Unique In-school Garden and Nutrition Intervention Improves Vegetable Preference and Food Literacy in Two Independently Conducted Evaluations (P16-040-19)

Abstract Objectives In 2016, Big Green (BG), a youth wellness and school garden organization, and Common Threads (CT), a health and wellness nutrition education organization, co-created Garden Bites (GB), a garden-based nutrition and health curriculum for PreK-8th students. GB is a fifteen lesson, school-based program featuring nutrition education, hands-on snack preparation, and outdoor garden activities. In 2018, CT evaluated GB independently from BG who supplemented the program with additional gardening activities (EGI). The purpose of the evaluation was to assess Big Green and Common Threads’ shared organizational impact areas: increasing knowledge and preference for fruits and vegetables and food literacy (nutritional skills and knowledge). Methods For GB only intervention, 81 students were evaluated pre-post intervention using survey methodology. For the GB plus EGI, a total of 820 students across four urban school districts took pre- and post-treatment surveys during the course of one semester. Results GB alone was found to significantly improve (all P < .05) vegetable preference, vegetable exposure, and fruit and vegetable consumption. When GB was complemented with EGI, it was found to significantly improve (all P < .05) vegetable likability and preferences, healthy eating expectations, and perceived access to healthy food and parental support at home. Conclusions GB was found to show promising, repeated results as a school-based intervention to improve student nutrition knowledge and food literacy, which are both important precursors to improved health behaviors. Results from this evaluation will be used to improve Garden Bites and EGI as well as inform school garden programming more widely. Funding Sources Both organizations are 501(c)(3) non-profits funded by grants.

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The Impact of Combining Nutrition Education with Active Choice on the Fruit and Vegetable Consumption Among Second Grade Students

International Journal Of Nutrition ◽

10.14302/issn.2379-7835.ijn-20-3458 ◽

2020 ◽

Vol 5 (4) ◽

pp. 48-59

Author(s):

Robyn M. Cafiero ◽

Yeon Bai ◽

Charles Feldman ◽

Doreen Liou

Keyword(s):

Nutrition Education ◽

Fruits And Vegetables ◽

Cognitive Theory ◽

Vegetable Consumption ◽

Daily Intake ◽

Control Group ◽

Post Intervention ◽

Active Choice ◽

The Impact ◽

Experimental Group

Daily intake of fruits and vegetables provides the basis for healthy nutrition. Yet low consumption of fruits and vegetables (FV) persists among school-aged children. Framed by the Social Cognitive Theory, this study aimed to determine the effectiveness of nutrition lessons combined with an active choice intervention on children’s FV consumption. Using a quasi-experimental design, 89 second graders were assigned to groups. Students in the experimental group (n=46) received four nutrition lessons combined with nine active choice sessions, while those in the control group (n=43) received active choice sessions only. Responses to pre- and post-intervention surveys that inquired FV knowledge and consumption were compared within and between groups using independent and paired t-tests. Empowered by improved knowledge, self-efficacy and the positive environment created through nutrition lessons and active choice, the experimental group showed improvement in consumption behavior compared to the control group at post-intervention: bringing FV to school and finish eating (69.7 vs. 51.2, p=.05 for fruits; 43.5 vs. 39.5, p=.41 for vegetables); like choosing FV (84.8 vs. 65.1, p=.01); like to eat more FV (80.4 vs. 62.8, p=.16); FV are healthy (100 vs. 95.3, p=.14). The magnitude of improvement is small yet consistent in every aspect of outcome measures. Combining nutrition education with the active choice component showed potential for a larger impact on behavior change among study participants. Parental support and community involvement could enhance the effectiveness of nutrition education in schools.

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Education or Provision? A Comparison of Two School-Based Fruit and Vegetable Nutrition Education Programs in the Netherlands

Nutrients ◽

10.3390/nu12113280 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3280

Author(s):

Angeliek Verdonschot ◽

Emely de Vet ◽

Jolien van Rossum ◽

Anouk Mesch ◽

Clare E. Collins ◽

...

Keyword(s):

Nutrition Education ◽

School Children ◽

Fruits And Vegetables ◽

Nutrition Knowledge ◽

Child Growth ◽

Primary School Children ◽

Education Programs ◽

Post Intervention ◽

School Based ◽

Food Policies

A healthy diet is important for optimal child growth and development. School-based opportunities to encourage children to achieve healthy eating behaviors should be explored. Nutrition education programs can provide school children with classroom-based nutrition education and access to fruits and vegetables (FV). However, the effectiveness of specific program components implemented separately has not yet been comprehensively evaluated. The current study examined effectiveness of individual components of two programs targeting primary school children (n = 1460, n = 37 schools) aged 7–12 years. Nutrition knowledge and FV consumption were measured using a student questionnaire, and presence of school food policies was measured in the teachers’ questionnaire. A quasi-experimental design with three arms compared: (1) schools that implemented both programs: FV provision + education (n = 15), (2) schools that implemented the FV provision program only (n = 12), (3) schools that did not implement either program (n = 10). Outcomes were assessed pre-intervention (T0), during the intervention (T1), and 6 months post-intervention (T2). Results indicated a significant increase in nutrition knowledge for children attending schools that had participated in both programs, compared to control schools (p < 0.01), but no significant increase in FV intake. In schools without food policies, FV provision alone contributed to an increase in child FV intake (p < 0.05).

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Implementation and outcome evaluation of a team nutrition intervention: increasing knowledge, attitudes, and preferences

Health Education Research ◽

10.1093/her/cyaa036 ◽

2020 ◽

Author(s):

Natoshia M Askelson ◽

Patrick Brady ◽

Grace Ryan ◽

Carrie Scheidel ◽

Patti Delger ◽

...

Keyword(s):

Dietary Intake ◽

Nutrition Education ◽

Low Income ◽

Fruits And Vegetables ◽

Linear Models ◽

Vegetable Consumption ◽

Low Cost ◽

Outcome Evaluation ◽

Nutrition Intervention ◽

Taste Testing

Abstract Low-income, rural children are at a greater risk for poor dietary intake. Schools offer a venue to deliver appropriate interventions. Our aim was to evaluate the implementation and effectiveness of Healthy Schools, Healthy Students (HSHS). We conducted a mixed-methods evaluation using a cluster-randomized trial design with 20 schools in a rural, Midwestern state. HSHS included education sessions, cafeteria coaching and taste testing. We interviewed implementers (n = 13) and nutrition educators (n = 8), conducted six focus groups with cafeteria coaches, and surveyed fourth graders (n = 1057) about their nutrition knowledge, attitudes toward and preferences for fruits and vegetables (F&V), F&V consumption and MyPlate awareness. We used multi-level linear models to estimate the intervention effect and qualitative data were coded. There were very few challenges to implementation. HSHS participation was positively associated with knowledge, attitudes toward F&V, preferences for vegetables from the taste tests, MyPlate awareness and vegetable consumption. HSHS was viewed as beneficial and easy to deliver, suggesting this type of intervention could be widely implemented. Improving knowledge and attitudes through nutrition education and preferences through taste testing have the potential to improve dietary intake among rural students. Low-cost nutrition interventions can be successfully implemented in rural elementary schools with positive outcomes.

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Impact of a behaviourally focused nutrition education intervention on attitudes and practices related to eating habits and activity levels in Indian adolescents

Public Health Nutrition ◽

10.1017/s1368980021000203 ◽

2021 ◽

pp. 1-12

Author(s):

Panchali Moitra ◽

Jagmeet Madan ◽

Preeti Verma

Keyword(s):

Nutrition Education ◽

Eating Habits ◽

Vegetable Consumption ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Control Group ◽

Activity Levels ◽

Post Intervention ◽

Attitudes And Practices ◽

Indian Adolescents

Abstract Objective: To evaluate the effectiveness of a behaviourally focused nutrition education (NE) intervention based on the Health Belief Model (HBM) to improve knowledge, attitudes and practices (KAP) related to eating habits and activity levels in 10–12-year-old adolescents in Mumbai, India. Design: School-based cluster randomised controlled trial. The experimental group (EG) received weekly NE and three parent sessions over 12 weeks; no sessions were conducted for the control group (CG). The theoretical framework of HBM and focus group discussion results guided the development of behaviour change communication strategies and NE aids. KAP were measured using a validated survey instrument, administered at baseline and endline in EG and CG. Paired and independent t tests determined within-group and between-group changes in pre–post scores. Setting: Two aided and two private schools that were randomly allocated to either an EG or CG. Participants: Adolescent boys and girls (n 498; EG n 292 and CG n 206). Results: EG reported improvements in mean knowledge (39·3%), attitude (7·3 %), diet (9·6 %) and activity practice (9·4%) scores from pre to post intervention. No significant changes were observed in CG. Significant improvements in scores associated with perceived benefits, barriers and self-efficacy, breakfast and vegetable consumption, and moderate-to-vigorous activities were observed in EG. Conclusions: Integrating NE into the academic curriculum and adopting evidence-based lessons that entail targeted information delivery and participatory activities can improve knowledge, foster right attitudes and facilitate better eating and activity-related practices in Indian adolescents.

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Consider BMI Change When Evaluating Nutrition Intervention Impact on Eating Competence: Findings from an Intervention with Eating Competence Constructs for Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzaa059_043 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1326-1326

Author(s):

Barbara Lohse ◽

Leslie Cunningham-Sabo

Keyword(s):

Physical Activity ◽

Nutrition Education ◽

Repeated Measures ◽

Online Survey ◽

Physical Activity Intervention ◽

Pearson Correlation ◽

Nutrition Intervention ◽

Linear Modeling ◽

Post Intervention ◽

Eating Competence

Abstract Objectives Examine change in adult eating competence (EC) over a 12 month period following participation in a controlled 7-month nutrition education intervention with EC constructs. Methods Parents of 4th grade youth in a cluster randomized impact assessment of a 7 month school-based culinary and physical activity intervention were assigned to 1 of 4 incrementally complex treatments that included components congruent with EC tenets. An online survey included validated measures of EC (ecSI 2.0TM), physical activity, stress, diet quality, healthful modeling, self-efficacy (SE) to offer fruits and vegetables to youth, and self-reported height/weight. EC was defined as ecSI 2.0TM ≥32. Measures were completed at baseline (BL), post-intervention (FU) and 5 months later (FU2). SPSS 24.0 analyses included repeated measures general linear modeling, means testing, chi square, Pearson correlation. Results Mean age of the mostly female (86%) sample (n = 418) was 39.1 ± 6.0 y; at FU2 126 were intervention and 96 control parents. BL analyses supported EC tenets with greater ecSI 2.0TM scores associated with less stress, lower BMI, less overweight/obesity, greater physical activity, greater SE and modeling behaviors (all P < 0.01). These relationships persisted at FU (n = 220) and FU2 (n = 221) for BMI, SE, modeling, and stress measures (all P < 0.01) and physical activity (P = 0.001 FU and 0.09 FU2). EC was denoted for 53% and 57% at BL and FU2 respectively. BL to FU2 ecSI 2.0TM change was not significant when controlling for changes in stress or physical activity. However, compared to those with increased FU2 BMI, ecSI 2.0TM tended (P = 0.06) to increase when BMI was decreased or unchanged, even when controlling for BL BMI. BL to FU2 ecSI 2.0 change was inversely related to BMI change (P = 0.01). ecSI 2.0TM tended to decrease for control, but increase for intervention parents (P = 0.07; –0.34 vs. 1.05), but not when controlling for BMI change. Conclusions An intervention with attention to EC congruent tenets showed modest effect on ecSI 2.0TM suggesting that successful programs require attributes that directly align with EC, which may be uniquely different from traditional nutrition education. Accurate EC intervention assessment required consideration of BMI change. Funding Sources USDA, NIFA.

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Is an ecological school-based nutrition intervention effective to improve adolescents’ nutrition-related knowledge, attitudes and behaviour in rural areas of China?

Global Health Promotion ◽

10.1177/1757975915626864 ◽

2016 ◽

Vol 24 (4) ◽

pp. 81-89 ◽

Cited By ~ 5

Author(s):

Dongxu Wang ◽

Donald Stewart ◽

Chun Chang

Keyword(s):

Rural Areas ◽

Dietary Habits ◽

Rural China ◽

Nutrition Intervention ◽

Ecological Approach ◽

Control School ◽

Post Intervention ◽

School Based ◽

Health Promoting School ◽

Health Promoting

Purpose: The purpose of this article is to examine the effect of a school-based nutrition intervention using an ecological approach to improve adolescents’ nutrition-related knowledge, attitudes and behaviour in rural China. Methods: A cluster-randomised intervention trial design was employed. Two middle schools were randomly selected and assigned to the school that was conducting a holistic school-based intervention using health-promoting school (HPS) framework, ‘HPS School’, or to the ‘Control School’ in Mi Yun County, Beijing. From each school we randomly selected 65 seventh-grade students to participate in the study. Their nutrition-related knowledge, attitudes and behaviour were measured by pre- and post-intervention surveys with the same instrument. The nutrition intervention lasted for six months. Results: Adolescents in the intervention school were more likely to know the nutrition knowledge items, with an odds ratio (OR) ranging from 1.86 (95% confidence interval (CI): 1.11–3.09) to 6.34 (95% CI: 3.83–10.47); more likely to think nutrition is very important to health, developing healthy dietary habits is very important, and that expired foods should be thrown away, with ORs of 3.03 (95% CI: 1.60–5.76), 2.76 (95% CI: 1.66–4.59) and 2.35 (95% CI: 1.33–4.17) respectively, and more likely to consume no soft drinks, desserts or fried food, and to eat vegetables every day of the last week, with ORs of 1.99 (95% CI: 1.31–3.04), 3.96 (95% CI: 2.43–6.46), 3.63 (95% CI: 2.26–5.85), and 2.51 (95% CI: 1.41–4.48) respectively, as compared with those in the control school after interventions. Conclusions: Our intervention using the HPS framework, an ecological approach, was an appropriate model to promote nutrition among adolescents in rural China and its use should be advocated in future school-based nutrition promotion programmes for adolescents.

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Community-based culinary and nutrition education intervention promotes fruit and vegetable consumption

Public Health Nutrition ◽

10.1017/s1368980021003797 ◽

2021 ◽

pp. 1-13

Author(s):

Jessica Jarick Metcalfe ◽

Melissa Pflugh Prescott ◽

Melissa Schumacher ◽

Caitlin Kownacki ◽

Jennifer McCaffrey

Keyword(s):

Nutrition Education ◽

Vegetable Consumption ◽

Controlled Trial ◽

Fruit And Vegetable Consumption ◽

Control Group ◽

Fruit And Vegetable ◽

Structured Interviews ◽

Post Intervention ◽

Cooking Classes ◽

The Impact

Abstract Objective: The main objective of this study was to evaluate the impact of the Market to MyPlate (M2MP) program on fruit and vegetable consumption and cooking behaviours. Secondary objectives were to examine factors that affected participant retention and program completion, and analyse program feedback provided by participants. Design: This study conducted a mixed methods evaluation embedded within a cluster randomised controlled trial of the M2MP intervention. Adult participants completed a pre- and post-program survey reporting on their fruit and vegetable consumption and cooking behaviours. A subsample participated in structured interviews, providing feedback about M2MP and the impact of the program. Setting: Seven weekly classes took place in community centres and extension offices in central Illinois. Participants: 120 adults and their families participated. Class cohorts were randomly assigned to one of three treatment groups: (1) nutrition education and cooking classes with produce allocations (PAE, n 39); (2) nutrition education and cooking classes only (EO, n 36) or (3) control group (n 45). Results: Compared to control, PAE participants reported larger increases from pre- to post-intervention in fruit (P = 0·001) and vegetable consumption (P = 0·002), with no differences in cooking frequency. Interview analyses identified key themes in behaviour changes due to M2MP, including reported increases in dietary variety, cooking self-efficacy and children’s participation in cooking. Conclusions: PAE participants who received an intervention that directly increased their access to fresh produce (via produce allocations) increased their reported fruit and vegetable consumption. Though participants’ cooking frequency did not change, interviewees reported increased variety, cooking confidence and family participation in cooking.

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Evaluation of "College CHEF," a Campus-based, Culinary Nutrition Education Program

Building Healthy Academic Communities Journal ◽

10.18061/bhac.v1i1.5436 ◽

2017 ◽

Vol 1 (1) ◽

pp. 29 ◽

Cited By ~ 1

Author(s):

Jennifer McMullen ◽

Melinda Ickes ◽

Melody Noland ◽

Don Helme

Keyword(s):

College Students ◽

Nutrition Education ◽

Education Program ◽

Vegetable Consumption ◽

Overweight And Obesity ◽

Fruit And Vegetable Consumption ◽

Fruit And Vegetable ◽

Post Intervention ◽

Nutrition Education Program ◽

The Impact

Aim: Evaluate the impact of a campus-based culinary nutrition education program, the College CHEF: Cooking Healthfully Education for Life-long Change, to determine if there were significant differences preto post- intervention with participants' attitudes, behaviors, and knowledge with healthy eating/cooking.Background: College students have high rates of overweight and obesity and tend to have unhealthy dietary practices. Culinary nutrition programs may provide students a means to improve related attitudes, behaviors, and knowledge.Methods: College students residing on campus were recruited. Participants completing both pre- and post-measures were included in analysis: Control (n= 17) and intervention groups (n = 15). Quasi-experimental pre-, post- design: Surveys were administered to both groups at baseline and post-intervention in October-November 2015.Results: There was a statistically significant improvement in fruit and vegetable consumption (p = .03) and with knowledge of cooking terms and techniques (p < .001).Conclusions: Campus-based culinary nutrition education programming has potential to positively impact college students’ fruit and vegetable consumption and cooking knowledge. Future programs should incorporate strategies such as additional opportunities to engage in hands-on practice and building cross-campus collaborations to promote sustainability.

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Using epidemiological models to estimate the health effects of diet behaviour change: the example of tailored fruit and vegetable promotion

Public Health Nutrition ◽

10.1079/phn2005873 ◽

2006 ◽

Vol 9 (4) ◽

pp. 415-420 ◽

Cited By ~ 11

Author(s):

J Lennert Veerman ◽

Jan J Barendregt ◽

Johan P Mackenbach ◽

Johannes Brug

Keyword(s):

Nutrition Education ◽

Health Effects ◽

Behaviour Change ◽

Fruits And Vegetables ◽

Vegetable Consumption ◽

Adult Population ◽

Evaluation Study ◽

Epidemiological Models ◽

Fruit And Vegetable ◽

Life Years

AbstractObjectiveTo explore the use of epidemiological modelling for the estimation of health effects of behaviour change interventions, using the example of computer-tailored nutrition education aimed at fruit and vegetable consumption in The Netherlands.DesignThe effects of the intervention on changes in consumption were obtained from an earlier evaluation study. The effect on health outcomes was estimated using an epidemiological multi-state life table model. Input data for the model consisted of relative risk estimates for cardiovascular disease and cancers, data on disease occurrence and mortality, and survey data on the consumption of fruits and vegetables.ResultsIf the computer-tailored nutrition education reached the entire adult population and the effects were sustained, it could result in a mortality decrease of 0.4 to 0.7% and save 72 to 115 life-years per 100 000 persons aged 25 years or older. Healthy life expectancy is estimated to increase by 32.7 days for men and 25.3 days for women. The true effect is likely to lie between this theoretical maximum and zero effect, depending mostly on durability of behaviour change and reach of the intervention.ConclusionEpidemiological models can be used to estimate the health impact of health promotion interventions.

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Improving the Metabolic and Mental Health of Children with Obesity: A School-Based Nutrition Education and Physical Activity Intervention in Wuhan, China

Nutrients ◽

10.3390/nu12010194 ◽

2020 ◽

Vol 12 (1) ◽

pp. 194

Author(s):

Hong-jie Yu ◽

Fang Li ◽

Yong-feng Hu ◽

Chang-feng Li ◽

Shuai Yuan ◽

...

Keyword(s):

Mental Health ◽

Physical Activity ◽

Nutrition Education ◽

Plasma Glucose ◽

Fasting Plasma Glucose ◽

Primary Schools ◽

Physical Activity Intervention ◽

Post Intervention ◽

School Based ◽

Fasting Plasma

This study aimed to evaluate the effectiveness of a school-based nutrition education and physical activity intervention on cardiovascular risk profile and mental health outcomes among Chinese children with obesity. Two primary schools were randomly allocated to the control group (CG) and the intervention group (IG). We selected children with obesity from 1340 students in the third and fourth grades as participants. The IG received 8 months of nutrition education and physical activity intervention, while the CG was waitlisted. A generalized estimating equation model was applied to assess repeated variables over time. A total of 171 children with obesity (99 IG and 72 CG) aged 9.8 ± 0.7 years completed the post-intervention stage. Compared with baseline, significant reductions were observed within the IG for depression and fasting plasma glucose at post-intervention. After adjusting for confounders, group and time interaction effects showed that the IG achieved improvements in the risk of poor well-being (p = 0.051) and social anxiety (p = 0.029), had decreased diastolic blood pressure (p = 0.020) and fasting plasma glucose (p < 0.001), and had significantly increased high-density lipoprotein (p < 0.001) from baseline to post-intervention relative to the CG. The effects of school-based nutrition education and physical activity intervention on children with obesity are diverse, including not only the improvement of metabolic health but also mental health promotion.

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