Herscovici 2013.

Study characteristics
Methods	Study design: cluster‐RCT Intervention period: 6 months Follow‐up period (post‐intervention): nil Differences in baseline characteristics: reported Reliable outcomes: reported Protection against contamination: NR Unit of allocation: schools Unit of analysis: individual
Participants	N (control baseline) = 171 N (control follow‐up) = 164 N (intervention baseline) = 234 N (intervention follow‐up) = 205 Setting (and number by study group): 6 schools (4 intervention, 2 control) Recruitment: the sample was pooled from 6 schools that had been waitlisted and randomised for receiving the intervention Geographic region: poor areas of Rosario, Argentina Percentage of eligible population enrolled: NR for schools, 96% participants Mean age: intervention: 9.64 ± 0.77; control: 9.76 ± 0.68 Sex: intervention: 53% female; control: 47% female
Interventions	To evaluate changes in BMI and food intake among children at schools that received the Healthy Snack Bar intervention For the intervention arm, the participating grades took part in 4 workshops: 3 for the children (Healthy eating, Body in motion, and Healthy body); and one for their parents/ caregivers. Workshops lasted 40 min, were conducted monthly by an interdisciplinary team, and had an interactive modality. The intervention consisted of 5 parts: the 4 workshops, plus modifications to the school cafeteria menu. Workshop 1: Healthy eating. The 1st workshop aimed to help children identify healthy foods, understand why healthy foods improve health, and contemplate the disadvantages of including competitive options in their diet (e.g. pros and cons of fat and sodium consumption). This workshop specifically encouraged the intake of 5 healthy food items targeted by the programme: orange juice (100% orange, no sugar added), whole fruits, low‐sugar cereal, skim milk, and vegetables (fresh, canned, or cooked). Workshop 2: Body in motion. The 2nd workshop aimed to get children motivated about PA, and to understand the health‐related benefits of regular exercise. Workshop 3: Healthy body. The 3rd workshop sought to help children establish the connection between good eating habits, regular PA, and a healthy body. An additional goal was to enable children to identify a healthy menu based on nutritional components. Workshop 4: parent/caregiver. The 4th workshop aimed to provide dietary education to the children’s parents/caregivers and emphasised the importance of PA. School Snack Bar. At the start of the study, the school snack bar options were modified to include 3 of the aforementioned 5 healthy food items stimulated by the programme (orange juice, fruit, and low‐sugar cereal). Control: no details Diet and PA intervention vs control
Outcomes	Outcome measures Primary outcome: zBMI, children’s intake of healthy and unhealthy foods Secondary outcomes: NR Process evaluation: reported (attendance)
Implementation‐related factors	Theoretical basis: NR Resources for intervention implementation: reported Who delivered the intervention: reported PROGRESS categories assessed at baseline: gender PROGRESS categories analysed at outcome: gender Outcomes relating to harms/unintended effects: NR Intervention included strategies to address diversity or disadvantage: targeted at poor areas Economic evaluation: NR
Notes	Funding: this work was supported by the International Life Sciences Institute (ILSI) Research Foundation (Washington, D.C., USA, and ILSI Argentina, Buenos Aires, Argentina). Parents’ and/or caregivers’ attendance was 53% and was not considered exclusion criteria
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Simple randomisation after schools matched by socioeconomic status
Allocation concealment (selection bias)	Unclear risk	NR. Overall, boys were more overweight and obese than girls (31% vs 24.3%), and for the former, a statistically significant difference was found in their zBMIs, with boys in the control group being slightly heavier than boys in the intervention group. Controlled for gender in analyses
Blinding (performance bias and detection bias) All outcomes	Unclear risk	NR
Incomplete outcome data (attrition bias) All outcomes	Low risk	Low attrition balanced between groups
Selective reporting (reporting bias)	Unclear risk	Protocol/trial registration documents were unavailable
Other bias	Low risk	No additional threats to validity
Other bias‐ timing of recruitment of clusters	Low risk	Figure shows enrolment happened prior to randomisation