Effect of interventions to improve adolescents’ nutrition knowledge in China

A Systematic Review of Tools Measuring Nutrition Knowledge of Pre-Adolescents and Adolescents in a School-Based Setting

BACKGROUND

Measurement of nutrition knowledge is common in interventions targeting dietary modifications in a school-based setting. Previous research has noted a general lack of disclosure regarding the details and psychometric properties of nutrition knowledge tools, which makes uptake of previously used instruments extremely difficult.

METHODS

Our systematic literature review sought to identify interventions measuring nutrition knowledge in school settings to students aged 9 to 18. Studies were categorized according to content subject and relevant descriptive characteristics and psychometric properties were extracted.

RESULTS

Following the initial screening of 16,868 articles, 308 papers were evaluated for eligibility. Sixty-seven studies consistent with the inclusion criteria were included in the review. A minority of studies reported analysis of validity (31.3%) and/or reliability (40.3%), and 73.1% of studies had at least one unknown relevant descriptive characteristic. The majority (68.7%) of studies were custom developed, of which only 13 reproduced the tool in the publication.

CONCLUSION

Overall, there was an alarming lack of reporting across studies, both in terms of the description of knowledge tools as well as their psychometric properties. These omissions make the selection of appropriate instruments for use in novel contexts difficult, and highlight the need for greater disclosure and pre-intervention testing.

Middle school nutrition knowledge tool development and evaluation in North Carolina

Purpose –

This study aims to develop and empirically assess an instrument for measuring nutrition knowledge aligned to the North Carolina (NC) Healthful Living Essential Standards for teaching nutrition. The instrument was critically evaluated and used to assess nutrition knowledge in Eastern NC students.

Design/methodology/approach –

Researchers evaluated 250 students in 16, eighth-grade classrooms using a 22-question researcher-developed nutrition knowledge questionnaire. Assessment questions were aligned with NC Healthful Living Essential Standards, which suggest students should be able to: apply tools to plan healthy nutrition, create strategies to improve dietary intake, create plans for lifelong health, and evaluate health information and products. Survey reliability and validity (face) were evaluated prior to study implementation. Descriptive statistics for individual items, total and individual standard scores were analyzed. Instrument efficacy was evaluated using item-difficulty and discrimination indexes.

Findings –

The survey displayed appropriate levels of item difficulty with three exceptions: two questions were identified as too difficult, and one as too easy. The majority of items also displayed acceptable (>0.20) or excellent (>0.40) discrimination (17 out of 20). Average total nutrition knowledge score was 11.82-3.26 (53.7 per cent). Within aligned standards, students scored highest in creating plans for lifelong health (79 per cent) and lowest in evaluating health information (37.6 per cent).

Originality/value –

Study findings suggest eighth-grade students may only possess half the nutrition knowledge standards expected in the eighth grade. More instrument development is needed to supply researchers with standard means of assessing nutrition knowledge.

School-based intervention for nutrition promotion in Mi Yun County, Beijing, China

Purpose

– The purpose of this paper is to assess whether the school-based nutrition programme using the health-promoting school (HPS) framework was effective to improve parents’ knowledge, attitudes and behaviour (KAB) in relation to nutrition in rural Mi Yun County, Beijing.

Design/methodology/approach

– A cluster-randomised intervention trial design was employed. Two middle schools were randomly selected and assigned to either the intervention school using the HPS framework (HPS School), or to the Control School, in Mi Yun County, Beijing. From each school 65 parents of seventh-grade students were randomly selected to participate in the study. Nutrition-related KAB were measured at pre- and post-intervention surveys with the same instrument. The nutrition intervention last for six months.

Findings

– The school-based nutrition intervention using the HPS framework was effective in increasing parents’ nutrition knowledge; however, it had no statistical significant impact on improving parents’ attitudes towards nutrition and their eating behaviours.

Research limitations/implications

– The intervention appeared to be inadequate from the point of view of its impact on parents in terms of content, form and frequency.

Practical implications

– Future school-based nutrition promotion programmes using the HPS framework should focus more on parents, providing them with a more informative, participative and interactive, and frequent intervention.

Originality/value

– There is very limited published research focusing on the effect of the school-based nutrition promotion programmes using an HPS framework on parents’ nutrition-related KAB. Although, the improved KAB in relation to nutrition among parents is essential to promote young people’s nutrition and healthy eating behaviours.

Effect of a school-based nutrition education program on adolescents' nutrition-related knowledge, attitudes and behaviour in rural areas of China

OBJECTIVES

This study aimed at examining the effect of the nutrition education program on adolescents' knowledge, attitudes and behaviour in relation to nutrition in rural China.

METHODS

A cluster-randomised intervention trial design was employed. Two middle schools were randomly selected and assigned to the school conducting nutrition education (NE school), or to the Control school, in Mi Yun County, Beijing. From each school 65 seventh-grade students were randomly selected to participate in the study. Nutrition-related knowledge, attitudes and behaviour were measured at pre- and post-intervention surveys with the same instrument. The nutrition education lasted for 6 months.

RESULTS

After the intervention, more students in NE school knew the main function of dairy products and vegetables, which micronutrient is rich in dairy products and beans, and in meat, and the symptom of food poisoning, than those in Control school. The rate of students who thought nutrition is very important to health, and foods with an expired date should be thrown away in NE school was higher than that in Control school (93.8 vs. 80.3 and 92.3 vs. 78.7%, respectively). The rate of students who ate vegetables and breakfast everyday in NE school was higher than that in Control school (96.9 vs. 80.3, and 89.2 vs. 75.4%, respectively). (p < 0.05).

CONCLUSIONS

This nutrition education programme is effective in improving adolescents' knowledge, attitudes, and behaviour in relation to nutrition; therefore, the nutrition education with interactive and innovative intervention components is strongly recommended for future nutrition promotion programmes for adolescents.