Weight-inclusive nutrition education in K-12 schools: deconstructing the weight-normative narrative

The LSU AgCenter Healthy Communities Initiative: Community-Participatory Policy, Systems, and Environmental Change

Updating the Dietary Guidelines for Americans: Status and Looking Ahead

Set the Pace: Nutrition Education DVD for Head Start Parents

P125 Role of Cooperative Extension in Obesity Prevention Efforts: Program Implementation, Effectiveness, and Implications

Weight-based stigma and discrimination exist toward individuals whose body size deviates from stringent societal ideals of thinness. Growing concerns about the prevalence and damaging consequences of weight-based bullying, stigma, and discrimination have led to increasing calls for policy measures to protect people from weight-based prejudice on a broader scale. This chapter reviews policy and legal efforts that have been proposed or implemented to facilitate positive embodiment for youth and adults, including evidence on public attitudes about policies and laws that aim to reduce weight-based bullying and discrimination. In addition, policy initiatives and research evidence in North America, Europe, and other parts of the world are highlighted, including the strengths and limitations of these efforts. Directions for future policy research and advocacy efforts are identified that can improve on existing legal initiatives to promote equitable treatment of individuals of diverse body sizes.

Purpose This study aims to explore how systemic, scientific, critical and innovative thinking sub-competencies interact within the broader competency of complex thinking among undergraduate students from diverse international contexts. The purpose is to determine these sub-competencies’ mutual influences and examine regional variations, highlighting how distinct cultural and educational environments shape complex cognitive skills. The ultimate objective is to inform higher education practices, enabling educators and institutions to design tailored, culturally relevant interventions that effectively enhance complex thinking competencies in diverse student populations across different geographic regions and educational contexts. Design/methodology/approach This study examines interactions among four sub-competencies of complex thinking – systemic, scientific, critical and innovative – using data from 435 undergraduate students across ten universities in eight countries (Chile, Colombia, Mexico, Pakistan, the Philippines, Finland, Spain and Serbia). A validated instrument (eComplexity) measured student perceptions and partial least squares structural equation modeling (PLS-SEM) with a multi-group comparative analysis assessed the strength and variability of relationships among these sub-competencies. The analysis aimed to identify differences between geographic regions to reveal contextual nuances shaping cognitive development, contributing to a deeper understanding of how complex thinking develops within diverse cultural and educational contexts. Findings Significant regional differences were identified in interactions among sub-competencies of complex thinking. A strong correlation between systemic and scientific thinking emerged among students from Mexico and northern Spain, while a notable link between scientific and critical thinking was observed in Colombia. Moreover, Finland, Pakistan and Colombia displayed strong relationships between innovative and complex thinking. These findings demonstrate that cognitive development within complex thinking is strongly context-dependent, influenced by specific cultural and educational conditions. The study highlights the necessity of accounting for regional characteristics when developing educational programs aimed at effectively fostering complex thinking competencies in higher education contexts across diverse international settings. Research limitations/implications The study’s primary limitation is reliance on students’ self-reported perceptions, potentially introducing subjective biases. Additionally, although geographically diverse, the sample’s limited representation of each country could affect generalizability. Future research should incorporate broader, balanced sampling, longitudinal analyses and mixed-method approaches combining qualitative and quantitative data to validate these findings further. Research implications emphasize exploring deeper cultural, pedagogical and institutional factors influencing complex thinking. This could enable more precise educational guidelines, enhancing curriculum design, teaching practices and policy formulation, thus addressing specific contextual needs across diverse educational environments and providing robust, empirically supported strategies for higher education institutions globally. Practical implications This research provides universities and educators with practical insights for designing culturally and regionally adapted strategies to develop complex thinking competencies. Educators can identify and leverage the cognitive interactions most relevant in their contexts, adjusting curricula and instructional methods accordingly. Institutions could implement targeted faculty development programs to reinforce region-specific competency interactions, thus enhancing educational effectiveness. Additionally, policymakers and curriculum developers can utilize these findings to create responsive educational frameworks attuned to local cognitive and cultural dynamics, better preparing students to navigate contemporary global challenges with enhanced analytical capabilities, adaptability and innovative problem-solving skills. Social implications Enhancing complex thinking through culturally responsive educational practices equips students with critical cognitive tools necessary for addressing contemporary societal issues effectively. By recognizing regional variations in developing critical, scientific, systemic and innovative thinking competencies, educational institutions can better prepare graduates for diverse global challenges such as sustainability, technological innovation and intercultural understanding. Promoting complex thinking contributes to forming reflective, adaptable and innovative citizens capable of critically evaluating information and creatively resolving complex problems. Ultimately, this fosters inclusive, resilient and thoughtful societies, better positioned to manage and respond effectively to local, regional and global complexities and challenges. Originality/value This study uniquely applies partial least squares structural equation modeling (PLS-SEM) and multi-group analyses across diverse cultural and educational contexts in Latin America, Europe and Asia, explicitly exploring the interplay among complex thinking’s sub-competencies. Its comprehensive international approach addresses a gap by examining cross-national cognitive interactions rarely studied concurrently. By identifying significant regional variations, this research provides novel insights and empirical evidence emphasizing the importance of contextual factors in cognitive skill development. Its innovative methodology and extensive international sample make original contributions, guiding higher education practices toward more nuanced, culturally informed strategies to foster complex thinking competencies effectively worldwide.

Purpose ChatGPT is a generative artificial intelligence (AI) technology that can solve multiple complex tasks. ChatGPT-4 can facilitate educational empowerment in China through technology to understand and generate Chinese text. Although ChatGPT's benefits have been widely discussed, its educational capabilities have not been systematically assessed. This study provides evidence of and insights into the educational applications of AI tools in China. Design/Approach/Methods This study uses various tests to systematically assess the latest iteration of the AI chatbot ChatGPT-4, including the Watson-Glaser Critical Thinking Appraisal (WGCTA), Five Core Competencies Questionnaire, and written test of China's 2022 National Teacher Certificate Examination (NTCE). Findings The WGCTA results suggest that ChatGPT requires strong critical thinking. Compared with the other four competencies, the tool showed a lower aptitude for creativity. Regarding its educational applications, ChatGPT performed well on the 2022 NTCE written test. As technology enhances, ChatGPT and similar AI tools have potential applications in China for lesson planning, student self-learning, classroom interaction, and checking assignments. Originality/Value This study systematically tested ChatGPT at a logical level and assessed its core competencies and educational applications. The study innovatively used 2022 NTCE data to test ChatGPT, with results providing support for the application of generative AI in future curricula and instruction in China.

P59 The Future of Clinical-Community Linkages – Nutrition Education Takes Root in Maine's Underserved Communities Through a Learning Partnership with SNAP-Ed

Cardiovascular diseases account for a large part of total mortality: in 1974 45.7% of all deaths in the Netherlands were due to these diseases. As at least part of these diseases is man-made, the need for prevention is often stressed. The Netherlands Heart Foundation has many activities which aim at getting people to change their way of life if it increases their susceptibility to cardiovascular disease. One of these activities is a nutrition educational project, started in 1972. Dieticians work with members of various organizations to improve eating habits.The literature was reviewed to answer the following questions:- what influences people's nutrition and health behaviour?- which of these influences can be changed by nutrition and health education?These two questions are studied to acquire information with which a more systematic policy of nutrition education can be established.Chapter 2. and 3. deal with nutrition behaviour, roughly defined as 'ways in which people act with regard to their food'. It includes choice of food, how and where food is prepared and consumed etc. (2.1.). As nutrition behaviour is part of human behaviour in general, Chapter 2. sums up some theoretical ideas about changing human behaviour from consistency theories, social judgment theories, functional theories and learning theories (2.2.1.). Implications for nutrition and health education are as far as possible explicitly stated.Some learning theories are dealt with more extensively (2.2.2.), because:- their concepts of (selective) reinforcement, modeling etc. can be applied in practice,- they offer many cause-and-effect relations of behaviour that have been experimentally tested,- many extension programmes are already based on the applications of these theories.Chapter 2. ends with a summary of what is known about the development of nutrition behaviour specifically (2.2.3.). The results are not impressive; much more research in this field is needed.Chapter 3. deals with the factors influencing nutrition behaviour. The data, collected from many different fields - (social) psychology, sociology, extension education, home economics, marketing - have been structured in a model after Langenheder (3.1.). In this chapter a distinction is made between the following factors:a. 'objective' data in the physical and social surroundings as well as in man himself (3.2.),b. culture (3.3),c. indirect communication and direct social interaction (3.4.),d. internal psychological structure: cognitions, motivation etc. (3.5.).The 'objective' data roughly fix the limits of nutrition behaviour.Culture is an important moulding agent, because it permeates all other factors, especially social interaction. It gives rise to typical patterns of nutrition; an ideal-type of Dutch menu is given in section 3.3.Indirect communication, mainly but not uniquely transferred by mass media, can change a person's nutrition behaviour (3.4.1.), but only if:- selective processes hardly work,,- the message of the media covers a field unknown to the receiver (new products for instance),- persons are already actively looking for the information they accidentally receive via mass media,- the decisions to be made are relatively unimportant for the individual,- mass communication contributes - in the long term - to norm setting for certain kinds of (nutrition) behaviour.Direct social interaction is a very powerful influence (3.4.2.). Nearly every individual strives towards harmonious relations with his or her surroundings by fulfilling role obligations, coming up to expectations, in short by being not too different from 'normal'. Many of the values and norms developed in continuous interaction with others, have become fully internalized and are therefore resistant to change.In dealing with the influence of cognitions on nutrition behaviour (3.5.1.), a distinction is made between factual knowledge (of ingredients, or categories of food products: the basic five etc.) and the more extensive cognitions, of which experience and all kinds of reality testing are part. A clear relation exists between nutrition behaviour and these extensive cognitions, while the relation between factual, more theoretical knowledge and nutrition behaviour is mostly non-existent.As second part of the internal psychological structure the relations between people's needs and motives, and nutrition behaviour are analysed (3.5.2.). Four models are presented, two of which relate to nutrition. Generally nutrition has a (symbolic) function in creating physiological security (biologic needs); it fulfils the need for sensoric pleasure, emotional security (attention, acceptance) and for sociological security (status, self-expression).The third aspect discussed is how people value certain goals and the actions to reach those goals (3.5.3.). Special attention should be paid to the discrepancy that often exists between goals of the extension organization and those of people themselves.A separate part of section 3.5. is devoted to the question how attitudes - part of the internal structure - relate to behaviour. From much, often contradictory, literature the following conclusions were drawn:- a relation between attitudes and behaviour exists, but is very complex,- many more variables than attitudes determine behaviour,- how and to what extent these other variables interact with behaviour is yet largely unknown.After the chapters dealing with nutrition behaviour, chapter 4. clarifies the concept of extension. We defined extension as systematically planned communication, to be distinguished from other ways of influencing people's behaviour when high priority is given to the interests and well being of clients. Extension work has been chosen as an instrument for prevention of cardiovascular disease from a practical and ethical point of view, as well as for reasons of effect and efficiency (4.2.).We defined two sets of goals for nutrition education (4.3.). The first set of goals is that:- people should realize their actual nutrition behaviour,- people should become aware of the consequences of that behaviour.- people should decide on alternative behaviour.The second set of goals is more structure-oriented, namely:- to reorganize the existing (structural) forces influencing nutrition behaviour into a direction more positive to health, so that the alternative behaviour meant in the first set is really possible. Thus it is necessary for extension programmes - short-term and long-term - to be directed towards the public as well as towards policy makers (Fig. 10).At the moment health education is given by various groups of people (4.4.). A distinction is made into four categories:a. those working in the health system for which education is an integral part of their job: general practitioners, dentists, (district)nurses etc.,b. those working in specialized health fields for which education is an important part of their job: dieticians, drug educators, dental hygienists etc.,c. those not working in the health system but whose work touches on health aspects: teachers, youth leaders etc.,d. those working as advisers and consultants for the professionals, mentioned under a., b. an c.: health education consultants.A more integrated health education is essential for long-term success.Most of what has been said in Chapter 1. to 4. about nutrition behaviour applies to health behaviour. Yet Chapter 5. explicitly deals with health behaviour, mainly because many efforts to influence nutrition behaviour are part of more extensive health education activities. We can say every nutrition behaviour is health behaviour, because all nutrition behaviour eventually influences people's health. Then we talk about health-related behaviour. If nutrition behaviour is purposefully meant to maintain or promote health, we talk about health-directed behaviour (5.1. and 5.2.).Section 5.3. presents two social-psychological models and some more sociological ideas about health behaviour and their implications for influencing it. The two models are the health belief model (HBM) and a related model after Jaccard. Variables in the HBM are:- the perceived susceptibility to a certain disease,- the perceived seriousness,- evaluation of actions and their benefits,- evaluation of barriers to action.Jaccard's model puts more emphasis on an individual's intention for certain health behaviour, determined by:- his perception of the consequences of performing that behaviour,- the value he attaches to these consequences,- his beliefs about what relevant others think he should do,- his motivation to comply with those others.In both models, most clearly in Jaccard's one, the influence of social norms is very important.In addition to the HBM the role of fear is discussed. Three kinds of variables determine the effects of a fear-approach:- characteristics of the receiver: vulnerability, self-image, self-confidence, tolerance of stress etc.,- the degree of fear: a certain degree of emotional arousal seems necessary for success (behaviour change) but the relationship is not linear. The optimum degree of fear depends on personality and situational variables,- characteristics of the specific message: simple changes in behaviour can be brought about by a high-fear-approach. To achieve more complex (more important?) changes, a low-fear-approach seems more effective.The results of our search for an integrated sociological view on health behaviour have been somewhat disappointing. With a few exceptions we only found ideas about certain role-configurations in relation to health, but mostly with the emphasis on disease or illness. More research is needed into the processes underlying unhealthy habits of large parts of the population and into changes in these habits (consumption of too much alcohol, preference for too many calories etc.).The final chapter (6.) integrates a number of considerations and ideas from earlier chapters, resulting in a model for a nutrition and health educational policy (Fig. 15.). In section 6.1. a few views on the concept of strategy are mentioned. A division into three kinds of strategy is presented:- power strategy,- persuasive strategy,- re-educative strategy.The power strategies use sanctions and control to change behaviour, the persuasive strategies use rational, emotional and moral appeals.The re-educative strategies try to change values and norms, so that internalization of changed values leads to changes in behaviour.Section 6.2. gives 14 barriers to changing people's nutrition behaviour, where possible with implications for extension programmes.To give an idea of nutrition education at present, section 6.3. presents a selection of three kinds of programmes: person-oriented, structure-oriented and integrated programmes. Special attention is given to the methods used in the treatment of obesity.Section 6.4. 'towards a policy of nutrition education' is organized according to the stages of the model (Fig. 15): a. information and diagnosis, b. goals and target groups, c. content, d. methods, e. structure of the extension organization and f. evaluation.Each stage is discussed in general and in relation to the nutrition educational project of the Netherlands Heart Foundation.The stage of collecting information is aimed at problemdiagnosis, as well as at getting a rough idea of the kind of strategy one is going to choose: power, persuasive or re-educative. Not only health-related date have to be collected but also extension-related data.The goals of an extension programme (communication goals!) are distinguished into changes in knowledge, attitudes or behaviour. Within target groups a distinction is made between final groups: clients and institutions, and intermediary ones: the public, government, commercial firms and professionals.We categorize the content of the extension programme according to whether the goal is to make people aware of something, to inform, to advise or to persuade.For the methods the usual distinction into mass, group and individual methods is used. Because we summarized which method is suitable for certain goals, it is possible to deduce special combinations of methods from (communication) goals stated.Every extension programma must be backed by some kind of a structured organization. Whether the structure is permanent or temporary, certain functions have to be fulfilled: leaders (managers, advocates, financers, technicians, administrators, organizers) and supporters (workers, donors, symphatizers).Evaluation is possible from various aspects; we can consider the input into a programme, the results, the adequacy of the results, the balance of performance to input and the process.The appendix lists considerations to be taken into account in designing a policy of nutrition and health education.

This study examined how curriculum development efforts are reported in the health professions literature. From the classic curriculum development literature, we abstracted a common set of curriculum development components and steps that we subsequently used to evaluate 85 articles on curriculum development efforts in medicine, nursing, allied health, and dentistry. Only 29% of the articles mentioned all four components of a curriculum, and only 12% of the articles reported all steps in the curriculum development process. Twenty‐seven percent of the articles reported using educational consultants or units in describing curriculum development efforts. More than half the articles’ citations were to references from the content of the profession of the curriculum being developed. Authors of the identified curriculum development articles generally did not follow established curriculum development principles, involve others with curriculum development training, or include curriculum development literature among ...

Bangladesh has worked to improve disaster adaptation strategies in line with the United Nations Sustainable Development Goal 13 (climate action). Notwithstanding recognitions and efforts, Bangladesh's coastal villages continue to encounter numerous challenges and require assistance to manage natural disasters, which remain a largely underexplored field of inquiry due to the absence of epistemological scholarships incorporating a socio-ecological point of view. With that in mind, this study aims at identifying multiple-level barriers and enablers to adapting disaster risk reduction strategies by the coastal community at Sharankhola upazila in Bangladesh. Focus Group (FG) and In-Depth Interview (IDI) methods were used to collect data from the purposefully selected disaster-affected coastal community in Bangladesh. In this study, FGs and IDIs utilized an interview topic guide, which was constructed upon the principles of the Social Ecological Model (SEM). Data gathered from the three FG and six IDI participants were analyzed using Framework Approach underpinned by the SEM. Besides, the SEM has also been a cornerstone for preparing the conceptual blueprint of the study as well as organizing and interpreting the outcomes of the research. The findings related to barriers and facilitators to adapting disaster risk reduction strategies are discussed specifically under five broad themes: (i) individual-level, (ii) family-level, (iii) community and societal-level, (iv) organizational-level, and (v) policy-level barriers and facilitators. Barriers to adapting disaster risk reduction included inadequate knowledge about disaster adaptation, household financial instability, poor cyclone forecasting systems, inadequate cyclone shelters, and insufficient media exposure. By contrast, being younger, strong family ties, social cohesion among community members, relief assistance, and media outreach played supportive roles for coastal communities in adapting to disasters. This research identifies essential initiatives for improving adaptation strategies, including training to enhance coastal peoples’ adaptation capabilities, organizing community awareness programs to mitigate social stigma and gender-related issues, developing community infrastructure and security systems, and increasing mass media exposure.

Intercultural misunderstandings involve a number of complex causes which can easily escalate into conflicts. Since conflicts are also complex, it is not easy to find solutions because there is no one solution for all problems. Systems Theory, transdisciplinarity, and the social ecological model take a holistic approach in investigating complex phenomena. They permit the creation of a theoretical framework based on previous empirical research and theories across scientific disciplines to identify the relevant elements of complex phenomena and to understand the interrelationship of these elements. Intercultural misunderstandings and conflicts are very complex phenomena because they include culture, perception, identity, ethnocentrism, relationships, trust building and conflict management as well as intercultural commu-nication competence which entails cognition, metacognition, and social metacognition. Since most em-pirical studies focus on isolated, individual elements in specific contexts, this article describes the theoretical framework of how the various findings and theories developed in different scientific disciplines can be used to form a cohesive framework to help circumvent intercultural misunderstandings and conflicts. In so doing, it follows the general principles of Systems Theory, transdisciplinarity, and the social ecological model.

This study explores the use of When They See Us, a Netflix miniseries depicting the wrongful convictions of the Central Park Five, as a teaching tool in an undergraduate public health course. The series was integrated into the curriculum to help students examine the social determinants of health (SDOH) and the social-ecological model (SEM) through the lens of systemic racism and the criminal justice system. As part of the course, students analyzed the series using public health frameworks and proposed evidence-based interventions across multiple levels of influence. A mixed-methods approach was used to assess the impact of the assignment, drawing on rubric-based evaluations of student papers, thematic analysis of reflection responses, and post-course survey data. Quantitative results showed strong student performance in applying theoretical models, identifying structural drivers of health disparities, and developing practical, multi-level solutions. Qualitative findings pointed to increased emotional engagement, empathy, and critical reflection on the relationship between injustice, trauma, and health. Students reported that the series made course concepts more tangible and deepened their understanding of the broader systems that shape health outcomes. While some found the material emotionally challenging or entered with limited background knowledge, the overall findings suggest that narrative media can be a powerful tool for public health education. This approach not only supports the application of theory to real-world issues but also encourages critical thinking and prepares students to engage in equity-focused public health practice.

In the context of the Fourth Industrial Revolution, equipping students with critical and creative thinking skills within the framework of Education for Sustainable Development is essential but remains insufficiently explored, particularly in relation to nutrition concepts. This study evaluates the critical and creative thinking skills of eighth-grade students at a private junior high school and examines the relationship between these skills in the context of Education for Sustainable Development and nutrition. A total of 62 students participated in the study, which employed a correlational design to analyze data from a written test comprising fifteen multiple-choice questions on critical thinking and eight essay questions on creative thinking. To minimize guessing, the critical thinking test included well-designed distractors. Descriptive analysis was followed by the application of the Spearman test to determine the correlation between critical and creative thinking skills. The results indicated low performance in both areas, with average scores of 31.61 for critical thinking and 43.34 for creative thinking. Furthermore, no significant correlation was found between the two skills, as the significance value of 0.126 exceeded the threshold of 0.05. The findings suggest that systematic planning and continuous learning are necessary to enhance these skills and improve academic performance. The study emphasizes the need for structured educational strategies to develop critical and creative thinking concurrently, thereby informing curriculum development to support Education for Sustainable Development goals and prepare students to address future sustainability challenges.

Education policy refers to decisions or regulations made by the government or educational institutions to organize, manage, and improve the education system in order to achieve the desired educational goals. The policy on enhancing students' critical thinking skills in Fiqh education at SMA Dayah Perbatasan Minhajussalam, Subulussalam City, still faces some challenges, thus requiring further investigation. This study aims to examine the education policy in improving students' critical thinking skills in Fiqh lessons at SMA Dayah Perbatasan Minhajussalam. The research methods used are qualitative descriptive by collecting data through interviews, observations and using the data analysis of the Miles and Huberman model including data reduction, data presentation, conclusion drawn/verification. The research method used is descriptive qualitative, with data collection through interviews, observations, and document analysis. The results show that the education policy at SMA Dayah Perbatasan Minhajussalam has successfully integrated a critical thinking approach into the Fiqh curriculum. Additionally, the teaching of Fiqh at this school also supports the development of students' critical and reflective attitudes toward religious understanding and social context. This study recommends the need for increased teacher training to optimize teaching techniques that promote students' critical thinking skills within the context of Fiqh education.