Experiential Nutrition Education Research Articles

Long-term effects of a school-based experiential nutrition education intervention

ABSTRACT Nutrition education is essential for the development of healthy eating behaviours among children. Over the past few years, multiple nutrition education programmes have been implemented in primary schools. In the current study, the long-term effects of the experiential nutrition education programme ‘Learning Street’ are assessed. This 3-week programme comprises a classroom-based introduction lesson, a visit to a fruit or vegetable (FV) farmer, a cooking workshop, and a joint eating moment. The programme is designed for children aged 8–12 years. Questionnaire outcomes of 11-to-12-year-old children (n = 87) who participated in a Learning Street programme two years before were compared to those of a control group (n = 102) with similar demographics. The questionnaire included questions on children’s FV knowledge, liking, intake, and attitude, as well as their general health attitude, cooking self-efficacy, and cooking attitude. There was a significant difference in FV attitude (Cohen’s d = 0.55; 95% CI: −0.69 to −0.21) and general health attitude (Cohen’s d = 0.37; 95% CI: −0.56 to −0.07) between the intervention and the control groups. For general health attitude, the difference was only significant for a subgroup of children (n = 25) who had participated in two Learning Street programmes. The findings suggest that regularly exposing children to experiential nutrition education may have long-term benefits.

Improvements in dietary intake, behaviors, and psychosocial measures in a community-randomized cardiovascular disease risk reduction intervention: Strong Hearts, Healthy Communities 2.0

BackgroundCardiovascular disease (CVD) prevalence has disproportionately risen among midlife and older female adults of rural communities, partly due to poor diet and diet-related behaviors and psychosocial factors that impede healthy eating. ObjectivesThis study aimed to evaluate the impact of Strong Hearts Healthy Communities 2.0 (SHHC-2.0) on secondary diet-related outcomes between intervention and control participants that align with the dietary goal and behavioral aims of the SHHC-2.0, a CVD risk reduction program. MethodsA community-randomized controlled trial was conducted in rural, medically underserved communities. Participants were female adults ≥40 y who were classified as obese or both overweight and sedentary. Communities were randomized to SHHC-2.0 intervention (n = 5 communities; n = 87 participants) or control (with delayed intervention) (n = 6 communities; n = 95 participants). SHHC-2.0 consisted of 24 wk of twice-weekly experiential nutrition education and group-based physical activity classes led by local health educators. Changes between baseline and end point (24 wk) in dietary intake (24-h recalls), dietary behaviors (e.g., Rapid Eating Assessment for Participants-Short Version [REAP-S] scores) and diet-related psychosocial measures (e.g., Three Factor Eating questionnaire) between groups were analyzed using linear mixed-effects multilevel models. ResultsAt 24 wk, participants from the 5 intervention communities, compared with controls, consumed fewer calories (mean difference [MD]= −211 kcal, 95% CI: −412, −110, P = 0.039), improved overall dietary patterns measured by REAP-S scores (MD: 3.9; 95% CI: 2.26, 5.6; P < 0.001), and improved psychosocial measures (healthy eating attitudes, uncontrolled eating, cognitive restraint, and emotional eating). ConclusionsSHHC-2.0 has strong potential to improve diet patterns and diet-related psychosocial wellbeing consistent with improved cardiovascular health.This trial was registered at www.clinicaltrials.gov as NCT03059472.

Experiential nutrition education at primary schools: a retrospective cohort study

Experiential nutrition education at primary schools: a retrospective cohort study

Physician-Chef-Dietitian Partnerships for Evidence-Based Dietary Approaches to Tackling Chronic Disease: The Case for Culinary Medicine in Teaching Kitchens.

Since the middle of the 20th century, the American food environment has become increasingly ultra-processed. As a result, the prevalence of chronic, diet-related disease in the United States has skyrocketed. Meanwhile, physicians are still poorly trained in nutrition. A recent innovation that aims to address this is "culinary medicine" programming taught by teams of physicians, chefs, and registered dietitian nutritionists. Culinary medicine is an evidence-based, interprofessional field of medicine that combines culinary arts, nutrition science, and medical education to prevent and treat diet-related disease. It employs hands-on learning through healthy cooking and is typically taught in a teaching kitchen, either in-person or virtually. It can be dosed either as a patient care intervention or as experiential nutrition education for students, medical trainees, and healthcare professionals. Culinary medicine programs are effective, financially feasible, and well-received. As a result, healthcare systems and medical education programs are increasingly incorporating culinary medicine, teaching kitchens, and interprofessional nutrition education into their patient care and training models.

Nutrition Effects of a Family-Centered Health Promotion Program for Mexican-Heritage Children in the Lower Rio Grande Valley of Texas.

Systemic and social factors, like poverty and food insecurity, negatively influence fruit and vegetable (FV) intake and body mass index (BMI) among Latino/a children. Behavioral programs are needed to support children's nutrition. This study examined program effects on FV intake and BMI outcomes for Mexican-heritage children (9-11 years). The program used a modified stepped-wedge design in the Lower Rio Grande Valley of Texas (2019 and 2020). Promotoras led experiential nutrition education sessions and collected height, weight, and instant skin carotenoid scores (biomarker for FV intake) at pre-test (baseline), post-test (6 weeks), and maintenance (3-4 months after post-test). Mean changes and group differences in skin carotenoid scores, BMI z-scores and percentiles were obtained from analyses of variance. Linear mixed-effects models were used to determine overall program effects. Mexican-heritage children were enrolled (n = 57 and 52.6% female). An overall decrease in skin carotenoid scores was observed at post-test (-15.1; 95% CI: -24.95, -5.33). While scores varied widely (range: 17-498), an increase of 14.8 ± 23.8 points occurred in one intervention group. Compared to the control period, greater reductions in BMI outcomes occurred during the program. These findings provide evidence for the use of strengths-based approaches in behavioral nutrition programs.

Web-Based Experiential Nutrition Education Intervention “The Green Hub” to Promote Sustainable and Healthy Diets among Young Adults in Australia

Background: Sustainable and healthy dietary patterns can help achieve both optimal health and reduce environmental impacts. They involve the increased intake of plant-based foods which are local and seasonal, and reduced intake of animal-derived foods and food wastage. There is emerging evidence regarding the use and effectiveness of web-based health promotion programs to improve diet related behaviours especially in young adults. This study investigated the effectiveness of the “Green Hub” pilot study, a four-week web-based experiential nutrition education intervention to promote sustainable and healthy diets among young adults in Australia. Methods: This study used a pre-/post-study design with process evaluation. The four-week intervention integrated modules on different aspects of a sustainable and healthy diets and was delivered through a private Facebook group. Eligible participants were young adults between the age of 18–25 years old residing in Australia. Results: Out of 19 participants who consented, 17 participants completed the program. Two thirds of participants (67%) stated that they were familiar with the sustainable and healthy diet concept but only 33% were able to define this concept comprehensively. The post-intervention survey resulted in improved knowledge, attitudes, and motivation to adopt more sustainable eating patterns. Conclusion: The “Green Hub” experiential nutrition education program showed positive impact on participants’ willingness to adopt sustainable and healthy diets. The findings of this pilot study will inform future larger scale studies and policy development on improving sustainable and healthy diets among young adults.

P135 The SPORKS for Kids: A Preschool Nutrition Education Program to Increase Children's Willingness to Try New Foods

<h3>Objective</h3> To assess the impact of an experiential nutrition education program, The SPORKS for Kids program, on preschoolers' willingness to try a novel vegetable. <h3>Use of Theory or Research</h3> Intervention approaches which integrate repeated taste exposure, sensory learning, and nutrition education to provide repeated exposures to novel foods in fun, positive environments (positive valence) have been successful at increasing willingness to try new foods. These approaches were coupled with Social Cognitive Theory constructs to develop The SPORKS activities. <h3>Target Audience</h3> Preschool-aged children from 2 rural Colorado communities. <h3>Program Description</h3> The 6-week program was conducted in evenings as a complementary component to parent workshops. Children attended weekly 90-minute sessions focused on taste exposure and sensory learning via nutrition-related activities and imaginary trips/musical journeys. The SPORKS family consists of Sally Spoon (mom), Frankie Fork (dad); Buddy and Bubbles (preschoolers) and Junior and Freckles (older siblings). The SPORKS characters were embedded into activities and materials to facilitate experiential learning and build children's familiarity with the target vegetable (cauliflower). At tasting activities, 3 pieces of cauliflower were provided to each child and children were encouraged to try the food in a group setting. <h3>Evaluation Methods</h3> Observers recorded whether each child tried the cauliflower provided during the sessions. <h3>Results</h3> Sixteen children participated in the program across 2 sites. During week 1, 50% of children tried cauliflower and tries steadily increased (58%, 80%, 73%, 85%, weeks 2-5, respectively), and by week 6 this number rose to 100%. Once children tried cauliflower, they continued to try it across subsequent weeks (100%). Half of the children requested ‘seconds' beginning in week 3. <h3>Conclusions</h3> While half of the children tried the food at the start of The SPORKS program, repeated exposure with positive valence resulted in the remaining children's willingness to try a target vegetable.

Healthy Teaching Kitchen Programs: Experiential Nutrition Education Across Veterans Health Administration, 2018.

Traditional clinical interventions yield few positive effects on diet. The Healthy Teaching Kitchen (HTK) program implemented by the Veterans Health Administration at sites across the United States delivers interactive nutrition and culinary education, guided instruction, and social opportunities for patients and caregivers. We report HTK outcomes of veterans' self-reported acceptability, self-efficacy for dietary change, and dietary and cooking habits. The HTK program is acceptable and feasible and may empower participants to improve health.

Using Food Models to Enhance Sugar Literacy among Older Adolescents: Evaluation of a Brief Experiential Nutrition Education Intervention.

Adolescent diets high in sugar are a public health concern. Sugar literacy interventions have changed intake but focused more on children, adults, and early adolescents and on sugar sweetened beverages rather than total sugar consumption. Food models are an efficacious experiential learning strategy with children. This study assessed the impact of two 45 min nutrition lessons using food models on adolescents’ sugar literacy. Classes (n = 16) were randomized to intervention or control with knowledge, label reading skills, intentions to limit sugar consumption measured at baseline and follow-up. Two hundred and three students aged 14 to 19 from six schools on Vancouver Island, BC, Canada participated in the study. Adolescents’ knowledge of added sugar in foods and beverages and servings per food group in a healthy diet was limited at baseline but improved significantly in the intervention condition (F(1, 201) = 104.84, p < 0.001) compared to controls. Intention to consume less added sugar increased significantly after intervention (F(1, 201) = 4.93, p = 0.03) as did label reading confidence (F(1, 200) = 14.94, p < 0.001). A brief experiential learning intervention using food models was efficacious for changing student’s knowledge about sugar guidelines and sugar in food, label reading confidence, and intention to change sugar consumption.

A Dinner-Table Approach to a Unique Interactive Nutrition Curriculum for Healthcare Professional Students.

Nutrition education is significantly lacking from healthcare provider educational curricula despite its proven benefit for some of the most chronic and challenging diseases facing Americans today. We successfully developed and implemented an interprofessional, experiential nutrition education course for healthcare professional students that emphasizes evidence-based nutrition interventions for patient care.

A Community-Engaged Approach to Developing a Mobile Cancer Prevention App: The mCPA Study Protocol.

BackgroundRapid growth of mobile technologies has resulted in a proliferation of lifestyle-oriented mobile phone apps. However, most do not have a theoretical framework and few have been developed using a community-based participatory research approach. A community academic team will develop a theory-based, culturally tailored, mobile-enabled, Web-based app—the Mobile Cancer Prevention App (mCPA)—to promote adherence to dietary and physical activity guidelines.ObjectiveThe aim of this study is to develop mCPA content with input from breast cancer survivors.MethodsMembers of SISTAAH (Survivors Involving Supporters to Take Action in Advancing Health) Talk (N=12), treated for Stages I-IIIc breast cancer for less than 1 year, 75 years of age or younger, and English-speaking and writing, will be recruited to participate in the study. To develop the app content, breast cancer survivors will engage with researchers in videotaped and audiotaped sessions, including (1) didactic instructions with goals for, benefits of, and strategies to enhance dietary intake and physical activity, (2) guided discussions for setting individualized goals, monitoring progress, and providing or receiving feedback, (3) experiential nutrition education through cooking demonstrations, and (4) interactive physical activity focused on walking, yoga, and strength training. Qualitative (focus group discussions and key informant interviews) and quantitative (sensory evaluation) methods will be used to evaluate the participatory process and outcomes.ResultsInvestigators and participants anticipate development of an acceptable (frequency and duration of usage) feasible (structure, ease of use, features), and accessible mobile app available for intervention testing in early 2017.ConclusionsDepending on the availability of research funding, mCPA testing, which will be initiated in Miami, will be extended to Chicago, Houston, Philadelphia, and Los Angeles.

Engaging African Americans in developing an intervention to reduce breast cancer recurrence: A brief report.

BackgroundTo develop a culturally appropriate lifestyle intervention, involvement of its intended users is needed.MethodsMembers of an African American (AA) breast cancer support group participated in two 4-hour guided discussions, which were audiotaped, transcribed, and analyzed to guide the content.ResultsThe support group collaborated with researchers to develop 24 experiential nutrition education sessions using a social cognitive framework and incorporating self-regulation skills (goal-setting, self-monitoring, problem-solving, stimulus control) and social support to enhance self-efficacy for changes in dietary intake.ConclusionsCommunity engagement fostered autonomy, built collaboration, and enhanced the capacity of AA breast cancer survivors to participate in developing a lifestyle intervention.

Impact of a School-Based Cooking Curriculum for Fourth-Grade Students on Attitudes and Behaviors Is Influenced by Gender and Prior Cooking Experience

To compare effects of the Cooking With Kids (CWK) cooking and tasting curriculum (CWK-CT) with a less-intense, tasting-only curriculum (CWK-T) and to conduct a non-treatment comparison on fourth graders' cooking self-efficacy (SE), cooking attitudes (AT), and fruit and vegetable preferences (FVP). Pre-post, quasi-experimental, 2 cohorts. Eleven low-income public schools in a Southwestern city. Fourth-grade students, 50% female and 84% Hispanic. School-based experiential nutrition education program of 5 2-hour cooking and/or 51-hour fruit and vegetable tasting lessons throughout the school year. Cooking self-efficacy, AT, and FVP were assessed with 3 tested, validated scales administered in a 37-item survey pre- and post-classroom intervention. General linear modeling with gender and prior cooking experience were fixed factors. Among 961 students, CWK positively affected FVP, especially in CWK-CT students and males (P = .045 and .033, respectively); vegetable preference drove this outcome. Independent of treatment, students without cooking experience (61% male) had more than twice the gains in cooking self-efficacy (P = .004) and an improved AT response (P = .003). Cooking With Kids increased FVP, especially with vegetables. Greatest gains in preferences and self-efficacy were seen in boys without prior cooking experience. For fourth graders, experiential nutrition education improved cognitive behaviors that may mediate healthful food choices.

Engaging Participants in Design of a Native Hawaiian Worksite Wellness Program

Native Hawaiians today face a disproportionately high rate of obesity. The Designing Healthy Worksites (DHW) project investigated existing administrative policies and supports for healthy eating and physical activity at eight Native Hawaiian-serving organizations in Hawai'i, along with employee preferences for worksite wellness programming. We describe the process by which Native Hawaiian researchers and community members worked together to gather formative data to design future worksite wellness programs. A Native Hawaiian doctoral student (JHL) and a Native Hawaiian activist (CKH) spearheaded the project, mentored by a Caucasian professor (KLB) who has worked in Hawaii communities for 30 years. Advisors from the worksites supported the use of environmental assessments (n = 36), administrative interviews (n = 33), focus groups (n = 9), and an employee survey (n = 437) to collect data. We used an interactive process of data collection, sharing, and interpretation to assure mutual agreement on conclusions and future directions. Worksites were at different stages of readiness for worksite wellness programming, suggesting that a toolkit be developed from which agencies could create a program that fit. Activities preferred by large proportions of employees included support groups, experiential nutrition education (e.g., cooking demonstrations and field trips for smart food shopping), food buying clubs, and administrative policies supporting healthy lifestyles. High participation in data collection and interpretation suggest that our methods fostered enthusiasm for worksite wellness programming and for Native Hawaiians as researchers. The team continues to work together to develop and test interventions to promote worksite wellness. Native-directed research that engages administrators and employees in designing programs heightens program acceptability and applicability.

Focus on Food: Development of the Cooking with Kids Experiential Nutrition Education Curriculum

The Cooking with Kids curriculum blends traditional nutrition education with hands-on experience and academic learning. Stakeholder feedback has been a critical component of Cooking with Kids curriculum development. Students, parents, classroom teachers, and school administrators have consistently expressed enthusiastic support for Cooking with Kids and provided valuable suggestions to enhance the curriculum. Hands-on nutrition education curricula that focus on food exploration and cooking provide positive experiences with a variety of foods. These curricula encourage and support healthful dietary behaviors among children and families.

Melding Social Learning Theory With Piagetian-Dewey Educational Philosophies To Achieve 5 A Day

LEARNING OUTCOME: To name two components of Social Learning Theory and Piagetian Cognitive Development Theory that could influence behavior change. Elementary aged children have less than optimal fruit and vegetable consumption. Increasing their fruit/vegetable (FV) intake could reduce early atherosclerotic plaque formation, displace fatty foods, and establish diet behaviors that could reduce cancer, obesity, and heart disease risks later in life. The purpose of this project was to test a yearlong integrated, experiential nutrition education program encompassing classroom, lunchroom, and parent involvement on children's 5 A Day behavior. The project involved 450 students in 3 elementary schools. Aspects of Social Learning Theory such as self-efficacy through food preparation skill building, self-assessment and goal setting, and modeling through peer interaction were employed. Activities, conducted by special resource teachers trained in Piagetian Cognitive Development Theory and Dewey's learning theories, were characterized by: hands-on versus didactic strategies which accommodated the concrete operational stage of learning; integration into current themes and disciplines yielding meaningful rather than segmented or isolated experiences; and sensory-based experiences via preparing and eating a variety of FV weekly. Classroom teachers were part of weekly planning sessions to insure their ownership of the activities. Parent lunchroom volunteers reinforced FV selection through mini-lessons and rewards for choosing two FV items. Eighty-percent of the targeted, multicultural 3roV4th grade audience qualified for free/reduced school lunch. FV consumption behavior was measured through school lunchroom platewaste; knowledge, attitudes, and self-reported behaviors through surveys.