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Balderas-Arteaga N, Mendez K, Gonzalez-Rocha A, Pacheco-Miranda S, Bonvecchio A, Denova-Gutiérrez E. Healthy lifestyle interventions within the curriculum in school-age children: systematic review and meta-analysis. Health Promot Int 2024; 39:daae020. [PMID: 38470184 DOI: 10.1093/heapro/daae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Childhood obesity is a major public health challenge. Previous research has identified the impact of school-based interventions for preventing and treating obesity; we hypothesized that when curricular changes are integrated, results could be exponentiated. This study aimed to systematically review and conduct a meta-analysis of the published literature analyzing information about school-based interventions inserted in the curriculum. The Cochrane Handbook methodology was followed. An electronic search was conducted in five databases, with a specific design strategy per database. Randomized controlled trials or quasi-experimental studies of children with nutrition and physical activity (PA) interventions inserted into the school curricula were included. The risk of bias was assessed with the Risk of Bias tool. The mean differences were pooled using a fixed-effects model for the meta-analysis. The certainty of the evidence was evaluated according to the guidelines of the Grading of the Recommendations, Assessment, Development, and Evaluations working group (Protocol ID: CRD42021270557). After the screening and selection process, 12 studies were included. The interventions identified, based on the school curricula, include classroom activities and homework, among others. A meta-analysis with five intervention groups presented an overall mean difference of -0.14 body mass index (BMI) Z-score (95% CI: -0.25, -0.03) after this intervention with high certainty of the evidence. This systematic review and meta-analysis suggest that nutrition and PA lessons inserted into the curricula and supported with additional activities (i.e. homework, workshops, etc.) could increase nutrition knowledge and improve attitudes toward fruit, vegetables, and water consumption, and BMI Z-score reduction.
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Affiliation(s)
- Nydia Balderas-Arteaga
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Kenia Mendez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Alejandra Gonzalez-Rocha
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Selene Pacheco-Miranda
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Anabelle Bonvecchio
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Edgar Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Laitinen AL, Antikainen A, Mikkonen S, Kähkönen K, Talvia S, Varjonen S, Paavola S, Karhunen L, Tilles-Tirkkonen T. The 'Tasty School' model is feasible for food education in primary schools. J Hum Nutr Diet 2023; 36:75-85. [PMID: 35902780 PMCID: PMC10087126 DOI: 10.1111/jhn.13071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 07/25/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The 'Tasty School' is a tailored teacher-delivered food education model for primary schools in Finland. The aim of the current study was to investigate the feasibility of the Tasty School model in primary schools. Furthermore, the aim was to assess changes during the intervention in the class teachers' perspectives and experiences related to food education and school dining. METHODS The method involved a quasi-experimental study with intervention and control groups. A total of 130 class teachers from 15 intervention and 10 control schools from five municipalities in Finland participated in the study during one school year. The theoretical framework of acceptability was utilised to evaluate feasibility using frequencies. The comparison data were analysed using a mixed-effects model for repeated measures to account for the intervention effects and selected standardising effects. RESULTS Teachers reported that the model was highly acceptable and easily integrated into the school environment. Support from principals and colleagues was the most important facilitator of food education, and lack of time was the barrier. Teachers in the intervention schools were more likely to consider school meals healthy after the intervention, and they reported having sufficient materials and supplies for food education. CONCLUSIONS The Tasty School was shown to be a feasible model for food education in primary schools. The current study especially found that the commitment of the whole school and principals' role are crucial in the implementation of food education. The factors that support the implementation must be strengthened, and efforts must be made to reduce the barriers.
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Affiliation(s)
- Aija Liisa Laitinen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Amma Antikainen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Kähkönen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sanna Talvia
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Silja Varjonen
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Saila Paavola
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Leila Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tanja Tilles-Tirkkonen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Saintila J, Calizaya-Milla YE, Calizaya-Milla SE, Elejabo-Pacheco AA, Sandoval-Valentin GA, Rodriguez-Panta SG. Association Between Nutritional Knowledge, Dietary Regimen, and Excess Body Weight in Primary School Teachers. J Multidiscip Healthc 2022; 15:2331-2339. [PMID: 36267850 PMCID: PMC9578462 DOI: 10.2147/jmdh.s385713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction Peru is one of the developing countries with the highest prevalence of overweight and obesity in Latin America and Caribbean region. Primary school teachers are identified as a high-risk group for overweight and obesity. However, studies conducted in this population group are limited. This study evaluated the association between nutritional knowledge, dietary regimen, and excess body weight in primary school teachers. Methods This was a cross-sectional study that included 151 teachers from two state schools in the eastern region of Lima, Peru. The level of nutritional knowledge was assessed using a validated questionnaire. Dietary regimen was also determined. The body mass index (BMI) was determined through self-reported weight and height. Logistic regression analysis was used to assess the association between possible risk factors with excess body weight among teachers. Results Inadequate nutritional knowledge level (AOR = 5.21, 95% CI: 1.31–20.93), being male teachers (AOR = 2.25, 95% CI: 1.13–4.45), and being married (AOR = 2.49, 95% CI: 1.17–5.30) were the significant predictors of excess body weight. In contrast, vegetarian teachers were less likely to have excess body weight (AOR = 0.35, 95% CI: 0.47–0.97). Conclusion Future intervention programs should include improving nutritional knowledge with greater attention to male and married teachers to decrease the risk of excess body weight.
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Affiliation(s)
- Jacksaint Saintila
- Medical School, Señor De Sipán University, Chiclayo, Peru,Correspondence: Jacksaint Saintila, Medical School, Señor De Sipán University, Km 5, Carretera a Pimentel, Chiclayo, 14001, Peru, Email
| | - Yaquelin E Calizaya-Milla
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru,Yaquelin E Calizaya-Milla, Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Km 19, Carretera Central, Lima, 15033, Peru, Email
| | - Sergio E Calizaya-Milla
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru
| | - Ashly A Elejabo-Pacheco
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru
| | | | - Shirley G Rodriguez-Panta
- Research Group for Nutrition and Lifestyle, Human Nutrition School, Peruvian Union University, Lima, Peru
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Laitinen AL, Antikainen A, Mikkonen S, Kähkönen K, Talvia S, Varjonen S, Paavola S, Karhunen L, Tilles-Tirkkonen T. Implementation of food education in school environments improves pupils' eating patterns and social participation in school dining. Public Health Nutr 2022; 25:1-11. [PMID: 36210798 PMCID: PMC9991779 DOI: 10.1017/s1368980022002154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/19/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Schools can be an effective arena for food education. The Tasty School is a tailored teacher-driven food education model that provides tools for implementing food education in primary schools. This study aimed to investigate the effects of the Tasty School model on pupils' eating patterns and experiences. We also aimed to assess the implementation strength of the Tasty School. DESIGN A quasi-experimental study was conducted during one school year 2019-2020 in fifteen intervention and ten control schools. The intervention schools implemented the Tasty School food education model. The pupils completed web-based baseline and follow-up questionnaires in class during a school day. The principals were interviewed after the intervention. The data were analysed using a mixed-effects model for repeated measures, accounting for the implementation strength and selected standardisation effects. SETTING A total of twenty-five general Finnish primary schools. PARTICIPANTS 1480 pupils from grades 3-6 (age 8-12 years) from five municipalities in Finland. RESULTS Percentages of pupils eating a balanced school meal increased in schools where food education was actively implemented (P = 0·027). In addition, pupils' experience of social participation in school dining strengthened in schools where the Tasty School model was implemented (5-point scale mean from 2·41 to 2·61; P = 0·017). CONCLUSIONS Healthy eating patterns can be promoted by the active implementation of food education in primary schools. The Tasty School model offers a promising tool for developing healthy eating patterns and increasing social participation among pupils not only in Finland, but also potentially in other countries as well.
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Affiliation(s)
- Aija L Laitinen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Amma Antikainen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Santtu Mikkonen
- Department of Applied Physics and Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Kähkönen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Sanna Talvia
- School of Applied Educational Science and Teacher Education, University of Eastern Finland, Joensuu, Finland
| | - Silja Varjonen
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Saila Paavola
- Finnish Society for Food Education Ruukku, Helsinki, Finland
| | - Leila Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
| | - Tanja Tilles-Tirkkonen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, Kuopio70211, Finland
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Annan RA, Apprey C, Agyemang GO, Tuekpe DM, Asamoah-Boakye O, Okonogi S, Yamauchi T, Sakurai T. Nutrition education improves knowledge and BMI-for-age in Ghanaian school-aged children. Afr Health Sci 2021; 21:927-941. [PMID: 34795753 PMCID: PMC8568213 DOI: 10.4314/ahs.v21i2.55] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Adequate nutrition is required for growth and development in children. This study tested the effectiveness of nutrition education on knowledge and BMI-for-age (BFA) of school-aged children in the Kumasi Metropolis. METHODS Children, aged 9-13 years old were recruited from ten randomly selected primary schools in the Metropolis. The schools were randomly allocated into 3 groups: nutrition education (3 schools), physical activity (PA) education (3 schools), both interventions (2 schools), or control (2 schools). Following a baseline nutrition and PA knowledge and status assessment in 433 children, twice-monthly nutrition and PA education and demonstrations were carried out for 6 months, followed by a post-intervention assessment. RESULTS PA and nutrition knowledge improved in all groups (P<0.001); the highest improvement was among those who received both interventions (31.0%), followed by the nutrition education group (29.8%), and the least, the control group (19.1%). Overall, BFA improved by +0.36, from baseline (-0.26) to end of the intervention (+0.10, P<0.001). Within the groups, the nutrition group (+0.65, P<.001) had the highest improvement, then, both the intervention group (+0.27, P<0.001), the PA group (+0.23, P<0.001) and lastly, the control group (+0.18, P=0.001). CONCLUSION Nutrition education could improve knowledge and BMI-for-age in school-aged children in Ghana.
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Affiliation(s)
- Reginald A Annan
- Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Apprey
- Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Godwin O Agyemang
- Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Diane M Tuekpe
- Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Odeafo Asamoah-Boakye
- Department of Biochemistry and Biotechnology, Faculty of Biosciences, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Satoru Okonogi
- Department of Agricultural and Resource Economics, School of Agricultural and Life Sciences, University of Tokyo, Japan
| | - Taro Yamauchi
- Department of Health Sciences, School of Medicine, Hokkaido University, Japan
| | - Takeshi Sakurai
- Department of Agricultural and Resource Economics, School of Agricultural and Life Sciences, University of Tokyo, Japan
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Nutrition across the curriculum: a scoping review exploring the integration of nutrition education within primary schools. Nutr Res Rev 2021; 35:181-196. [PMID: 33926596 DOI: 10.1017/s0954422421000111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Primary schools contribute to promoting healthy eating behaviour and preventing overweight and obesity by providing nutrition education. Research highlights the importance of improving teachers' programme implementation to enhance intervention effectiveness. An integrative approach has been suggested to reduce time barriers that teachers currently experience in teaching nutrition. This scoping review explores use and effectiveness of integrative teaching in primary-school-based nutrition education programmes. Six databases were searched for primary-school-based interventions on nutrition education. Papers reporting on integration of nutrition topics within core curriculum were included. Abstracts and full texts of potentially relevant articles were screened to determine eligibility. Next, data were extracted and tabulated. Findings were collated and summarised to describe intervention characteristics, subject integration and effectiveness of the included programmes. Data describing integration of nutrition into the primary school curriculum were extracted from 39 eligible papers. Nutrition education programmes often involve lessons about food groups and are frequently embedded within the mathematics, science or literacy syllabus. Although articles report on the integration of nutrition, the use of this approach was not commonly described in detail. Only seven papers discussed student outcomes related to the integration of nutrition education within core subjects. The ability to draw strong conclusions about school-based nutrition intervention effectiveness is limited by the current lack of programme description and methodological issues. Hence, more research is warranted to inform evidence on effectiveness of integrative nutrition education for both teacher and student outcomes. Future studies that include greater detail regarding the integrative approach are needed.
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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 Nutr 2021; 24:2715-2726. [PMID: 33468283 DOI: 10.1017/s1368980021000203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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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Saintila J, Salinas Arias SA, Calizaya-Milla YE, Dávila Villavicencio R, Castellanos-Vazquez AJ, Turpo-Chaparro J, Pacheco-Espinoza JI, Apaéstegui-Huamán AK, Huancahuire-Vega S, Ruiz Mamani PG. Effectiveness of a Program Based on Telehealth in Nutritional Knowledge and Body Mass Index in Peruvian University Teachers. J Prim Care Community Health 2021; 12:21501327211023704. [PMID: 34109879 PMCID: PMC8202259 DOI: 10.1177/21501327211023704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/24/2021] [Accepted: 05/18/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND University teachers, as agents of socialization, are one of the most influential groups in improving public health, and their nutritional knowledge can influence both the eating behavior of students and the family. OBJECTIVE This study was carried out to evaluate the effect of a telehealth program on the level of nutritional knowledge and body mass index (BMI) of university teachers. METHODS A pre-experimental study was carried out from August to December 2020. A pretest and a posttest were applied. The number of teachers in the initial test was 88 and those included in the final evaluation, 83; and they were selected by nonprobability sampling for convenience. The telehealth-based program lasted 18 weeks and included basic information on nutrition and motivational messages. Sociodemographic and anthropometric data were collected through a predesigned questionnaire before and after the educational program. RESULTS Posttest knowledge scores increased significantly from 6.40 ± 1.70 to 10.59 ± 1.18 (P < .001). In relation to time, significant variations are observed in weight measurements (P < .001), BMI (P < .001), and basic nutritional knowledge (P < .001) before and after the intervention program. CONCLUSION The telehealth-based intervention improved basic nutritional knowledge levels and BMI. Likewise, the current findings provide evidence on the importance and need to develop future nutritional education programs that comprehensively encompass all study plans for the benefit of the university community.
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Cheng G, Yang F, Xiong F, Zhao L, Zhang L, Wang Y. Comparison of nutrition education policies and programs for children in China and other selected developed countries. GLOBAL HEALTH JOURNAL 2020. [DOI: 10.1016/j.glohj.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Katsagoni CN, Apostolou A, Georgoulis M, Psarra G, Bathrellou E, Filippou C, Panagiotakos DB, Sidossis LS. Schoolteachers' Nutrition Knowledge, Beliefs, and Attitudes Before and After an E-Learning Program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:1088-1098. [PMID: 31402288 DOI: 10.1016/j.jneb.2019.07.001] [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: 02/08/2019] [Revised: 06/11/2019] [Accepted: 07/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Το explore teachers' nutrition knowledge, beliefs, and attitudes and to examine the effectiveness of an electronic learning (e-learning) program in teachers' nutrition knowledge. DESIGN Cross-sectional and experimental design. SETTING The study took place in Greece, while schoolteachers were invited by e-mail. PARTICIPANTS Teachers of primary and secondary education, with no exclusion criteria, were enrolled in the study between March, 2015 and 2016. MAIN OUTCOME MEASURES Schoolteachers' nutrition knowledge, beliefs, and attitudes. INTERVENTION Teachers completed a 36-item nutrition questionnaire and then a subgroup participated in an e-learning program. After the intervention, teachers completed the same questionnaire. ANALYSIS Principal component analysis and multivariate logistic regression were used for data analysis. RESULTS A total of 1,094 teachers completed the questionnaire; 619 participated in the e-learning program. Teachers showed moderate nutrition knowledge scores (ie, 65% correct answers) before the intervention, whereas their attitudes regarding acting as role models and their belief in the importance of the role of nutrition were associated with 74% (odds ratio, 1.28; 95% confidence interval, 1.13-1.45) and 79% (odds ratio, 1.21; 95% confidence interval, 1.07-1.37) increased possibility of having good nutrition knowledge, respectively. The e-learning program was effective in strengthening teachers' nutrition knowledge (P < .001) and improving their beliefs and attitudes (P < .05). CONCLUSIONS AND IMPLICATIONS Future research is needed to validate the current results, which can be used to design and implement similar educational programs to teachers as a means of creating health-promoting schools.
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Affiliation(s)
- Christina N Katsagoni
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ
| | - Aris Apostolou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Glykeria Psarra
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ
| | - Eirini Bathrellou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Christina Filippou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ
| | - Labros S Sidossis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece; Department of Kinesiology and Health, Division of Life Sciences, School of Arts and Sciences, Rutgers University, The State University of New Jersey, New Brunswick, NJ.
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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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