l # p # op#p lv # p# rpvl# # p# #l p # #kp # l# # ep# # # p#l # n # p # 1# k Ahn HS, Lim HJ (1994): Articles / Analysis of factors associated with the preschool children's nutrition awareness - 1. assessment of the nutrition awareness and involvement in food-related activities -. Korean J Food Cult 9(3): 311-321 An JB (2010): Public policy measures in the era of population aging. International Trade Business Institute Review, pp. 1-110 Brush KH, Woolcott DM, Kawash GF (1986): Evaluation of an affective-based adult nutrition education. J Nutr Educ 18(6): 258-264 Centers for Disease Control (1978): Nutrition section CDC analysis of nutritional indices for selected WIC participants. Atlanta, GA Centers for Disease Control Choi MJ, Yoon JS (2003): The effect of eating habits and nutrient intake on the physical growth indices in preschool children. Korean J Community Nutr 8(1): 3-14 Choi MS (2009): Effects of nutrition education and exercise intervention on health and diet quality of middle-aged women. Korean J Nutr 42(1): 48-58 Collins T, Leeper J, Northrup RS, Demeillier S (1981): Integration of WIC with other infant mortality s. Final Report Appalachian Region Commission Report. Tuscaloosa, AL: University of Alabama Edozian JC, Switzer BR, Bryan RB (1979): Medical evaluation of the special supplemental food for women, infants, and children. Am J Clin Nutr 32(3): 677-692 Hammond GK, Barr SI, McCargar LJ (1994): Teacher's perception and use of an innovative early childhood nutrition education. J Nutr Educ 26(5): 233-237 Han HK, Lee YR (2009): A study on factors impacting on the mental health level of the elderly people living alone. J Korean

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