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Goldthorpe J, Epton T, Keyworth C, Calam R, Armitage CJ. Are primary/elementary school-based interventions effective in preventing/ameliorating excess weight gain? A systematic review of systematic reviews. Obes Rev 2020; 21:e13001. [PMID: 32162477 DOI: 10.1111/obr.13001] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/21/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022]
Abstract
This systematic review of systematic reviews addresses a current gap in evidence by synthesizing findings relating to weight management interventions set entirely in primary/elementary schools targeting, diet, and/or physical activity as key strategies. Eight databases were searched for systematic reviews of trials of school-based interventions targeting children aged 4 to 12 years that looked at biometric and behavioral outcomes. From the 10 selected systematic reviews, we found that interventions designed to promote physical activity or reduce sedentary behavior were most effective for weight loss. Interventions designed to improve diet and nutrition had a small effect on behavioral and cognitive outcomes, and these outcomes could be enhanced through the use of experiential learning. The most effective interventions involved a range of stakeholders in the development process and included parents and families in implementation. This systematic review of systematic reviews offers evidence-based guidance for the development and implementation of multistrategy weight-management interventions in primary/elementary schools.
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Affiliation(s)
- Joanna Goldthorpe
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences Coupland 1 Building, University of Manchester, M13 9PL, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences Coupland 1 Building, University of Manchester, M13 9PL, UK
| | - Chris Keyworth
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences Coupland 1 Building, University of Manchester, M13 9PL, UK
| | - Rachel Calam
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health Sciences, Zochonis Building, University of Manchester, M13 9PL, UK
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, Division of Psychology & Mental Health, School of Health Sciences, Coupland 1 Building University of Manchester, M13 9PL, UK Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Ranaei V, Dadipoor S, Davoodi H, Aghamolaei T, Pilevar Z. Effectiveness of Interventions Based on Social Marketing Theory in Promoting Healthy Eating Habits: A Systematic Review. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.2.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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103
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Mayr HL, Cohen F, Isenring E, Soenen S, Marshall S. Multidisciplinary lifestyle intervention in children and adolescents - results of the project GRIT (Growth, Resilience, Insights, Thrive) pilot study. BMC Pediatr 2020; 20:174. [PMID: 32312241 PMCID: PMC7169025 DOI: 10.1186/s12887-020-02069-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 04/06/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND During childhood and adolescence leading behavioural risk factors for the development of cardiometabolic diseases include poor diet quality and sedentary lifestyle. The aim of this study was to determine the feasibility and effect of a real-world group-based multidisciplinary intervention on cardiorespiratory fitness, diet quality and self-concept in sedentary children and adolescents aged 9 to 15 years. METHODS Project GRIT (Growth, Resilience, Insights, Thrive) was a pilot single-arm intervention study. The 12-week intervention involved up to three outdoor High Intensity Interval Training (HIIT) running sessions per week, five healthy eating education or cooking demonstration sessions, and one mindful eating and Emotional Freedom Technique psychology session. Outcome measures at baseline and 12-week follow-up included maximal graded cardiorespiratory testing, the Australian Child and Adolescent Eating Survey, and Piers-Harris 2 children's self-concept scale. Paired samples t-test or Wilcoxon signed-rank test were used to compare baseline and follow-up outcome measures in study completers only. RESULTS Of the 38 recruited participants (median age 11.4 years, 53% male), 24 (63%) completed the 12-week intervention. Dropouts had significantly higher diet quality at baseline than completers. Completers attended a median 58 (IQR 55-75) % of the 33 exercise sessions, 60 (IQR 40-95) % of the dietary sessions, and 42% attended the psychology session. No serious adverse events were reported. Absolute VO2peak at 12 weeks changed by 96.2 ± 239.4 mL/min (p = 0.06). As a percentage contribution to energy intake, participants increased their intake of healthy core foods by 6.0 ± 11.1% (p = 0.02) and reduced median intake of confectionary (- 2.0 [IQR 0.0-3.0] %, p = 0.003) and baked products (- 1.0 [IQR 0.0-5.0] %, p = 0.02). Participants significantly improved self-concept with an increase in average T-Score for the total scale by 2.8 ± 5.3 (p = 0.02) and the 'physical appearance and attributes' domain scale by median 4.0 [IQR 0.5-4.0] (p = 0.02). CONCLUSIONS The 12-week group-based multidisciplinary lifestyle intervention for children and adolescents improved diet quality and self-concept in study completers. Future practice and research should focus on providing sustainable multidisciplinary lifestyle interventions for children and adolescents aiming to improve long-term health and wellbeing. TRIAL REGISTRATION ANZCTR, ACTRN12618001249246. Registered 24 July 2019 - Retrospectively registered.
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Affiliation(s)
- Hannah L Mayr
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia. .,Weight Loss Solutions Australia, Gold Coast, Queensland, Australia. .,Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
| | - Felicity Cohen
- Weight Loss Solutions Australia, Gold Coast, Queensland, Australia
| | - Elizabeth Isenring
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Stijn Soenen
- Adelaide Medical School, Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia.,Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | | | - Skye Marshall
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.,Nutrition Research Australia, Sydney, New South Wales, Australia
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Brown JM, Savaglio R, Watson G, Kaplansky A, LeSage A, Hughes J, Kapralos B, Arcand J. Optimizing Child Nutrition Education With the Foodbot Factory Mobile Health App: Formative Evaluation and Analysis. JMIR Form Res 2020; 4:e15534. [PMID: 32301743 PMCID: PMC7195667 DOI: 10.2196/15534] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/25/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Early nutrition interventions to improve food knowledge and skills are critical in enhancing the diet quality of children and reducing the lifelong risk of chronic disease. Despite the rise of mobile health (mHealth) apps and their known effectiveness for improving health behaviors, few evidence-based apps exist to help engage children in learning about nutrition and healthy eating. OBJECTIVE This study aimed to describe the iterative development and user testing of Foodbot Factory, a novel nutrition education gamified app for children to use at home or in the classroom and to present data from user testing experiments conducted to evaluate the app. METHODS An interdisciplinary team of experts in nutrition, education (pedagogy), and game design led to the creation of Foodbot Factory. First, a literature review and an environmental scan of the app marketplace were conducted, and stakeholders were consulted to define the key objectives and content of Foodbot Factory. Dietitian and teacher stakeholders identified priority age groups and learning objectives. Using a quasi-experimental mixed method design guided by the Iterative Convergent Design for Mobile Health Usability Testing approach, five app user testing sessions were conducted among students (ages 9-12 years). During gameplay, engagement and usability were assessed via direct observations with a semistructured form. After gameplay, qualitative interviews and questionnaires were used to assess user satisfaction, engagement, usability, and knowledge gained. RESULTS The environmental scan data revealed that few evidence-based nutrition education apps existed for children. A literature search identified key nutrients of concern for Canadian children and techniques that could be incorporated into the app to engage users in learning. Foodbot Factory included characters (2 scientists and Foodbots) who initiate fun and engaging dialogue and challenges (minigames), with storylines incorporating healthy eating messages that align with the established learning objectives. A total of five modules were developed: drinks, vegetables and fruit, grain foods, animal protein foods, and plant protein foods. Seven behavior change techniques and three unique gamified components were integrated into the app. Data from each user testing session were used to inform and optimize the next app iteration. The final user testing session demonstrated that participants agreed that they wanted to play Foodbot Factory again (12/17, 71%), that the app is easy to use (12/17, 71%) and fun (14/17, 88%), and that the app goals were clearly presented (15/17, 94%). CONCLUSIONS Foodbot Factory is an engaging and educational mHealth intervention for the Canadian public that is grounded in evidence and developed by an interdisciplinary team of experts. The use of an iterative development approach is a demonstrated method to improve engagement, satisfaction, and usability with each iteration. Children find Foodbot Factory to be fun and easy to use, and can engage children in learning about nutrition.
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Affiliation(s)
- Jacqueline Marie Brown
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Robert Savaglio
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Graham Watson
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Allison Kaplansky
- Faculty of Community Services, Ryerson University, Toronto, ON, Canada
| | - Ann LeSage
- Faculty of Education, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Janette Hughes
- Faculty of Education, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Bill Kapralos
- Faculty of Business & Information Technology, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
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de Vlieger N, van Rossum J, Riley N, Miller A, Collins C, Bucher T. Nutrition Education in the Australian New South Wales Primary School Curriculum: Knowledge and Attitudes of Students and Parents. CHILDREN-BASEL 2020; 7:children7040024. [PMID: 32230736 PMCID: PMC7231028 DOI: 10.3390/children7040024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/06/2020] [Accepted: 03/24/2020] [Indexed: 12/20/2022]
Abstract
In NSW, Australia, the views of primary-school aged children and their parents in regard to the importance of nutrition education at school are unclear. The aim of the current study was to explore children’s knowledge of nutrition and eating habits and to identify gaps that future school nutrition education programs could target. Students aged 9 to 12 years and their parents (n = 21 dyads) were invited to participate in semi-structured interviews, complete a nutrition knowledge questionnaire, and perform a “healthy-unhealthy” food sorting task in a University food laboratory. Among the children, nutrition knowledge scores concerning “serves & portions” of common foods were lowest, identifying a gap in knowledge related to portion size. All children categorized fruits, vegetables, cola, and water correctly as “healthy” or “unhealthy” in the sorting task, but not for the sausage and muesli bar, suggesting that further support categorising processed foods may be needed. The interviews indicated that parents do actively try to teach their children about nutrition, although they reported feeling uncertain about their own level of nutrition knowledge. Children and parents indicated that there is very little nutrition education in school and more is needed. This research could be used to inform future curriculum components related to nutrition education for primary school children.
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Affiliation(s)
- Nienke de Vlieger
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan 2308, NSW, Australia; (N.d.V.); (C.C.)
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, NSW, Australia
| | - Jolien van Rossum
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan 2308, NSW, Australia; (N.d.V.); (C.C.)
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, NSW, Australia
| | - Nicholas Riley
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, NSW, Australia
- School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan 2308, NSW, Australia
| | - Andrew Miller
- School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan 2308, NSW, Australia
- Teachers and Teaching Research Centre, School of Education, Faculty of Education and Arts, The University of Newcastle, Callaghan 2308, NSW, Australia
| | - Clare Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan 2308, NSW, Australia; (N.d.V.); (C.C.)
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, NSW, Australia
| | - Tamara Bucher
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, NSW, Australia
- School of Environmental and Life Sciences (SELS), The University of Newcastle, Ourimbah 2258, NSW, Australia
- Correspondence:
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106
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Ng CM, Kaur S, Koo HC, Mukhtar F. Nutrition-related outcomes of childrenʼs involvement in healthy meal preparation. JBI Evid Synth 2020; 18:534-542. [DOI: 10.11124/jbisrir-d-19-00209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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107
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Habib-Mourad C, Ghandour LA, Maliha C, Awada N, Dagher M, Hwalla N. Impact of a one-year school-based teacher-implemented nutrition and physical activity intervention: main findings and future recommendations. BMC Public Health 2020; 20:256. [PMID: 32075607 PMCID: PMC7031897 DOI: 10.1186/s12889-020-8351-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the current study is to describe the effectiveness of a school-based intervention when delivered by a non-nutrition specialist (trained schoolteachers) as compared to an expert in nutrition. METHODS Two trials of the same school-based intervention using the same intervention package were delivered, one by nutritionists and another by trained schoolteachers. The intervention focused mainly on dietary behaviours, as well as physical activity. In both trials, purposively selected schools were randomized to intervention or control groups; students (aged 9-11 years) in both groups were compared at post-test on knowledge and self-efficacy scores, as well as dietary and physical activity behaviours, controlling for their baseline status on the various measures. All analyses accounted for clustering at the school level. RESULTS In both trials, a statistically significantly greater improvement was observed for both the knowledge and self-efficacy scores in intervention vs. school students. When the programme was delivered by trained schoolteachers, frequency of breakfast intake was increased, crisps consumption was reduced, but no change in fruit and vegetable consumption was observed (latter increased when delivered by nutrition professionals only). Physical activity did not improve in both trials. CONCLUSION Trained schoolteachers can have a positive impact on students' dietary behaviours with the appropriate training to ensure they are equipped with the right information, skills, and resources to deliver the programme with the highest fidelity. TRIAL REGISTRATION ClinicalTrial.gov Identifier: NCT03040271. Retrospectively registered on 2 February 2017.
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Affiliation(s)
- Carla Habib-Mourad
- Department of Nutrition and Food Sciences, American University of Beirut, Riad El-Solh, Beirut, 1107-2020 Lebanon
| | - Lilian A. Ghandour
- Department of Epidemiology and Population Health, American University of Beirut, Riad El-Solh, Beirut, 1107-2020 Lebanon
| | - Carla Maliha
- Department of Nutrition and Food Sciences, American University of Beirut, Riad El-Solh, Beirut, 1107-2020 Lebanon
| | - Nancy Awada
- Department of Nutrition and Food Sciences, American University of Beirut, Riad El-Solh, Beirut, 1107-2020 Lebanon
| | - Michèle Dagher
- Department of Nutrition and Food Sciences, American University of Beirut, Riad El-Solh, Beirut, 1107-2020 Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, American University of Beirut, Riad El-Solh, Beirut, 1107-2020 Lebanon
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Relationships between children's sugar consumption at home and their food choices and consumption at school lunch. Public Health Nutr 2020; 23:2941-2949. [PMID: 31957630 DOI: 10.1017/s1368980019003458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the relationships between children's food and drink choices at school lunch for children who consume high and low sugar intakes at home. DESIGN Children's food and drink consumption at home was assessed using diet diaries over three consecutive days. Children were classified as 'high' or 'low' sugar consumers at home using the WHO recommendation that free sugars should be less than 10 % of their daily total energy intake. A purposive sample of children was then selected and observed during school lunch, recording food selections, food left on plates and content of packed lunches. SETTING Six primary schools in Newham and Kent, England. PARTICIPANTS Parents and children aged 6-7 years. RESULTS Seventy-one parents completed diet diaries. From the seventy-one, thirty-nine children were observed during school lunch. Twenty children were high sugar consumers, nineteen children were low sugar consumers; thirty-one children had a school meal. Eleven of the fifteen children (73 %) who had school meals and who were high sugar consumers selected a high-sugar dessert rather than fruit. Only five of the sixteen (31 %) children who had school meals and were low sugar consumers at home chose a high-sugar dessert. Most of the children who had packed lunches had sweet items, despite school policies. CONCLUSIONS Children who consumed high sugar intake at home tended to select foods high in sugar for school meals or had packed lunches containing high-sugar foods. The implications for public health programmes include healthy eating workshops and implementing school food policies.
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Love P, Booth A, Margerison C, Nowson C, Grimes C. Food and nutrition education opportunities within Australian primary schools. Health Promot Int 2020; 35:1291-1301. [DOI: 10.1093/heapro/daz132] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Schools are regarded as a key setting for obesity prevention, providing an opportunity to reach a large number of children, frequently and over a prolonged period, through formal and informal opportunities to learn about health behaviours. However, the low value placed on health versus academic achievement is a barrier to effective implementation of food and nutrition (F&N) education. This study used a qualitative exploratory approach to explore the views of teachers and key health and education sector stakeholders regarding opportunities for F&N education within the Australian primary school setting. To the best of our knowledge, this is the first study to explore this topic from the perspectives of state-level coordination and development through to local-level implementation and support within the Australian primary school context. Only 2.6% of the Victorian Curriculum related to F&N education, taught through two (of seven) learning outcomes: Health and Physical Education, and Technologies. While stakeholders considered child health a priority, and schools an ideal setting for F&N education, barriers included a lack of strategic policy alignment, limited leadership and coordination, a ‘crowded curriculum’ and poor availability of shelf-ready resources with explicit curriculum links. A cross-curriculum approach was considered essential for F&N education to become embedded as a core component of the curriculum.
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Affiliation(s)
- Penelope Love
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong Campus, Victoria 3216, Australia
| | - Alison Booth
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, Victoria 3125, Australia
| | - Claire Margerison
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, Victoria 3125, Australia
| | - Caryl Nowson
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong Campus, Victoria 3216, Australia
| | - Carley Grimes
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, Victoria 3125, Australia
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Percepción sobre alimentación saludable en cuatro instituciones escolares. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2018.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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111
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Sahota P, Christian M, Day R, Cocks K. The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme. Pilot Feasibility Stud 2019; 5:152. [PMID: 31890264 PMCID: PMC6925414 DOI: 10.1186/s40814-019-0542-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 12/06/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study aims to evaluate the feasibility and acceptability of the PhunkyFoods Programme, a primary school-based intervention to promote healthy nutrition and physical activity knowledge and behaviours to assess outcomes to inform a phase 3 trial. Methods The cluster randomised feasibility trial recruited eight primary schools from the North of England. Elibility criteria included all primary schools in one town, excluding independent and special schools and schools that comprised of only key stage 2 pupils (years 3–6). Eight schools agreed to participate. Randomisation to intervention or control arms was in a 1:1 ratio. Intervention schools received PhunkyFoods over 17 months. Control schools continued with usual curriculum. Assessors were blinded to group assignment. Measures comprised of a Healthy Lifestyle Knowledge Questionnaire and Synchronised Nutrition and Activity Program to assess diet and physical activity, height, weight, and psychological wellbeing. Feasibility outcomes were recruitment, attrition rates, interviews with teaching staff, focus groups with pupils to explore the acceptability of outcome measures, implementation, intervention content, and programme fidelity. Results Three hundred fifty-eight pupils, aged 6–9 years from eight schools were recruited at baseline (control n = 170, intervention n = 188); 337 (94.1%) at 6 months (control n = 163, intervention n = 181); and 331 (92.5%) at 18 months (control n = 152, intervention n = 179), and 6 pupils opted out. Trends in increased knowledge of healthy lifestyle behaviours, healthier eating, and liking of fruit and vegetables were reported in the intervention compared to the control group. Year 4 intervention pupils had significantly higher healthy balanced diet knowledge scores compared to control pupils, mean difference 5.1 (95% CI 0.1 to 10.1, p=0.05). At 18 months, the mean percentage of vegetables liked was higher (intervention 53.9% vs. 43.0% control). Similarly, percentage of fruits liked was also higher (intervention 76.9% vs. 67.2% control). Qualitative data showed that delivery of the intervention was feasible and acceptable to teachers and pupils. Lessons were learned to inform the phase 3 trial around the dietary assessment measure and timing of recruitment. Conclusions Whilst the study was not powered to detect a definitive effect, results suggest a potential to increase knowledge of healthy lifestyle behaviours and dietary behaviours, suggesting that with minor changes, a phase 3 trial is likely to be deliverable. Trial registration ISRCTN, ISRCTN15641330. Registered 8 May 2015—retrospectively registered, 10.1186/ISRCTN15641330
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Affiliation(s)
- Pinki Sahota
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
| | - Meaghan Christian
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
| | - Rhiannon Day
- 1School of Clinical and Applied Sciences, Leeds Beckett University, Calverley Street, Leeds, LS1 3HE UK
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112
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Koo HC, Poh BK, Ruzita AT. GReat-Child Trial™ based on social cognitive theory improved knowledge, attitudes and practices toward whole grains among Malaysian overweight and obese children. BMC Public Health 2019; 19:1574. [PMID: 31775696 PMCID: PMC6881981 DOI: 10.1186/s12889-019-7888-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 11/01/2019] [Indexed: 01/03/2023] Open
Abstract
Background Studies have reported that improvement of dietary habits through increased whole grain foods consumption at an early age has the potential to lead to betterment in lifelong health and wellness. The GReat-Child Trial™ was a 12-week quasi-experimental study with 6 months follow-up investigating a multi-component whole grain intervention, which consisted of behavioral, personal and environmental factors based on Social Cognitive Theory (SCT). This study aimed to evaluate the feasibility and acceptability of the GReat-Child Trial™, as well as to determine the changes in knowledge, attitudes and practices (KAP) of whole grains consumption among overweight/obese children. Methods Two schools in Kuala Lumpur with similar socio-demographic characteristics were assigned as intervention (IG) and control (CG), respectively. Inclusion criteria were healthy Malaysian overweight/obese children aged 9 to 11 years who had no serious co-morbidity. Children who reported consuming whole grain foods in their 3-day diet-recall during recruitment were excluded. A total of 63 children (31 IG; 32 CG) completed the intervention. KAP questionnaire was self-administered at baseline [T0] and post intervention (at 3rd [T1] and 9th month [T2]). The baseline differences between the IG and CG across socio-demographics and scores of KAP toward whole grains were determined using chi-square and t-test, respectively. ANCOVA was performed to determine the effect of the GReat-Child Trial™ on KAP towards whole grains at post-intervention and follow-up. Baseline variables were considered as covariates. Results The IG attained significantly higher scores in knowledge (mean difference = 4.23; 95% CI: 3.82, 4.64; p < 0.001), attitudes (mean difference = 7.39; 95% CI: 6.36, 8.42; p < 0.001) and practice (mean difference = 6.13; 95% CI: 4.49, 7.77; p < 0.001) of whole grain consumption compared to the CG, after adjusting for confounders. The IG reported significantly higher scores in knowledge (mean difference = 6.84; 95% CI: 6.53, 7.15; p < 0.001), attitudes (mean difference = 9.16; 95% CI: 8.08, 10.24; p < 0.001) and practice (mean difference = 8.03; 95% CI: 5.34, 10.73; p < 0.001) towards whole grains at T2 compared to T0. Conclusions These findings indicate that this intervention made a positive impact on improving children’s KAP on whole grains. We anticipate the GReat-Child Trial™ to be a program that could be incorporated into school interventions to improve whole grain consumption among Malaysian children for obesity prevention.
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Affiliation(s)
- H C Koo
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.,Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - B K Poh
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - A T Ruzita
- Nutritional Sciences Programme & Centre for Community Health, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
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Rongen FC, van Kleef E, Sanjaya S, Vingerhoeds MH, Buurma-Rethans EJM, van den Bogaard C, van Rossum CTM, Seidell JC, Dijkstra SC. What's for lunch? The content and quality of lunches consumed by Dutch primary schoolchildren and the differences between lunches consumed at home and at school. BMC Public Health 2019; 19:1365. [PMID: 31651297 PMCID: PMC6814114 DOI: 10.1186/s12889-019-7750-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/07/2019] [Indexed: 01/23/2023] Open
Abstract
Background Lunch is an important part of a healthy diet, which is essential for the development, growth and academic performance of school-aged children. Currently there is an increasing number of Dutch primary schoolchildren who are transitioning from eating lunch at home to school. There is limited knowledge about the current quality of the lunches consumed by primary schoolchildren in the Netherlands and whether there are any differences between lunches consumed at home or at school. To investigate differences in content and quality of lunches consumed by Dutch primary schoolchildren at home and at school. Methods Cross-sectional study among 363 Dutch primary schoolchildren aged 4–12 years based on the first two years of the 2012–2016 Dutch National Food Consumption Survey. Demographic characteristics were obtained through a questionnaire. Diet was assessed with two non-consecutive 24-h dietary recalls. Quality of lunches was assessed on their nutritional quality whether they fitted the nutritional guidelines. ‘Nonparametric tests were used to examine the content and quality of the lunches between place of consumption and parental educational position. Results The most consumed lunch products among primary schoolchildren were bread, dairy products and sugar-sweetened beverages. Fruit and vegetable consumption was very low. Consumption of milk and other dairy products was higher among children who eat lunch at home than children who eat lunch at school (p < 0.01). Consumption of sugar-sweetened beverages was higher among children who eat lunch at school than children who eat lunch at home (p < 0.01), and at school a higher proportion of the drinks did not fit within the Dutch dietary recommendations (p < 0.01). Conclusions The current content of the lunches consumed by Dutch primary schoolchildren leaves room for improvement, especially regarding fruit and vegetables. The statistically significantly higher consumption of sugar-sweetened beverages and lower consumption of milk and dairy products at school vs. home is worrisome, as currently more children in the Netherlands are transitioning to having lunch at school.
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Affiliation(s)
- Frédérique C Rongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, The Netherlands.
| | - Ellen van Kleef
- Marketing and Consumer Behaviour Group, Wageningen University, Wageningen, The Netherlands
| | - Sienna Sanjaya
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, The Netherlands
| | - Monique H Vingerhoeds
- Food, Health & Consumer Research group, Wageningen Food & Biobased Research, P.O. Box 17, 6700AA, Wageningen, The Netherlands
| | | | | | | | - Jacob C Seidell
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, The Netherlands
| | - S Coosje Dijkstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081, HV, Amsterdam, The Netherlands
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114
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Murimi MW, Moyeda-Carabaza AF, Nguyen B, Saha S, Amin R, Njike V. Factors that contribute to effective nutrition education interventions in children: a systematic review. Nutr Rev 2019; 76:553-580. [PMID: 29800311 DOI: 10.1093/nutrit/nuy020] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Context Establishing healthy dietary practices at an early age is crucial, as dietary behaviors in childhood track to adulthood. Objective The purpose of this systematic review was to identify factors associated with successful nutrition education interventions conducted in children and published between 2009 and 2016. Data Sources Using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines, relevant studies were identified through the PubMed, Web of Science, ScienceDirect, and ERIC (Educational Resources Information Center) databases. Study Selection Studies published in English between 2009 and 2016 that included a nutrition education intervention among children aged 2 to 19 years were included. Review articles, abstracts, qualitative or cross-sectional studies, and studies targeting children with special nutritional needs were excluded. Data Extraction Four authors screened and determined the quality of the studies using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system and extracted the data from the articles. Data Analysis Forty-one studies were included: 7 targeted preschool children, 26 targeted elementary school children, and 8 targeted secondary school children. A total of 46% met their primary objectives of nutrition education intervention, while the rest either partially achieved or did not achieve their stated objectives. Results Successful interventions targeting school children engaged parents by means of face-to-face sessions, identified specific behaviors to be modified, and assured fidelity by training teachers or recruiting trained experts to deliver the intervention. In addition, they allowed adequate dosage, with an intervention duration of at least 6 months, and used age-appropriate activities. Conclusions Interventions with a multicomponent approach that were age appropriate and of adequate duration (≥ 6 months), that engaged parents, and that ensured fidelity and proper alignment between the stated objectives, the intervention, and the desired outcomes were more likely to succeed.
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Affiliation(s)
- Mary W Murimi
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, Texas, USA
| | | | - Bong Nguyen
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sanjoy Saha
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Ruhul Amin
- Institute of Nutrition and Food Science, Dhaka University, Dhaka, Bangladesh
| | - Valentine Njike
- Yale-Griffin Prevention Research Center, Derby, Connecticut, USA
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115
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Kupolati MD, MacIntyre UE, Gericke GJ, Becker P. A Contextual Nutrition Education Program Improves Nutrition Knowledge and Attitudes of South African Teachers and Learners. Front Public Health 2019; 7:258. [PMID: 31620415 PMCID: PMC6759471 DOI: 10.3389/fpubh.2019.00258] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 08/27/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Evaluating the impact of a nutrition education program could provide insight into the effectiveness of an intervention. Researchers tested the hypothesis that a theory-based contextual nutrition education program (NEP) would improve the nutrition knowledge, attitudes, and dietary practices (KAP) of teachers and learners. Methods: Twenty three teachers who taught nutrition in Grades 4-7 (treatment school, n = 12) and 681 learners (treatment school, n = 350) participated in the study. In this quasi-experimental study, two primary schools were randomly selected to implement a contextual NEP. The nutrition KAP were assessed using previously validated questionnaires. The treatment school teachers taught nutrition using a developed nutrition education manual, while the control school teachers taught nutrition in the usual manner. Random effects Generalized Least Squares regression estimated the difference in the teachers' and learners' KAP for the treatment and control schools; p = 0.025 for a one-tailed test. Results: At post-implementation, the treatment school teachers' had higher total nutrition knowledge mean score (85.5% ± 8.2, p = 0.003) compared to the control school. Within the treatment school, total nutrition knowledge mean score of the teachers improved by 14.1%, p ≤ 0.001. Learners in the treatment school had higher total nutrition knowledge (53.2% ± 16.9, p = 0.002) and nutrition attitude (63.9% ± 19.7, p = 0.001) scores compared to learners in the control school. Within the treatment school, learners' total nutrition knowledge and nutrition attitudes scores increased by 4.9%, p ≤ 0.001 and 6.9%, p ≤ 0.001, respectively. The dietary practices of the teachers and the learners, and the nutrition attitudes of the teachers in the treatment school showed no significant within school improvement or in comparison with the control school (p > 0.025). Conclusions: The NEP led to the improvement in the teachers' and the learners' nutrition knowledge and the learners' nutrition attitudes. However, no significant improvement in the dietary practices of either teachers or learners was found.
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Affiliation(s)
| | - Una E. MacIntyre
- Human Nutrition Department, University of Pretoria, Pretoria, South Africa
| | - Gerda J. Gericke
- Human Nutrition Department, University of Pretoria, Pretoria, South Africa
| | - Piet Becker
- Research Office, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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van der Horst K, Mathias KC, Prieto Patron A, Allirot X. Art on a Plate: A Pilot Evaluation of an International Initiative Designed to Promote Consumption of Fruits and Vegetables by Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:919-925.e1. [PMID: 31047810 DOI: 10.1016/j.jneb.2019.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/18/2019] [Accepted: 03/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate the 2016 International Chefs Day cooking workshops Art on a Plate. DESIGN Nonexperimental pretest-posttest design SETTING: Art on a Plate workshops with children from 14 countries in Asia, America, and Europe. PARTICIPANTS A total of 433 workshop participants aged 4-14 years (mean age, 8.6 years). INTERVENTION Instructed by a chef, children in the workshops created a self-chosen design on their plate with a spinach-fruit salad. MAIN OUTCOME MEASURES Before and after the workshop, a questionnaire assessing liking and willingness to eat or taste; hunger was assessed using the Teddy the Bear method and emotions were assessed using the Self-assessment Manikin. The event coordinator evaluated salad intake. ANALYSIS Linear and generalized linear (logit) mixed models were used to test statistical differences before and after the workshop. RESULTS The workshop resulted in a small increase in liking (n = 409; P = .02) and person control (n = 375; P < .001) and a decrease in hunger (n = 379; P < .001). A total of 30% of children increased their liking scores, 18% decreased them, and 52% did not change them. Significant associations of liking and change in liking with salad intake were in the expected direction. CONCLUSION AND IMPLICATIONS This study showed the positive effect of a cooking workshop on children's salad liking across a selection of countries worldwide. Further research and novel methods are needed to evaluate the long-term effectiveness of cooking activities in real-life settings across countries.
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Affiliation(s)
- Klazine van der Horst
- Nestec Ltd, Nestlé Research Center, Institute of Nutritional Science, Vers-Chez-Les-Blanc, Lausanne, Switzerland; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
| | - Kevin C Mathias
- Nestec Ltd, Nestlé Research Center, Institute of Nutritional Science, Vers-Chez-Les-Blanc, Lausanne, Switzerland
| | - Alberto Prieto Patron
- Nestec Ltd, Nestlé Research Center, Institute of Nutritional Science, Vers-Chez-Les-Blanc, Lausanne, Switzerland
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117
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Holzmann SL, Schäfer H, Groh G, Plecher DA, Klinker G, Schauberger G, Hauner H, Holzapfel C. Short-Term Effects of the Serious Game "Fit, Food, Fun" on Nutritional Knowledge: A Pilot Study among Children and Adolescents. Nutrients 2019; 11:nu11092031. [PMID: 31480257 PMCID: PMC6770093 DOI: 10.3390/nu11092031] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/21/2019] [Accepted: 08/27/2019] [Indexed: 01/25/2023] Open
Abstract
“Serious games” are a novel and entertaining approach for nutritional education. The aim of this pilot study was to evaluate the short-term effectiveness of “Fit, Food, Fun” (FFF), a serious game to impart nutritional knowledge among children and adolescents. Data collection was conducted at two secondary schools in Bavaria, Germany. The gameplay intervention (gameplay group; GG) consisted of a 15-minute FFF gameplay session during each of three consecutive days. The teaching intervention (teaching group; TG) was performed in a classic lecture format. Nutritional knowledge was evaluated via questionnaires at baseline and post-intervention. Statistical analyses were performed using R (R Core Team, 2018). In total, baseline data were available for 39 participants in the GG and 44 participants in the TG. The mean age was 13.5 ± 0.7 years in the GG and 12.8 ± 0.9 years in the TG. There was a significant (p-value < 0.001) improvement in nutritional knowledge in both intervention groups. Moreover, a between-group difference with a significantly (p-value = 0.01) higher increase in nutritional knowledge was detected for the TG. This pilot study provides evidence for the short-term effectiveness of both educational interventions on the improvement in nutritional knowledge. Finally, the FFF game might be an adequate educational tool for the transfer of nutritional knowledge among children and adolescents.
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Affiliation(s)
- Sophie Laura Holzmann
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 80992 Munich, Germany
| | - Hanna Schäfer
- Research Group Social Computing, Department of Informatics, Technical University of Munich, 85748 Garching, Germany
| | - Georg Groh
- Research Group Social Computing, Department of Informatics, Technical University of Munich, 85748 Garching, Germany
| | - David Alexander Plecher
- Chair for Computer Aided Medical Procedures & Augmented Reality, Department of Informatics, Technical University of Munich, 85748 Garching, Germany
| | - Gudrun Klinker
- Chair for Computer Aided Medical Procedures & Augmented Reality, Department of Informatics, Technical University of Munich, 85748 Garching, Germany
| | - Gunther Schauberger
- Chair of Epidemiology, Department of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Hans Hauner
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 80992 Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, Else Kröner-Fresenius-Center for Nutritional Medicine, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 80992 Munich, Germany.
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118
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Gerritsen S, Renker-Darby A, Harré S, Rees D, Raroa DA, Eickstaedt M, Sushil Z, Allan K, Bartos AE, Waterlander WE, Swinburn B. Improving low fruit and vegetable intake in children: Findings from a system dynamics, community group model building study. PLoS One 2019; 14:e0221107. [PMID: 31415644 PMCID: PMC6695127 DOI: 10.1371/journal.pone.0221107] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/12/2019] [Indexed: 12/13/2022] Open
Abstract
Many children globally do not meet government guidelines for daily fruit and vegetable intake, and in New Zealand, adherence to the vegetable intake recommendation is declining. This study aimed to identify systemic barriers to children meeting fruit and vegetable (FV) guidelines and generate sustainable actions within a local community to improve children's FV intake. A qualitative system dynamics method of community group model building was used. The research team partnered with Healthy Families Waitākere, a Ministry of Health funded prevention initiative, to recruit 17 participants (including students, parents, teachers, community leaders, local retailers and health promoters) from a low-income, ethnically-diverse community in West Auckland, New Zealand. Three group model building workshops were held during which a systems map was created and used to identify actions by considering causal pathways and reinforcing loops in the system. Barriers to children's FV intake identified by participants were the saturation of fast-food outlets in the community and ubiquitous marketing of these products, the high cost of fresh produce compared to fast food, and parents having little time for food preparation plus declining cooking skills and knowledge. Several actions to improve children's FV intake by improving the local food environment were identified, which will be co-designed further and tested by a collaborative group involving community leaders. This project highlights the effectiveness of group model building for engaging a local community in systems change to improve child nutrition, and supplies a blueprint for future qualitative system dynamics research.
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Affiliation(s)
- Sarah Gerritsen
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Ana Renker-Darby
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Sophia Harré
- School of Population Health, University of Auckland, Auckland, New Zealand
| | | | | | | | | | - Kerry Allan
- Healthy Families Waitakere, Auckland, New Zealand
| | - Ann E. Bartos
- School of Environment, University of Auckland, Auckland, New Zealand
| | - Wilma E. Waterlander
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
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119
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Behavioural and social sciences to enhance the efficacy of health promotion interventions: redesigning the role of professionals and people. ACTA ACUST UNITED AC 2019. [DOI: 10.1017/bpp.2019.19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AbstractEvidence on the effectiveness of health promotion interventions is mixed, especially in terms of the magnitude of their impact and long-term adherence. This paper proposes a comprehensive approach informed by behavioural economics of developing behavioural change programmes, which is designed to educate, activate, engage and empower people by taking into consideration individual and social mechanisms. Three applied pilots and their results are presented in order to illustrate the approach using cognitive and social mechanisms to lead to better health outcomes, individually and community-wide. More research is needed to explore levers and barriers for the systemic adoption of this framework in implementing health promotion interventions.
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120
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Ehrenberg S, Leone LA, Sharpe B, Reardon K, Anzman-Frasca S. Using repeated exposure through hands-on cooking to increase children's preferences for fruits and vegetables. Appetite 2019; 142:104347. [PMID: 31278956 DOI: 10.1016/j.appet.2019.104347] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/01/2019] [Accepted: 07/02/2019] [Indexed: 11/26/2022]
Abstract
Few children in the United States meet national fruit and vegetable intake recommendations, highlighting a need for interventions. Children's food preferences act as a barrier to fruit and vegetable consumption, but prior research has demonstrated that repeated taste exposures can increase children's acceptance of these foods. Prior research in this area has typically utilized controlled procedures in which children sample small tastes of target foods over repeated occasions. The primary aim of the present pilot study was to test whether children's preferences for target fruits and vegetables increased following repeated taste exposures to them through hands-on cooking in a community setting. Seventeen 6-to-8-year-old children participated in biweekly study sessions during six weeks of a summer camp serving lower-income families. Liking of (yummy, just OK, yucky) and rank-ordered preferences for nine fruits and vegetables were measured before and after exposure sessions (pre-test and post-test). Based on pre-test assessments, four relatively less liked foods (two fruits, two vegetables) were chosen to become target foods. Children were then exposed to target foods during nine hands-on cooking sessions; liking of target foods was also measured at a midpoint assessment. At each exposure session, children assisted with preparation of a different snack using a recipe involving target foods and then ate the prepared snack together. Preferences for target foods increased from pre-test (Median = 5.8) to post-test (Median = 5.5; p < 0.05). On average, the majority of children rated the prepared snacks favorably. Results from this pilot study demonstrate the potential of applying repeated exposure techniques via hands-on cooking in a community setting.
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Affiliation(s)
- S Ehrenberg
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - L A Leone
- School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, USA
| | - B Sharpe
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - K Reardon
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - S Anzman-Frasca
- Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, USA; Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
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121
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Olan EL, Campbell LO, Jahani S. Examining Second Graders' Healthy Food Choices: Through Literacy and Active Learning. Nutr Metab Insights 2019; 12:1178638819839063. [PMID: 31105429 PMCID: PMC6501495 DOI: 10.1177/1178638819839063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/22/2019] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to investigate the implementation of a nutrition module and activities (Go, Slow, Whoa) in a literacy environment through an active learning approach. Second graders (N = 85) from diverse socioeconomic status (SES) areas completed the 12-week program. The participants' perceptions of healthy food choices were measured both pre- and post-intervention. Students met for 30 minutes twice a week, to complete 5-lessons from a Coordinated Approach to Child Health (CATCH) nutrition module and activities (Go, Slow, Whoa). Measures were taken both pre- and post-intervention (Food Fury Quiz) to distinguishing between healthy and unhealthy foods (images). There was a statistically significant improvement (t = 12.16, df =84, P = .000) from pretest (M = 19.06, SD = 3.13) and posttest (M = 23.34, SD = 0.48) scores. Administering a healthy food choice curriculum through literacy and active learning provides an alternative approach to improving health knowledge among second grade students.
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Affiliation(s)
- Elsie Lindy Olan
- Department of Learning Sciences and Educational Research, University of Central Florida, Orlando, FL, USA
| | - Laurie O. Campbell
- Department of Learning Sciences and Educational Research, University of Central Florida, Orlando, FL, USA
| | - Shiva Jahani
- Department of Learning Sciences and Educational Research, University of Central Florida, Orlando, FL, USA
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122
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Gerritsen S, Harré S, Swinburn B, Rees D, Renker-Darby A, Bartos AE, Waterlander WE. Systemic Barriers and Equitable Interventions to Improve Vegetable and Fruit Intake in Children: Interviews with National Food System Actors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1387. [PMID: 30999659 PMCID: PMC6518010 DOI: 10.3390/ijerph16081387] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 11/16/2022]
Abstract
Fruit and vegetable (FV) intake is declining in New Zealand, and over half of New Zealand's children do not meet the recommendation of two serves of fruit and three serves of vegetables daily (with even lower adherence among children in high-deprivation neighbourhoods). The aim of this study was to map the potential causal pathways explaining this decline and possible actions to reverse it. Semi-structured interviews were held in April-May 2018 with 22 national actors from the produce industry, food distribution and retail sector, government, and NGO health organisations. The qualitative systems dynamics method of cognitive mapping was used to explore causal relationships within the food system that result in low FV intake among children. Barriers and solutions identified by participants were analysed using thematic analysis and according to a public health intervention framework. Participants were in agreement with the goal of improving FV intake for health and economic outcomes, and that health promotion strategies had been ineffectual to date due to multiple systemic barriers. Common barriers discussed were poverty, high food prices, low skills/knowledge, unhealthy food environments, climate change, and urbanization. Solutions with the strongest evidence of efficacy identified by the participants were subsidizing FVs and early childhood interventions to improve FV exposure.
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Affiliation(s)
- Sarah Gerritsen
- School of Population Health, University of Auckland, Auckland 1142, New Zealand.
| | - Sophia Harré
- School of Population Health, University of Auckland, Auckland 1142, New Zealand.
| | - Boyd Swinburn
- School of Population Health, University of Auckland, Auckland 1142, New Zealand.
| | - David Rees
- Synergia Consulting Ltd, Auckland 1011, New Zealand.
| | - Ana Renker-Darby
- School of Population Health, University of Auckland, Auckland 1142, New Zealand.
| | - Ann E Bartos
- School of Environment, University of Auckland, Auckland 1142, New Zealand.
| | - Wilma E Waterlander
- Department of Public Health, Amsterdam UMC, University of Amsterdam, 1105AZ Amsterdam, The Netherlands.
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123
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Poelman AAM, Cochet-Broch M, Cox DN, Vogrig D. Vegetable Education Program Positively Affects Factors Associated With Vegetable Consumption Among Australian Primary (Elementary) Schoolchildren. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:492-497.e1. [PMID: 30579892 DOI: 10.1016/j.jneb.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To measure the effectiveness of a new sensory education program for Australian primary (elementary) schoolchildren (Vegetable Education Resource to Increase Children's Acceptance and Liking [VERTICAL]) designed to increase vegetable enjoyment and positively predispose to vegetable consumption. METHODS Pretest and posttest (collected 2 weeks after intervention) survey data (n = 299) on cognitive, attitudinal, and behavioral factors associated with vegetable consumption were compared between the intervention (which followed VERTICAL, a program consisting of five 1-hour teacher-led interventions) and control students (aged 8-12 years) from Sydney primary schools. RESULTS The VERTICAL intervention increased knowledge about vegetables and the senses (P = .002), the ability to verbalize sensations (P < .001), vegetable acceptance (P = .007), and willingness to try vegetables (P = .05). Middle primary students gained more positive attitudes toward vegetable consumption (P = .009). Moreover, VERTICAL had no effect on food neophobia, perceived norms of teacher and peers, emotions, behavioral intentions, and vegetables tried. CONCLUSIONS AND IMPLICATIONS Behavioral change was achieved through VERTICAL in a short intervention, supporting further development and validation.
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Affiliation(s)
- Astrid A M Poelman
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, North Ryde, New South Wales, Australia.
| | - Maeva Cochet-Broch
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Agriculture and Food, North Ryde, New South Wales, Australia
| | - David N Cox
- CSIRO Health and Biosecurity, Adelaide, South Australia, Australia
| | - Darren Vogrig
- CSIRO Education, North Ryde, New South Wales, Australia
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Huys N, Cardon G, De Craemer M, Hermans N, Renard S, Roesbeke M, Stevens W, De Lepeleere S, Deforche B. Effect and process evaluation of a real-world school garden program on vegetable consumption and its determinants in primary schoolchildren. PLoS One 2019; 14:e0214320. [PMID: 30897160 PMCID: PMC6428286 DOI: 10.1371/journal.pone.0214320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/11/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the effectiveness of a school garden program on children's vegetable consumption and determinants and to gain insight into the process of the program. METHODS The "Taste Garden" is a real-world nine-week school garden program developed and implemented by a local organization. A total of 350 children (149 intervention group, 201 control group) filled out questionnaires on vegetable consumption, determinants and process of the program. Additionally, teachers filled out a process evaluation questionnaire. For effect evaluation, interaction effects (time x group) were considered, using multilevel repeated measures analyses in MLwiN 3.02. Interaction effects were repeated, taking into account quality of implementation (time x implementation group). Process evaluation was descriptively assessed with SPSS 24.0. RESULTS Overall, beside some practical concerns of teachers, the program was well perceived by teachers and children. However, an intervention effect of "The Taste Garden" was only found for knowledge (p = 0.02), with a very small effect size (0.55%). When taking into account implementation quality, only small effects were found for awareness (p between 0.005 and 0.007 and an effect size of 0.63%) and knowledge (p between 0.04 and 0.09 and an effect size of 0.65%). CCONCLUSIONS Evaluation of the real-world "Taste Garden" program, which was positively perceived by teachers, showed no effects on vegetable consumption and small effects on its determinants. Adaptations of the current format and longer follow-up periods are therefore recommended.
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Affiliation(s)
- Nele Huys
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- * E-mail:
| | - Marieke De Craemer
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ninotchka Hermans
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Siska Renard
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | | | | | - Sara De Lepeleere
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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125
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Eanes LS, Fuentes LA, Bautista B, Salazar D, Garza D. Bridging the Gaps Through Nurse-Led Nutrition Education to Underserved Children. HISPANIC HEALTH CARE INTERNATIONAL 2019; 17:66-72. [PMID: 30859846 DOI: 10.1177/1540415319830762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although children residing in impoverished rural communities located along the Texas-Mexico border are at disproportionately high risk of unhealthy eating, limited resources may prevent devoting sufficient attention to school-based nutrition education. The purpose of this quasi-experimental study was to examine the teaching effectiveness of graduate nursing students on fourth-grade student learning about healthy eating. Purposive sampling was used to select 213 predominately Hispanic fourth-grade students enrolled in one of three low-socioeconomic status underserved elementary schools located in rural South Texas. Ten graduate nursing students implemented the Creating Healthy Eating Choices for Kids Nutrition Curriculum to approximately 40 fourth-graders per group who attended weekly 45- to 50-minute sessions for 6 weeks. The MyPlate standardized tests were administered before and following the intervention. Results showed a significant improvement in learning on all program modules for fourth-graders from each school ( p = .000). Results support the value of creating a strategic partnership between a university school of nursing and key community leaders as a feasible method of providing nutrition education for fourth-graders enrolled in schools with limited resources.
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Affiliation(s)
- Linda S Eanes
- 1 University of Texas Rio Grande Valley, Edinburg, TX, USA
| | | | | | - David Salazar
- 1 University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - Doreen Garza
- 1 University of Texas Rio Grande Valley, Edinburg, TX, USA
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126
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Azevedo J, Padrão P, Gregório MJ, Almeida C, Moutinho N, Lien N, Barros R. A Web-Based Gamification Program to Improve Nutrition Literacy in Families of 3- to 5-Year-Old Children: The Nutriscience Project. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:326-334. [PMID: 30579894 DOI: 10.1016/j.jneb.2018.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 09/29/2018] [Accepted: 10/13/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Assess the impact of a web-based gamification program on nutrition literacy of families and explore differences in impact by socioeconomic status. DESIGN Quasi-experimental. SETTING Thirty-seven kindergartens from Portugal. PARTICIPANTS Eight hundred seventy-seven families. INTERVENTION Web-based social network of participants' interactions, educational materials, apps and nutritional challenges, focused on fruit, vegetables, sugar, and salt. MAIN OUTCOME MEASURES Parental nutrition literacy (self-reported survey - 4 dimensions: Nutrients, Food portions, Portuguese food wheel groups, Food labeling). ANALYSIS General linear model - Repeated measures was used to analyze the effect on the nutrition literacy score. RESULTS Families uploaded 1267 items (recipes, photographs of challenges) and educators uploaded 327 items (photographs, videos) onto the interactive platform. For the intervention group (n = 106), the final mean (SD) score of nutrition literacy was significantly higher than the baseline: 78.8% (15.6) vs 72.7% (16.2); P < .001, regardless of parental education and perceived income status. No significant differences in the scores of the control group (n = 83) were observed (final 67.8% [16.1] vs initial 66.4% [15.6]; P = .364). CONCLUSIONS AND IMPLICATIONS Gamified digital interactive platform seems to be a useful, easily adapted educational tool for the healthy eating learning process. Future implementations of the program will benefit from longer time intervention and assessment of the eating habits of families before and after intervention.
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Affiliation(s)
- José Azevedo
- Faculdade de Letras, Universidade do Porto, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
| | - Patrícia Padrão
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Maria J Gregório
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal; EpiDoC Unit, Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Carla Almeida
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
| | - Nuno Moutinho
- Faculdade de Economia and Center for Economics and Finance, Universidade do Porto, Porto, Portugal
| | - Nanna Lien
- Department of Nutrition, University of Oslo, Oslo, Norway
| | - Renata Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
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127
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Pascual KJ, Vlasova E, Lockett KJ, Richardson J, Yochelson M. Evaluating the Impact of Personalized Stroke Management Tool Kits on Patient Experience and Stroke Recovery. J Patient Exp 2018; 5:244-249. [PMID: 30574543 PMCID: PMC6295809 DOI: 10.1177/2374373517750416] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hallmarks of the difficult period of transition from hospital to home following stroke include stroke survivor and caregiver uncertainty about actionable steps toward recovery and prevention and unfamiliarity with related resources. Current research shows that interdisciplinary interventions focusing on patient experience and patient education enable health-care providers to activate and empower patients, potentially leading to better clinical outcomes. Tool kit approaches have been successfully used to aid patients through ongoing education after hospital discharge and to improve patient experience. In this article, we describe our efforts to iteratively develop and test personalized stroke management tool kits aimed at connecting stroke survivors and their caregivers to empowering resources, while soliciting feedback from patients and family members.
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128
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Hagedorn RL, Baker K, DeJarnett SE, Hendricks T, McGowan M, Joseph L, Olfert MD. Katalyst Pilot Study: Using Interactive Activities in Anatomy and Physiology to Teach Children the Scientific Foundation of Healthy Lifestyles. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E162. [PMID: 30487474 PMCID: PMC6306697 DOI: 10.3390/children5120162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 12/04/2022]
Abstract
This pilot study evaluated the impact of the Katalyst curriculum, a fifth-grade experiential learning program, on students' knowledge of a healthy lifestyle's impact on body functions. Katalyst's interactive curriculum spans two days and includes four, 60-min stations on body systems: cardiovascular/endocrine, gastrointestinal, neurological, and respiratory/musculoskeletal. Three schools were recruited, and two schools completed the intervention sessions. Prior to beginning the stations, fifth-grade students completed a 37-item questionnaire to assess knowledge and perceptions. Students completed the same survey at the end of the Katalyst intervention. Teachers at the school also completed a survey post intervention to provide feedback on the program. Frequency and paired analyses were conducted on student responses and summative content analysis on teacher and volunteer feedback. The School 1 completer (n = 63) baseline mean knowledge score was 66.2%. The School 2 completer (n = 47) baseline mean knowledge score was 67.3%. Following the Katalyst intervention, both schools showed a statistically significant increase in the mean post score to 70.3% (p = 0.0017) and 78.4%(p < 0.0001) at School 1 (n = 63) and School 2 (n = 47), respectively. Teacher feedback (n = 7) revealed that Katalyst was effective in meeting state educational health standards and teachers perceived that the students benefitted from the program more than "reading about the body systems in a textbook or health magazine". The Katalyst pilot study appeared to improve fifth-grade students' knowledge of body systems and health. Katalyst aligned with state educational standards and is supported by teachers for an experiential learning opportunity. The Katalyst curriculum could be a potential avenue for health educators in Appalachia.
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Affiliation(s)
- Rebecca L Hagedorn
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources & Design, West Virginia University, G025 Agricultural Science Building, Morgantown, WV 26506, USA.
| | - Kathryn Baker
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Sara E DeJarnett
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources & Design, West Virginia University, G025 Agricultural Science Building, Morgantown, WV 26506, USA.
| | - Tyler Hendricks
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Melissa McGowan
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Lauren Joseph
- School of Medicine, West Virginia University, Morgantown, WV 26506, USA.
| | - Melissa D Olfert
- Division of Animal and Nutritional Sciences, Davis College of Agriculture, Natural Resources & Design, West Virginia University, G025 Agricultural Science Building, Morgantown, WV 26506, USA.
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129
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de Vlieger N, Riley N, Miller A, Collins CE, Bucher T. Nutrition education in the Australian New South Wales primary school curriculum: An exploration of time allocation, translation and attitudes in a sample of teachers. Health Promot J Austr 2018; 30:94-101. [PMID: 30054958 DOI: 10.1002/hpja.188] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/24/2018] [Indexed: 02/04/2023] Open
Abstract
ISSUE ADDRESSED The dietary intakes of Australian children are not optimal, with few meeting recommended vegetable and fruit intake targets. Nutrition education in childhood is important for developing healthy eating patterns, with schools an ideal setting for a wide reach. The aims of this study were to examine nutrition education within the NSW primary school syllabus, explore how much time teachers spend teaching nutrition, what is taught, what materials are used, and to identify attitudes towards nutrition education. METHOD An online survey consisting of 29 closed questions (with options for comments) was specifically developed for the purpose of this study. Teachers currently teaching at a NSW primary school were eligible to participate. RESULTS A total of 33 NSW primary school teachers completed the survey. Results indicate that limited time is spent on teaching nutrition with some important nutrition education components currently missed, resources perceived to be inadequate and lack of time reported as the largest barrier to teaching nutrition. CONCLUSION In order to improve the quality of nutrition education in NSW primary schools, several important topics need to be integrated into the curriculum, and time constraints of teachers should be taken into account. SO WHAT?: Findings from the current survey will inform the development of future nutrition education programs and resources with the aim of integrating nutrition education within the primary school curriculum.
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Affiliation(s)
- Nienke de Vlieger
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
| | - Nicholas Riley
- Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia.,School of Education, Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW, Australia
| | - Andrew Miller
- School of Education, Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW, Australia
| | - Clare E Collins
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
| | - Tamara Bucher
- School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
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130
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LaChausse RG, Sandoval E. Differences in Health Education Competencies Among Obesity Prevention and Nutrition Education Professionals. Health Promot Pract 2018; 21:114-122. [DOI: 10.1177/1524839918786234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The study purpose was to examine perceived health education competencies among those responsible for planning, implementing, and evaluating health education programs. A total of 172 obesity prevention and nutrition education professionals in the United States completed a survey measuring their perceived competency to plan, implement, and evaluate nutrition education/obesity prevention education programs based on the National Commission for Health Education Credentialing health education competencies and their endorsement of various health education approaches. Using a series of multiple hierarchical regression models, we found that those trained in health education had greater perceived competency in assessing needs ( B = 1.19, t = 2.11, p = .03), planning health education programs ( B = 1.63, t = 2.96, p = .004), implementing health education programs ( B = 1.00, t = 2.22, p = .03), evaluating health education programs ( B = 4.85, t = 3.54, p = .001), and managing health education programs ( B = 1.70, t = 2.21, p = .03) than those trained in nutrition or dietetics. Additionally, those trained in health education were more likely to endorse the use of a skill-based approach to obesity prevention ( B = 0.25, t = 2.53, p = .01) and less likely to endorse teaching facts and information ( B = 0.24, t = 1.99, p = .05) than those trained in nutrition or dietetics. These results have implications for improving the effectiveness of health education and promotion programs and the professional preparation of health educators and dietitians alike.
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Affiliation(s)
| | - Emma Sandoval
- University of California, Cooperative Extension, Moreno Valley, CA, USA
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131
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A process and outcome evaluation of an in-class vegetable promotion program. Appetite 2018; 125:182-189. [PMID: 29427693 DOI: 10.1016/j.appet.2018.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Nutrition interventions that target both fruits and vegetables are effective in increasing fruit consumption, but have been limited in their ability to improve vegetable intake. To address the low proportion of children meeting vegetable intake guidelines, approaches specifically targeting vegetables are needed. This paper reports on a mixed-method analysis of a 10-week vegetable promotion pilot project that aimed to increase vegetable intake as part of the existing Crunch&Sip in-class fruit and vegetable break program. DESIGN The intervention was designed to promote vegetable consumption through the implementation of vegetable-focused resources, including curriculum resources and parent education materials. Teachers completed pre- and end-of-intervention surveys. Process measures related to the use of resources and teachers' perceptions of barriers to implementation. The outcome evaluation included measures of children's vegetable consumption during Crunch&Sip breaks and teachers' attitudes and confidence relating to educating students about the benefits of consuming vegetables. SUBJECTS Twenty-one Western Australian primary schools already participating in the Crunch&Sip program participated in the pilot intervention and evaluation. Coverage included 35 primary school teachers representing 818 students aged 4-11 years. RESULTS The proportion of children bringing vegetables for Crunch&Sip more than doubled over the 10-week intervention (21% vs 46%; p < 0.001). Improvements were observed in teachers' perceived knowledge about the nutritional benefits of vegetables (p = 0.001) and confidence to educate students about the benefits of vegetable consumption (p = 0.028). CONCLUSIONS Preferentially promoting vegetable consumption as part of an existing school-based nutrition program may be an effective strategy to increase children's vegetable intake.
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132
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Amin SA, Panzarella C, Lehnerd M, Cash SB, Economos CD, Sacheck JM. Identifying Food Literacy Educational Opportunities for Youth. HEALTH EDUCATION & BEHAVIOR 2018; 45:918-925. [DOI: 10.1177/1090198118775485] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Recent efforts supporting children’s dietary behaviors suggest the importance of food literacy (FL), which is a multidimensional concept that encompasses food-related knowledge, skills, and behaviors. To date, FL has been largely informed by adult and adolescent research. Aims. To assess the FL experiences, perceived skills, and knowledge of school-age children to inform FL educational opportunities. Method. Six focus groups were conducted with children (age 9-12 years) from three Massachusetts elementary schools. Two team members independently reviewed and coded a portion of the transcripts to assess interrater reliability. Predominant themes connected to children’s perceived FL skills and knowledge were identified using an inductive and deductive content analysis approach. Results. There were five central FL themes identified during the focus groups ( n = 31 children), including (1) food systems concepts; (2) food safety and food freshness; (3) gardening environment, perceived skills, and knowledge; (4) cooking environment, perceived skills, and safety; and (5) autonomy of meal preparation. Discussion. The themes that emerged in these focus groups with children provided new information surrounding children’s perceived FL skills and knowledge as well as important context regarding the food environment (school vs. home). These findings captured important concepts across the “farm to plate” spectrum and highlight potential school-based opportunities where FL topics could be expanded upon most successfully. Conclusion. This formative research informed educational opportunities for a FL curriculum, which holds promise for improving food-based education and programs, designing more effective interventions, and developing measurement tools.
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133
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Kupolati MD, MacIntyre UE, Gericke GJ. A Theory-Based Contextual Nutrition Education Manual Enhanced Nutrition Teaching Skill. Front Public Health 2018; 6:157. [PMID: 29896470 PMCID: PMC5987015 DOI: 10.3389/fpubh.2018.00157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/09/2018] [Indexed: 11/13/2022] Open
Abstract
Background: A theory-based contextual nutrition education manual (NEM) may enhance effective teaching of nutrition in schools. School nutrition education should lead to the realization of such benefits as improved health, scholarly achievement leading to manpower development and consequently the nation's development. The purpose of the study was to develop a contextual NEM for teachers of Grade 5 and 6 learners in the Bronkhorstspruit district, South Africa, and to assess teachers' perception on the use of the manual for teaching nutrition. Methods: This descriptive case study used an interpretivist paradigm. The study involved teachers (N = 6) who taught nutrition in Life Skills (LS) and Natural Science and Technology (NST) in a randomly selected primary school in the Bronkhorstspruit district. Findings from a nutrition education needs assessment were integrated with the constructs of the Social cognitive theory (SCT) and the Meaningful learning model (MLM) and the existing curriculum of the Department of Basic Education (DoBE) to develop a contextual NEM. The manual was used by the teachers to teach nutrition to Grades 5 and 6 learners during the 2015 academic year as a pilot project. A focus group discussion (FDG) was conducted with teachers to gauge their perceptions of the usefulness of the NEM. Data were analyzed using the thematic approach of the framework method for qualitative research. Results: Teachers described the NEM as rich in information, easy to use and perceived the supporting materials and activities as being effective. The goal setting activities contained in the NEM were deemed to be ineffective. Teachers felt that they did not have enough time to teach all the important things that the learners needed to know. Conclusion: Teachers perceived the NEM as helpful toward improving their nutrition teaching skills.The NEM template may furthermore guide teachers in planning theory-based nutrition lessons.
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Affiliation(s)
- Mojisola D. Kupolati
- Human Nutrition, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Project SoL-A Community-Based, Multi-Component Health Promotion Intervention to Improve Eating Habits and Physical Activity among Danish Families with Young Children. Part 1: Intervention Development and Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061097. [PMID: 29843434 PMCID: PMC6025396 DOI: 10.3390/ijerph15061097] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/19/2018] [Accepted: 05/23/2018] [Indexed: 11/24/2022]
Abstract
Project SoL was implemented over a period of four years from 2012–2015 with the aim to promote healthy eating and physical activity among families with children aged 3–8 years, living in selected communities in two Danish municipalities. This was done by applying the supersetting approach to implement complex multi-component interventions in a participatory, coordinated, and integrated manner in childcare centres, schools, and supermarkets in three local communities, as well as in local media during a 19-month period in the Regional Municipality of Bornholm, which served as the intervention site. The matching municipality of Odsherred served as a control site based on its similarity to Bornholm regarding several socio-demographic and health indicators. The present paper describes the design of Project SoL as well as the processes of developing and implementing its complex interventions. Moreover, the theoretical and conceptual framework of the project is described together with its organisational structure, concrete activities, and sustainability measures. The paper discusses some of the key lessons learned related to participatory development and the implementation of a multi-component intervention. The paper concludes that coordinated and integrated health promotion activities that are implemented together with multiple stakeholders and across multiple settings in the local community are much more powerful than individual activities carried out in single settings. The supersetting approach was a useful conceptual framework for developing and implementing a complex multi-component health promotion intervention and for fostering ownership and sustainability of the intervention in the local community. The research and evaluation approach of the project is described in a separate paper (Part 2).
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Saraiva NCG, Medeiros CCM, Araujo TLD. Serial album validation for promotion of infant body weight control. Rev Lat Am Enfermagem 2018; 26:e2998. [PMID: 29791665 PMCID: PMC5969825 DOI: 10.1590/1518-8345.2194.2998] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 12/14/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: to validate the content and appearance of a serial album for children aged
from 7 to 10 years addressing the topic of prevention and control of body
weight. Method: methodological study with descriptive nature. The validation process was
attended by 33 specialists in educational technologies and/or in excess of
infantile weight. The agreement index of 80% was the minimum considered to
guarantee the validation of the material. Results: most of the specialists had a doctoral degree and a graduate degree in
nursing. Regarding content, illustrations, layout and relevance, all items
were validated and 69.7% of the experts considered the album as great. The
overall agreement validation index for the educational technology was 0.88.
Only the script-sheet 3 did not reach the cutoff point of the content
validation index. Changes were made to the material, such as title change,
inclusion of the school context and insertion of nutritionist and physical
educator in the story narrated in the album. Conclusion: the proposed serial album was considered valid by experts regarding content
and appearance, suggesting that this technology has the potential to
contribute in health education by promoting healthy weight in the age group
of 7 to 10 years.
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Maisonneuve AR, Witteman HO, Brehaut J, Dubé È, Wilson K. Educating children and adolescents about vaccines: a review of current literature. Expert Rev Vaccines 2018; 17:311-321. [PMID: 29569498 DOI: 10.1080/14760584.2018.1456921] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Until recently, research on vaccine hesitancy has focused primarily on parent populations. Although adolescent knowledge and views are gaining momentum within the literature, particularly with regards to the human papillomavirus and influenza, children remain a virtually unstudied population with regards to vaccine hesitancy. AREAS COVERED This review focuses on the lack of literature in this area and argues for more vaccine hesitancy research involving child and adolescent populations. It also outlines special issues to consider when framing health promotion messages for children and adolescents. Finally, we explore the use of new and existing technologies as delivery mechanisms for education on vaccines and immunizations in populations of children and adolescents. EXPERT COMMENTARY Children undergo cognitive development and experiences with vaccines (e.g. pain or education) have the potential to create future attitudes toward vaccines. This can influence future vaccine behaviour, including their participation in decision-making around adolescent vaccines, their decisions to vaccinate themselves when they are adults, and their decisions to vaccinate their own children. Interventions aimed at children, such as education, can create positive attitudes toward vaccines. These can also potentially influence parental attitudes toward vaccines as children convey this knowledge to them. Both of these impacts require further study.
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Affiliation(s)
| | - Holly O Witteman
- b Department of Family and Emergency Medicine , Université Laval , Québec , QC , Canada
| | - Jamie Brehaut
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
| | - Ève Dubé
- d Institut national de santé publique du Québec , Québec , QC , Canada
| | - Kumanan Wilson
- c Ottawa Hospital Research Institute , Ottawa , ON , Canada
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Dupart G, Berry DC, D’Auria J, Sharpe L, McDonough L, Houser M, Flanary S, Koppelberger S. A Nurse-Led and Teacher-Assisted Adolescent Healthy Weight Program to Improve Health Behaviors in the School Setting. J Sch Nurs 2017; 35:178-188. [DOI: 10.1177/1059840517744020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Adolescents with overweight and obesity are at risk for future health problems. The purpose of this study was to examine the feasibility and initial efficacy of a weight management intervention to help adolescents develop healthy nutrition and physical activity behaviors and improve their anthropometrics. This study used a single-group repeated measures design in a small school in Durham, North Carolina (NC). The intervention consisted of a nurse-led and teacher-assisted nutrition and physical activity education and exercise classes that met twice each week for 45–60 minutes for 7 weeks. Data were collected at Time 1 (baseline), Time 2 (after intervention completion), and Time 3 (after 3 months on their own). Interview feedback, low cost, and successful completion of all planned activities indicated that all stakeholders found the project beneficial and suitable for their school. This study suggests that a weight management intervention for adolescents was feasible in the school setting.
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Affiliation(s)
- Gary Dupart
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diane C. Berry
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer D’Auria
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leslie Sharpe
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Shimazaki T, Bao H, Deli G, Uechi H, Lee YH, Miura K, Takenaka K. Cross-cultural validity of the theory of planned behavior for predicting healthy food choice in secondary school students of Inner Mongolia. Diabetes Metab Syndr 2017; 11 Suppl 1:S497-S501. [PMID: 28408191 DOI: 10.1016/j.dsx.2017.03.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Indexed: 10/19/2022]
Abstract
AIMS Unhealthy eating behavior is a serious health concern among secondary school students in Inner Mongolia. To predict their healthy food choices and devise methods of correcting unhealthy choices, we sought to confirm the cross-cultural validity of the theory of planned behavior among Inner Mongolian students. MATERIALS AND METHODS A cross-sectional study, conducted between November and December 2014. Overall, 3047 students were enrolled. We devised a questionnaire based on the theory of planned behavior to measure its components (intentions, attitudes, subjective norms, and perceived behavioral control) in relation to healthy food choices; we also assessed their current engagement in healthy food choices. RESULTS A principal component analysis revealed high contribution rates for the components (69.32%-88.77%). A confirmatory factor analysis indicated that the components of the questionnaire had adequate model fit (goodness of fit index=0.997, adjusted goodness of fit index=0.984, comparative fit index=0.998, and root mean square error of approximation=0.049). Notably, data from participants within the suburbs did not support the theory of planned behavior construction. Several paths did not predict the hypothesis variables. However, attitudes toward healthy food choices strongly predicted behavioral intention (path coefficients 0.49-0.77, p<0.01), regardless of demographic characteristics. CONCLUSION Our results support that the theory of planned behavior can apply to secondary school students in urban areas. Furthermore, attitudes towards healthy food choices were the best predictor of behavioral intentions to engage in such choices in Inner Mongolian students.
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Affiliation(s)
- Takashi Shimazaki
- Department of Health & Physical Education, Faculty of Humanities, Sophia University, Japan.
| | - Hugejiletu Bao
- College of Physical Education, Inner Mongolia Normal University, China.
| | - Geer Deli
- College of Physical Education, Inner Mongolia Normal University, China.
| | | | - Ying-Hua Lee
- Hsinchu Municipal Min Fu Elementary School, Taiwan.
| | - Kayo Miura
- Faculty of Health & Medical Care, Saitama Medical University, Japan.
| | - Koji Takenaka
- Faculty of Human Sciences, Waseda University, Japan.
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139
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LaChausse RG. A clustered randomized controlled trial to determine impacts of the Harvest of the Month program. HEALTH EDUCATION RESEARCH 2017; 32:375-383. [PMID: 28931166 DOI: 10.1093/her/cyx056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 07/18/2017] [Indexed: 06/07/2023]
Abstract
The study purpose was to examine the impact of the Harvest of the Month (HOTM) program on fruit and vegetable (FV) consumption, FV preferences, other eating behaviors, physical activity and other variables related to healthy eating. A clustered randomized controlled trial was employed in 28 elementary schools. After parental consent was obtained, students in grades 4-6 were randomly assigned to treatment and control conditions (Intervention= 127, Control= 148). Students in the intervention group participated in HOTM, a widely used school-based nutrition promotion and obesity prevention program. Control group schools continued their usual practice. Participants completed baseline and follow-up surveys measuring fruit and vegetable (FV) consumption, FV preferences, other eating behaviors, physical activity, FV knowledge and self-efficacy to eat, prepare and ask for FV. No impacts of HOTM were found for FV consumption or other nutritional behaviors, physical activity, FV knowledge, or self-efficacy. A positive impact of the program was only found for FV preferences. This study suggests that the HOTM program did not affect eating behaviors or physical activity behaviors. The evidence base regarding school-based nutrition education programs including HOTM could be strengthened by the use of more rigorous impact evaluations to examine their effectiveness prior to wide-spread use.
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Affiliation(s)
- Robert G LaChausse
- Department of Public Health Sciences, California Baptist University, 8432 Magnolia Ave, Riverside, CA 92504, USA
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140
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Bauer NS, Azer N, Sullivan PD, Szczepaniak D, Stelzner SM, Downs SM, Carroll AE. Acceptability of Group Visits for Attention-Deficit Hyperactivity Disorder in Pediatric Clinics. J Dev Behav Pediatr 2017; 38:565-572. [PMID: 28816910 PMCID: PMC5657442 DOI: 10.1097/dbp.0000000000000492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Children with attention-deficit hyperactivity disorder (ADHD) have ongoing needs that impair home and school functioning. Group visit models are a promising way to deliver timely parenting support but family and provider acceptance has not previously been examined. The objective was to describe the acceptability of ADHD group visits in busy pediatric clinics based on caregivers, child participants and facilitators. METHODS Data were analyzed from school-age children and caregivers who participated in one of two 12-month long randomized controlled studies of the ADHD group visit model from 2012 to 2013 or 2014 to 2015. Feedback was obtained using semi-structured questions at each study end, by telephone or at the last group visit. Sessions were audio-recorded, transcribed and themes were extracted by participant type. RESULTS A total of 34 caregivers, 41 children and 9 facilitators offered feedback. Caregivers enjoyed the "support group" aspect and learning new things from others. Caregivers reported improved understanding of ADHD and positive changes in the relationship with their child. Children were able to recall specific skills learned including how skills helped at home or school. Facilitators acknowledged systems-level challenges to offering group visits but felt the group format helped increase understanding of families' needs, improved overall care, and provided innovative ways to engage with families. CONCLUSION The majority of comments from families and facilitators highlighted a variety of benefits of the use of a group visit model for ADHD chronic care. Despite systems-level barriers to implementation, families and facilitators felt the benefits outweighed the challenges.
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Affiliation(s)
- Nerissa S. Bauer
- Department of Pediatrics, Indiana University School of Medicine, Section of Children’s Health Services Research, Indianapolis, IN
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
| | - Nina Azer
- Department of Pediatrics, University of Kentucky, Lexington, KY
| | - Paula D. Sullivan
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Dorota Szczepaniak
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Stephen M. Downs
- Department of Pediatrics, Indiana University School of Medicine, Section of Children’s Health Services Research, Indianapolis, IN
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
| | - Aaron E. Carroll
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
- Department of Pediatrics, Indiana University School of Medicine, Section of Pediatric and Adolescent Comparative Effectiveness Research, Indianapolis, IN
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141
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Brumana L, Arroyo A, Schwalbe NR, Lehtimaki S, Hipgrave DB. Maternal and child health services and an integrated, life-cycle approach to the prevention of non-communicable diseases. BMJ Glob Health 2017; 2:e000295. [PMID: 29082005 PMCID: PMC5656183 DOI: 10.1136/bmjgh-2017-000295] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 04/10/2017] [Accepted: 04/30/2017] [Indexed: 12/31/2022] Open
Abstract
Described as the ‘invisible epidemic’, non-communicable diseases (NCDs) are the world’s leading cause of death. Most are caused by preventable factors, including poor diet, tobacco use, harmful use of alcohol and physical inactivity. Diabetes, cancer and cardiovascular and chronic lung diseases were responsible for 38 million (68%) of global deaths in 2012. Since 1990, proportionate NCD mortality has increased substantially as populations have aged and communicable diseases decline. The majority of NCD deaths, especially premature NCD deaths (<70 years, 82%), occur in low-income and middle-income countries, and among poor communities within them. Addressing NCDs is recognised as central to the post-2015 agenda; accordingly, NCDs have a specific objective and target in the Sustainable Development Goals. While deaths from NCDs occur mainly in adulthood, many have their origins in early life, including through epigenetic mechanisms operating before conception. Good nutrition before conception and interventions aimed at preventing NCDs during the first 1000 days (from conception to age 2 years), childhood and adolescence may be more cost-effective than managing established NCDs in later life with costly tests and drugs. Following a life-course approach, maternal and child health interventions, before delivery and during childhood and adolescence, can prevent NCDs and should influence global health and socioeconomic development. This paper describes how such an approach may be pursued, including through the engagement of non-health sectors. It also emphasises evaluating and documenting related initiatives to underwrite systematic and evidence-based cross-sectoral engagement on NCD prevention in the future.
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Affiliation(s)
- Luisa Brumana
- UNICEF Regional Office for Latin America and the Caribbean, Panama City, Panama
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142
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Sadegholvad S, Yeatman H, Parrish AM, Worsley A. Professionals' Recommended Strategies to Improve Australian Adolescents' Knowledge of Nutrition and Food Systems. Nutrients 2017; 9:nu9080844. [PMID: 28783108 PMCID: PMC5579637 DOI: 10.3390/nu9080844] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/02/2017] [Accepted: 08/02/2017] [Indexed: 12/12/2022] Open
Abstract
Background: Education and policy measures within schools are valuable strategies to promote health. This study explored views of experienced food-related educators, researchers and policy-makers regarding their recommended strategies to improve Australian adolescents’ knowledge of nutrition and food systems (N&FS). Methods: Semi-structured interviews were conducted with twenty-one experienced food-related experts from across Australia. Interviews were conducted either by telephone or face-to-face. Recorded interviews were transcribed verbatim and analyzed thematically. Results: Five central themes and five sub-themes were identified from food professionals’ suggestions for best strategies to improve adolescents’ knowledge of N&FS. The central themes included: (1) specific improvements in schools’ core curricula; (2) pre-service and in-service training of school teachers about N&FS; (3) training students to develop a critical mind about N&FS issues; (4) multidisciplinary collaborations to improve school-based N&FS education; and (5) a supportive N&FS education environment for students. Conclusion and implication: These findings provide a guide for curriculum developers, educational policy developers, and food educators to incorporate the suggested N&FS strategies into Australian education programs in order to improve Australian adolescents’ knowledge and skills of N&FS issues. The results of this investigation also may assist the development of international N&FS curricula guides.
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Affiliation(s)
- Sanaz Sadegholvad
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Heather Yeatman
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Anne-Maree Parrish
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Anthony Worsley
- Centre for Physical Activity Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia.
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143
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Preschool and School Meal Policies: An Overview of What We Know about Regulation, Implementation, and Impact on Diet in the UK, Sweden, and Australia. Nutrients 2017; 9:nu9070736. [PMID: 28696403 PMCID: PMC5537850 DOI: 10.3390/nu9070736] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 06/29/2017] [Accepted: 07/03/2017] [Indexed: 01/08/2023] Open
Abstract
School meals make significant contributions to healthy dietary behaviour, at a time when eating habits and food preferences are being formed. We provide an overview of the approaches to the provision, regulation, and improvement of preschool and primary school meals in the UK, Sweden, and Australia, three countries which vary in their degree of centralisation and regulation of school meals. Sweden has a centralised approach; all children receive free meals, and a pedagogical approach to meals is encouraged. Legislation demands that meals are nutritious. The UK system is varied and decentralised. Meals in most primary schools are regulated by food-based standards, but preschool-specific meal standards only exist in Scotland. The UK uses food groups (starchy foods, fruit and vegetables, proteins and dairy) in a healthy plate approach. Australian States and Territories all employ guidelines for school canteen food, predominantly using a "traffic light" approach outlining recommended and discouraged foods; however, most children bring food from home and are not covered by this guidance. The preschool standards state that food provided should be nutritious. We find that action is often lacking in the preschool years, and suggest that consistent policies, strong incentives for compliance, systematic monitoring, and an acknowledgement of the broader school eating environment (including home provided food) would be beneficial.
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144
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Communication Strategies to Improve Healthy Food Consumption among Schoolchildren: Focus on Milk. BEVERAGES 2017. [DOI: 10.3390/beverages3030032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This work provides an updated picture of communication strategies developed to improve healthy dietary habits in schoolchildren, with a focus on the importance of milk consumption. The paper has investigated two main areas: the definition of the main orientations and key points of research approach relative to the communication methods, with special attention to multiple strategies and the identification of their peculiarities to increase daily milk consumption. The school environment is considered as a unique environment to help increase the adoption of a correct dietary habit and lifestyle; it increases physical activity by facilitating the flow of health-related information. In this regard, several studies have highlighted the importance and effectiveness of school-based interventions on a large-scale, also considering multiple contexts, early interventions as well as the involvement of teachers, students and families. The effective actions range from interventions on prices and the availability of desirable and undesirable foods to educational programmes that improve food knowledge and the choices of students and/or their parents. From the nutritional point of view, milk is an important component of a well-balanced diet—especially for children—because it contains essential nutrients. It is a substantial contributor to the daily energy intake; however, its consumption often declines with aging and becomes insufficient. Therefore, developing strategies to increase its consumption is an important objective to reach.
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145
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Taylor MB, Emley E, Pratt M, Musher-Eizenman DR. Structure-based feeding strategies: A key component of child nutrition. Appetite 2017; 114:47-54. [DOI: 10.1016/j.appet.2017.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/13/2017] [Accepted: 03/15/2017] [Indexed: 01/29/2023]
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146
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de Moraes MM, Mediano MFF, de Souza RAG, Moura AS, da Veiga GV, Sichieri R. Discouraging soft drink consumption reduces blood glucose and cholesterol of Brazilian elementary students: Secondary analysis of a randomized controlled trial. Prev Med 2017; 100:223-228. [PMID: 28457714 DOI: 10.1016/j.ypmed.2017.04.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/25/2017] [Accepted: 04/10/2017] [Indexed: 12/17/2022]
Abstract
The objective of this study was to evaluate the effect of an educational program aimed at discouraging sugar-sweetened carbonated beverages intake on blood fasting glucose and total cholesterol. Forty-seven fourth grade classes in twenty-two schools have participated in a randomized controlled trial aimed at discouraging soft drink intake in order to prevent excessive weight gain during a school year, in the city of Niterói, Rio de Janeiro. Of 1140 randomized students, 478 (238 in intervention group and 240 in control group) aged 9-12years old had at least one result on biochemical data and were analyzed to evaluate the effect of the intervention on changes in fasting glucose and total cholesterol at the end of follow-up. Intention-to-treat analysis was performed taking into account the cluster (classes) effect. Statistically significant decrease in fasting glucose (-9.12mg/dL vs. +0.51mg/dL, p<0.001) and total cholesterol (-10.34mg/dL vs. +2.14mg/dL, p<0.001) were observed among students in the intervention group in comparison with controls. In addition, the prevalence of impaired fasting glucose and hypercholesterolemia decreased in interventions and increased in controls (-2.4% vs. +8.8%, p=0.04 and -10.0% vs. +2.7%, p=0.03, respectively). Discouraging soft drink consumption among children has led to a reduction in fasting glucose and total cholesterol, suggesting that these beverages may play a role in the development of cardiometabolic risk in childhood.
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Affiliation(s)
- Milena Miranda de Moraes
- Department of Social and Applied Nutrition, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - Rita Adriana Gomes de Souza
- Department of Epidemiology, Institute of Public Health, Federal University of Mato Grosso, Mato Grosso, Brazil
| | - Anibal Sanchez Moura
- Laboratory of Nutrition Physiology and Development, Department of Physiological Sciences, Institute of Biology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gloria Valeria da Veiga
- Department of Social and Applied Nutrition, Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosely Sichieri
- Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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147
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Pratt M, Hoffmann D, Taylor M, Musher-Eizenman D. Structure, coercive control, and autonomy promotion: A comparison of fathers’ and mothers’ food parenting strategies. J Health Psychol 2017; 24:1863-1877. [DOI: 10.1177/1359105317707257] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This study explored differences in mothers’ and fathers’ food parenting strategies, specifically coercive control, structure, and autonomy promotion, and whether parenting style and parental responsibility for food parenting related to the use of these strategies. Parents of children aged 2.5–7.5 years ( N = 497) reported about their parenting practices and food parenting strategies. Parenting style accounted for the majority of the variance in food parenting. Fathers were more authoritarian than mothers. Authoritarian and permissive parenting practices were related to more coercive strategies. Mothers reported more food parenting responsibility. Responsibility was related to less coercive practices and more autonomy promotion and structure.
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148
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Jørgensen TS, Rasmussen M, Jørgensen SE, Ersbøll AK, Pedersen TP, Aarestrup AK, Due P, Krølner R. Curricular activities and change in determinants of fruit and vegetable intake among adolescents: Results from the Boost intervention. Prev Med Rep 2016; 5:48-56. [PMID: 27896044 PMCID: PMC5123064 DOI: 10.1016/j.pmedr.2016.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 11/07/2016] [Accepted: 11/12/2016] [Indexed: 11/29/2022] Open
Abstract
Knowledge of the association between implementation of different intervention components and the determinants they are tailored to change may contribute to evaluating the effects and working mechanisms of multi-component interventions. This study examined 1) the effect of a Danish multi-component school-based intervention (2010 − 2011) on key determinants of adolescents' fruit and vegetable intake and 2) if dose of curricular activities was positively associated with change in these determinants. Using multi-level linear and logistic regression analyses stratified by gender and socioeconomic position, we analyzed survey data from the cluster-randomized Boost study targeting Danish 13-year-olds' fruit and vegetable intake. We examined 1) differences in knowledge of recommendations, taste preferences and situational norms between students from 20 intervention (n = 991) and 20 control (n = 915) schools at follow-up; and 2) associations between curriculum dose received and delivered (student and teacher data aggregated to school- and class-level) and these determinants among students at intervention schools only. At follow-up, more students from intervention than control schools knew the recommendation for vegetable intake (OR 1.56, CI:1.18, 2.06) and number of fruits liked (taste preferences) increased by 0.22 (CI:0.04, 0.41). At class-level, curriculum dose received was positively associated with proportion of students knowing the recommendation for vegetable intake (OR 1.06, CI:1.002, 1.13). In stratified analyses, this association was only significant among students from high social class (OR 1.17, CI:1.04, 1.31). The Boost intervention succeeded in improving students' taste preferences for fruit and knowledge of recommendation for vegetable intake, but only the latter determinant was positively associated with curriculum dose. Trial registration: ISRCTN11666034 Positive change in knowledge of recommendation for vegetable intake Positive change in taste preferences for fruit Knowledge of recommendation for vegetable intake was associated with curriculum dose
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Affiliation(s)
- Thea Suldrup Jørgensen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
- Corresponding author at: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark.National Institute of Public HealthUniversity of Southern DenmarkØster Farimagsgade 5A, 2nd floorCopenhagen K1353Denmark
| | - Mette Rasmussen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
| | - Sanne Ellegaard Jørgensen
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
| | - Annette Kjær Ersbøll
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
| | - Trine Pagh Pedersen
- National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
| | - Anne Kristine Aarestrup
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
| | - Pernille Due
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
| | - Rikke Krølner
- Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2nd floor, 1353 Copenhagen K, Denmark
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149
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Jarpe-Ratner E, Folkens S, Sharma S, Daro D, Edens NK. An Experiential Cooking and Nutrition Education Program Increases Cooking Self-Efficacy and Vegetable Consumption in Children in Grades 3-8. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2016; 48:697-705.e1. [PMID: 27575849 DOI: 10.1016/j.jneb.2016.07.021] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/21/2016] [Accepted: 07/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Evaluate the effect of a community-based, experiential cooking and nutrition education program on consumption of fruits and vegetables and associated intermediate outcomes in students from low-income families. DESIGN Quasi-experimental program evaluation by pre-post survey of participating students and their parents. SETTING Underserved elementary and middle schools in Chicago. PARTICIPANTS Students (n = 271; 65% girls, 44% Hispanic, 32% African American; 94% eligible for free/reduced price lunch) in grades 3-8 selected by school staff to participate by variable inclusion criteria. 59% of students who applied returned both pre- and post-surveys. INTERVENTION(S) Ten-week (2 h/wk) chef-instructor-led program held in cafeteria kitchens after school. MAIN OUTCOME MEASURE(S) Changes in student nutrition knowledge, cooking self-efficacy, fruit and vegetable liking and consumption, and communication to family about healthy eating. ANALYSIS Changes from beginning to end of program were analyzed with paired t test. Results were considered significant at P < .05. RESULTS Increased nutrition knowledge score from 0.6 to 0.8, cooking self-efficacy score from 3.2 to 3.6, and vegetable consumption score from 2.2 to 2.4 (all P < .05). Increased score for communication about healthy eating (4.1 to 4.4; P < .05) 6 months after the end of the course. CONCLUSIONS AND IMPLICATIONS Experiential cooking and nutrition education programs led by chef-instructors may be effective ways to improve nutrition in low-income communities.
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150
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Evans A, Ranjit N, Hoelscher D, Jovanovic C, Lopez M, McIntosh A, Ory M, Whittlesey L, McKyer L, Kirk A, Smith C, Walton C, Heredia NI, Warren J. Impact of school-based vegetable garden and physical activity coordinated health interventions on weight status and weight-related behaviors of ethnically diverse, low-income students: Study design and baseline data of the Texas, Grow! Eat! Go! (TGEG) cluster-randomized controlled trial. BMC Public Health 2016; 16:973. [PMID: 27624139 PMCID: PMC5022204 DOI: 10.1186/s12889-016-3453-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/05/2016] [Indexed: 11/21/2022] Open
Abstract
Background Coordinated, multi-component school-based interventions can improve health behaviors in children, as well as parents, and impact the weight status of students. By leveraging a unique collaboration between Texas AgriLife Extension (a federal, state and county funded educational outreach organization) and the University of Texas School of Public Health, the Texas Grow! Eat! Go! Study (TGEG) modeled the effectiveness of utilizing existing programs and volunteer infrastructure to disseminate an enhanced Coordinated School Health program. The five-year TGEG study was developed to assess the independent and combined impact of gardening, nutrition and physical activity intervention(s) on the prevalence of healthy eating, physical activity and weight status among low-income elementary students. The purpose of this paper is to report on study design, baseline characteristics, intervention approaches, data collection and baseline data. Methods The study design for the TGEG study consisted of a factorial group randomized controlled trial (RCT) in which 28 schools were randomly assigned to one of 4 treatment groups: (1) Coordinated Approach to Child Health (CATCH) only (Comparison), (2) CATCH plus school garden intervention [Learn, Grow, Eat & Go! (LGEG)], (3) CATCH plus physical activity intervention [Walk Across Texas (WAT)], and (4) CATCH plus LGEG plus WAT (Combined). The outcome variables include student’s weight status, vegetable and sugar sweetened beverage consumption, physical activity, and sedentary behavior. Parents were assessed for home environmental variables including availability of certain foods, social support of student health behaviors, parent engagement and behavior modeling. Results Descriptive data are presented for students (n = 1369) and parents (n = 1206) at baseline. The sample consisted primarily of Hispanic and African American (53 % and 18 %, respectively) and low-income (i.e., 78 % eligible for Free and Reduced Price School Meals program and 43 % food insecure) students. On average, students did not meet national guidelines for vegetable consumption or physical activity. At baseline, no statistical differences for demographic or key outcome variables among the 4 treatment groups were observed. Conclusions The TGEG study targets a population of students and parents at high risk of obesity and related chronic conditions, utilizing a novel and collaborative approach to program formulation and delivery, and a rigorous, randomized study design.
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Affiliation(s)
- A Evans
- Michael & Susan Dell Center for Healthy Living - Division of Health Promotion and Behavioral Sciences - University of Texas Health (UTHealth) Science Center, Austin Regional Campus, Austin, USA.
| | - N Ranjit
- Michael & Susan Dell Center for Healthy Living - Division of Health Promotion and Behavioral Sciences - University of Texas Health (UTHealth) Science Center, Austin Regional Campus, Austin, USA
| | - D Hoelscher
- Michael & Susan Dell Center for Healthy Living - Division of Health Promotion and Behavioral Sciences - University of Texas Health (UTHealth) Science Center, Austin Regional Campus, Austin, USA
| | - C Jovanovic
- Michael & Susan Dell Center for Healthy Living - Division of Health Promotion and Behavioral Sciences - University of Texas Health (UTHealth) Science Center, Austin Regional Campus, Austin, USA
| | - M Lopez
- Family Development & Resource Management, Texas A&M AgriLife Extension Service, College Station, USA
| | - A McIntosh
- Recreation, Park and Tourism Sciences & Sociology, Texas A&M University, College Station, USA
| | - M Ory
- Health Promotion and Community Health Sciences, Texas A&M Health Science Center School of Public Health, College Station, USA
| | - L Whittlesey
- Department of Horticultural Sciences, Texas A&M AgriLife Extension Service, College Station, USA
| | - L McKyer
- College of Education and Human Development, Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, USA
| | - A Kirk
- Family Development & Resource Management, Texas A&M AgriLife Extension Service, College Station, USA
| | - C Smith
- Michael & Susan Dell Center for Healthy Living - Division of Health Promotion and Behavioral Sciences - University of Texas Health (UTHealth) Science Center, Austin Regional Campus, Austin, USA
| | - C Walton
- Department of Horticultural Sciences, Texas A&M AgriLife Extension Service, College Station, USA
| | - N I Heredia
- Division of Behavioral Science and Health Promotion, University of Texas Health Science Center (UTHealth) School of Public Health, Houston, USA.,Center for Health Promotion and Prevention Research, University of Texas Health Science Center (UTHealth) School of Public Health, Houston, USA
| | - J Warren
- Family Development & Resource Management, Texas A&M AgriLife Extension Service, College Station, USA
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