Results
REGRESSION
27 primary schools were randomly allocated to the intervention group (with a median of 625 [IQR 424–1004] pupils) and 27 to the control group (with a median of 641 [375–1141] pupils). 162 in-school adolescent girls participated in the baseline survey between Oct 8 and Nov 4, 2019, and 536 adolescent girls (median age 13·3 years [IQR 12·1–14·0]) participated in the endline survey between March 22 and April 29, 2021 (Trial profileSample characteristicsData are n, mean (SD), or median (IQR) unless otherwise stated.Differences between study groups at endline, accounting for clustering, were calculated using two-sided At endline, parents (two fathers and four mothers) who attended religious school are included in the “Never attended school” category.For the primary outcome of dietary diversity, we observed an adjusted mean difference of 1·33 (95% CI 0·90–1·75, p<0·0001) food groups in the dietary diversity score between the intervention (mean 5·37 [SD 1·66]) and control (3·98 [1·43]) groups at endline (Dietary diversity, consumption of junk foods, and meal frequency among adolescent girls at endlineData are mean (SD) or n (%) unless otherwise stated. Differences between study groups are by intention-to-treat analyses, accounting for clustering using linear regression models for mean differences, with SEs clustered at the school level obtained using a sandwich estimator. For binary outcomes, intervention effects are reported as odds ratios and 95% CIs estimated from logistic regression models.Linear or logistic regression, adjusted for adolescent age, region, household food security, and wealth, clustered by school.Intra-cluster correlation coefficients: dietary diversity score (0·392), minimum dietary diversity (0·284), meal frequency in past 24 h (0·350), and consumed any junk foods in past 24 h (0·102).For meal frequency in the past 24 h, we observed an adjusted mean difference of 0·84 (95% CI 0·58–1·09, p<0·0001) meal or snack times between study groups (4·04 [SD 0·92] in the intervention group Both adolescent girls and their parents in the intervention group had higher knowledge at endline than those in the control group about dietary diversity, meal frequency, and consumption of unhealthy foods (Prevalence of correct knowledge about nutrition among adolescent girls and parents at endlineData are n (%) unless otherwise stated. Differences between study groups in intention-to-treat analyses, accounting for clustering using logistic regression models.Logistic regression, adjusted for adolescent age, region, household food security, and wealth, clustered by school.At endline, free school meals were not provided, nearly all study schools had at least one food vendor within 1 min walking distance (52 of 54 schools), and about a quarter of all adolescent girls had seen or heard a food advertisement in the past 3 months (Exposure to interventions in the past 3 months among adolescent girls and their parents at endlineData are n (%) unless otherwise stated. Differences between study groups in intention-to-treat analyses, accounting for clustering using logistic regression models.Logistic regression, adjusted for adolescent age, region, household food security, and wealth, clustered by school.There was an association between exposure to multiple intervention components and improved outcomes (