Knowledge, attitudes, and practices (KAP) of nutrition among school teachers in Bangladesh: A cross-sectional study

**Background:** Teachers are critical in shaping children's dietary habits and nutritional knowledge. In Bangladesh, no prior data existed on teachers' nutrition KAP. This study aimed to evaluate nutrition-related knowledge, attitudes, and practices among school teachers across Bangladesh to identify gaps and inform interventions.

**Methods:** A cross-sectional study was conducted from February to June 2022 across 9 districts in Bangladesh using multistage stratified random sampling. A pretested, structured 66-item questionnaire (Cronbach's α = 0.742) was self-administered via KoBo Collect software. The questionnaire covered demographics (8 items), nutrition knowledge (49 items across 7 domains: protein, fat, vitamin, calcium, dietary fiber, nutrient elements, child nutrition), attitudes (5 items), and practices (4 items). Knowledge was scored 0-49 (1 per correct answer). Data were analyzed using SPSS 23.0 with descriptive statistics, ANOVA, and multiple linear regression. A total of 280 teachers participated; 78.9% were professionally trained, 72.9% were male, 52.9% taught at government schools, and 41.1% were aged >40 years.

**Key Results:** The mean nutrition knowledge score was 34.33 (SD 18.16), or 70.07% of the maximum 49. Domain scores ranged from lowest in child nutrition (56.03±25.77%) to highest in calcium-related knowledge (85.72±18.16%). Only 9.9% of teachers were satisfied with their understanding of childhood nutrition, yet 97.7% had a positive attitude toward learning more. Only 38.7% had received pediatric nutrition training. Teachers who had participated in nutrition training scored higher (56.09±22.48) than those who had not (25.62±18.48). Teachers who paid attention to children's nutrition scored 49.01±21.85 vs. 16.53±16.10 for those who did not. Multiple linear regression showed that age (β = -0.723, p<0.001), type of school (β = 1.591, p<0.001), practice score (β = 0.086, p<0.001), and total knowledge score were significant predictors of nutrition knowledge. Attitude score significantly predicted knowledge (β = 0.163, p<0.001). Government school teachers had higher knowledge than private school teachers. Teachers with professional training performed better than untrained teachers across most domains.

**Clinical Implications:** The study reveals substantial gaps in Bangladeshi school teachers' nutrition knowledge, particularly regarding child nutrition. Most teachers are motivated to learn but lack formal training. School-based nutrition education programs and teacher training interventions are urgently needed. Teachers can serve as effective agents for improving children's dietary habits and preventing childhood obesity and malnutrition. The KAP model provides a framework for designing targeted interventions. Limitations include the cross-sectional design (cannot establish causality), small sample size (n=280), self-reported data, and potential information bias from limited questionnaire items in some domains.