Food Literacy Program Research Articles

Analysing the behaviour change techniques in an effective food literacy program to inform future program design.

Food literacy programs aim to improve food related skills and knowledge and are selected Governments as a strategy to address dietary intakes at a community level. The purpose of this research is to identify behaviour change techniques in a food literacy program, which were assessed by the achievement of participant goals related to food literacy and dietary behaviour changes. Consensus methods were applied to map behaviour change techniques to an adult food literacy program. A second phase investigation applied content analysis of participant process evaluation data (collected between 2016 and June 2021) to align target behaviours and behaviour change techniques. Chi-square and ANCOVA were used to assess the statistically significant demographic characteristics, food literacy, and dietary behaviour scores for participants who set goals and recorded changes. A total of 4697 program participants provided evaluation data from the 4-week food literacy program. Participants who set goals and made changes were statistically more likely to have higher food literacy factor scores (p < 0.001) and fruit serves (p = 0.004). Statistical analysis showed that participants were more likely to have set goals and recorded changes if they were female (p < 0.001), older (p < 0.001), higher education level (p < 0.001), had a higher socioeconomic status (p = 0.049), lived with children (p = 0.014), were born in Australia (p = 0.019), or did not identify as Indigenous (p < 0.001). The behaviour change technique mapping process identified nine techniques used weekly and a total of 22 techniques used over the entire 4 week program curriculum. This is the first Australian study to link the contribution of behaviour change techniques to food literacy and dietary behaviour change in an established effective food literacy program. Knowing the behaviour change techniques associated with effective programs will facilitate replication of effective interventions.

Effects of collaborative learning-based food literacy program on healthy eating behavior and hemoglobin A1c among older adults with uncontrolled type 2 diabetes: A randomized controlled trial study in Thailand.

Uncontrolled type 2 diabetes mellitus (T2DM) is a prevalent issue among older adults. Healthy eating behavior (HEB) is a significant factor contributing to blood sugar control. It is a complex behavior that requires knowledge, attitudes, and skills in food literacy, which can be achieved through collaborative learning by nurses. Although collaborative learning has successfully improved food literacy and HEB among adults and older adults in general, its effectiveness has not been investigated among older adults with uncontrolled T2DM. This randomized controlled trial aimed to examine the effects of the Collaborative Learning-Based Food Literacy Enhancement Program (CLFLEP) on HEB and hemoglobin A1c (HbA1c) levels among older adults with uncontrolled T2DM. Participants were 80 older adults with uncontrolled T2DM attending primary care units (PCUs) or sub-district health promotion hospitals in northern Thailand. They were randomly assigned to either the experimental group (n = 40) or the control group (n = 40). The experimental group received the CLFLEP to enhance four domains of food literacy through five major elements of collaborative learning, while the control group received standard care. Data were collected between January and June 2023 using the Demographic Data Form, the Eating Behavior Questionnaire, the HbA1c test, and the Short Food Literacy Questionnaire. Data analysis involved descriptive statistics for demographic characteristics and independent t-test and paired sample t-test for HEB and HbA1c based on intention-to-treat (ITT) and per-protocol (PP) analyses. The experimental group had a higher HEB score than the control group (p <0.001 for ITT and PP) and higher than their scores before program participation (p <0.001 for ITT and PP). The effect size (Cohen's d) was 1.46. The experimental group also had a lower HbA1c level than the control group (p = 0.002 for ITT and PP) and lower than their levels before program participation (p = 0.005 for ITT and 0.001 for PP). The effect size (Cohen's d) was 0.70. The CLFLEP was effective in promoting food literacy, HEB, and blood sugar control. Nurses can be trained to use this program to provide collaborative health education for older adults with uncontrolled T2DM. Nursing administrators can use these findings to develop organizational policies that enhance nurses' competencies as educators skilled in collaborative learning. TCTR20221222005 [Thai Clinical Trials Registry].

The role of food literacy and sustainable and healthy eating behaviors in ultra-processed foods consumption of undergraduate students

Few studies have explored the associations of food literacy and sustainable and healthy eating behaviors with ultra-processed food consumption. This cross-sectional study evaluated the possible role of both food literacy and sustainable and healthy eating behaviors in ultra-processed foods consumption of undergraduate students. The sample included 600 healthy university students aged 18 – 30 years. Dietary intake was assessed by two 24-h dietary recalls and percentage energy from each of the four NOVA categories—unprocessed/minimally processed, processed culinary ingredients, processed, and ultra-processed—was coded using NOVA. Food literacy was evaluated using self-perceived food literacy (SPFL) scale. Sustainable and healthy eating behaviors were assessed with Turkish version of sustainable and healthy eating behaviors scale. Multiple linear regression models, adjusted for sex, age, body mass index (BMI) and energy intake, were performed to examine the association between percentage energy from NOVA categories with food literacy and sustainable and healthy eating behaviors. Greater food literacy (β = 0.102, p = 0.034) and sustainable and healthy eating behaviors (β = 0.133, p = 0.006) predicted higher unprocessed/minimally processed food consumption. Lower food literacy (β = −0.140, p = 0.004) and sustainable and healthy eating behaviors (β = −0.104, p = 0.032) predicted higher ultra-processed foods (UPF) consumption. Results indicate that both food literacy and sustainable and healthy eating behaviors inversely associated with ultra-processed food consumption among undergraduate students. Future studies should investigate the longitudinal associations between food literacy, sustainable and healthy eating behaviors, and UPF consumption in order to provide different perspectives to develop food literacy programs and sustainable nutrition education which can contribute to reduce UPF consumption, so detrimental environmental impacts of UPF.

A scoping review of the impact of Food Policy Groups on local food systems in high-income countries.

This scoping review aimed to explore international evidence on the impact of Food Policy Groups (FPGs) on local food systems, in urban and rural regions of high-income countries. Peer-reviewed and grey literature were searched to identify 31 documents published between 2002 and 2022 providing evidence on the impact of FPGs. Activities spanned domains including increasing food equity (e.g. strengthening school meals programs); increasing knowledge and/or demand for healthy food (e.g. food literacy programs with children and adults); increasing food access (e.g. enhancing local food procurement); environmental sustainability (e.g. promoting low-waste food items on café menus); economic development (e.g. ensuring local businesses are not outperformed by large food distributors), and increasing food system resiliency (e.g. establishment of local produce schemes). Most FPGs reported conducting activities that positively influenced multiple food system domains and reported activities in urban areas, and to a lesser extent in rural areas. Our study highlighted a range of qualitative and quantitative evaluation strategies used to measure FPGs' impact on local food systems. Our recommendations focus on regular and systematic evaluation and research surrounding the impact of FPGs activities, to build the evidence base of their impact. Ideally, evaluation would utilise comprehensive, and established tools. We recommend exploring the establishment of FPGs across more regions of high-income countries, particularly rural areas; and forming partnerships between FPGs, local government and universities to maximise implementation and evaluation of activities.

Determining the Effectiveness of an Adult Food Literacy Program Using a Matched Control Group

ObjectiveTo determine the effect of Food Sensations for Adults on food literacy behaviors and selected dietary behaviors. MethodsA quasi-experimental design using preprogram and postprogram questionnaires over 4 weeks with a control group (n = 75) matched for sex, age group, and socioeconomic disadvantage to program participants (n = 867). General linear mixed models assessed change in food literacy behavior frequency in 3 self-reported domains (plan and manage, selection, and preparation) and fruit and vegetable servings. ResultsPostprogram, Food Sensations for Adults participants reported modest yet statistically significant score improvements in 2 of the 3 domains of food literacy behaviors in the plan and manage (12.4%) and preparation (9.8%) domains, as well as servings of vegetables (22.6% or 0.5 servings). Conclusion and ImplicationsQuasi-experimental designs indicate food literacy programs can produce modest short-term changes across a range of food literacy and dietary behaviors.

P24-067-23 The Effectiveness of Campus-Based Food Literacy Program Among Korean University Students

P24-067-23 The Effectiveness of Campus-Based Food Literacy Program Among Korean University Students

Effectiveness of a food literacy and positive feeding practices program for parents of 0 to 5 years olds in Western Australia.

Lifelong eating behaviours are established in childhood. Improving parents' food literacy skills is essential, as parents play a fundamental role in establishing their children's healthy eating behaviours and preferences for nutritious food. This paper describes the development and evaluation of an innovative program that combines food literacy with positive parent feeding practices, targeting parents in disadvantaged areas of Western Australia. The Food Sensations® for Parents five-week program was delivered to participants from community-based parenting organisations during 2020 and 2021. Formative research and a pre-post evaluation design were adopted. Pre- and post-evaluation data were collected from 224 participants (96% female). There was a statistically significant improvement in the mean score for 13 food literacy behaviours, 10 positive parenting feeding practices and a mean increase in parents' daily vegetable intake of 1/3 serve. Participants reported significantly greater net improvements in food literacy behaviours than feeding practices, the largest being the Use a nutrition information panel to make food choices (33.1%). Multivariate logistic regression analyses found English as a first language, being older than 35, and from a higher Socio-Economic Index for Areas resulted in a higher likelihood of positive changes in behaviours and practices. The findings indicate that the program is effective in improving the frequency of use of food literacy behaviours, positive parenting feeding practices and increasing vegetable consumption. SO WHAT?: Analysing improvements in food literacy behaviours and feeding practices provides clarity on what change can be expected with a five-week parent program.

Who has a high level of food literacy, and who does not?: a qualitative study of college students in South Korea.

Unhealthy food choices among young adults are common globally, and the incidence of chronic diseases, such as obesity, is rising. Food literacy (FL) is important for improving and maintaining individual health in a rapidly changing food environment and can form the basis for following a sustainable diet. Therefore, it is essential to improve FL among young adults, particularly college students, who are in the formative years of their lifelong food habits. This study examined the facilitators and barriers of FL and related dietary behavior among college students in South Korea. This study recruited 25 college students with different residence types using convenience and snowball sampling. In-person, telephone, and video interviews were conducted from March to November 2021. The interview data were analyzed using framework analysis based on the socio-ecological model. At the individual level, prior good experiences with food were the most frequently mentioned facilitator. In contrast, the major barriers were a lack of knowledge, financial hardship, irregular schedules, and academic stress. At the interpersonal level, the influences of family and peers, such as early exposure to healthy eating habits and opportunities to have easy accessibility to farms and farming, are major facilitators, but the lack of a sense of community was the major barrier. At the environmental level, the major barriers were unfavorable food environments at home and in neighborhoods, such as the absence of kitchens in housing and large packaging of produce at markets. Many factors affected the students' FL and related healthy eating practices. These findings suggest that a campus-based FL program should be developed by reflecting on these facilitators and barriers.

Indian adolescents’ perceptions of packaged food and food labels – A qualitative inquiry

In the last two decades, India has witnessed a dramatic rise in the consumption of packaged foods, especially among adolescents. Food labelling is often recognised as an instrumental population-based approach which can enable consumers to make informed food choices by providing all the necessary details about the food product on the packaging. In the Indian context, where adolescent obesity and the ensuing non-communicable diseases are escalating, it is crucial to understand adolescents' views on the use of non-nutritious packaged foods and food labels. Therefore, the aim of this qualitative inquiry was to explore Indian adolescents’ perceptions regarding the consumption of packaged food and use of food labels. Convenience sampling was employed to recruit 29 boys and 15 girls (aged 10–19 years) from rural Varanasi, India. Semi-structured, face-to-face interviews were conducted in the local language. Interview recordings were transcribed verbatim and translated to English. Narrative data were subjected to thematic analysis using NVivo software program. The adolescents reported frequent consumption of packaged food like potato chips, biscuits, chocolates, deep-fried Indian snacks both at school and home. Packaged foods were regarded as tasty, safe, and fresh. Brand name, date of expiry and cost were often read by the study respondents. Nevertheless, they reported difficulty in understanding other components of the label (e.g., nutrition information) and they were not aware of the negative impact of consuming unhealthy packaged foods. Nearly all the respondents insisted that food labels should be written in the local language for easy understanding. These emerging findings underscore the need to design school-based food literacy programs for vulnerable Indian adolescents to address obesity and diet-related complications in early adulthood.

A Study Protocol for the EATing in a GENdered World (EatGen) Study

Abstract Objectives This study will explore the development of a gender inclusive food literacy program targeting teens. To do this, three objectives will be investigated: 1. Teens’ perception of how social influences (parents, peers and the media), cognitive factors (motivation and self-efficacy), and gender norms influence eating; 2. Consider if social influences become more prominent following the onset of puberty; and 3. Evaluate whether targeting gender specific pressures improves the outcomes of a food literacy programs among teens. Methods Twenty structured one-on-one interviews will be used to explore teens’ perspectives of how gender norms, cognitive factors and social influences impact eating (objective 1). Teen participants (13–18 years) will be recruited from a single school in Vancouver (BC, Canada). Data will be used to inform the variables of interest to include in a larger cross-sectional survey for teens from across Canada (n = 300). The survey will collect information on teens’ eating practices, Tanner stage of development, self-efficacy, and motivation to further explore the role how social pressures for eating practices may change following puberty (objective 2). Findings from objectives 1 and 2 will guide the development of a 50-hr gender inclusive food literacy tool that aims to improve teens functional, relational and systems competencies (i.e., food literacy skills). Results Qualitative results will be analyzed for emerging higher order themes (objective 1). Themes will be described by teens’ self-reported gender and biological sex. Quantitative findings from cross-sectional surveys will be analysed by sex and gender as well using t-tests or chi-squared tests. Differences based on Tanner stage of development will also be considered (objective 2). The food literacy tool will be piloted in 30 teens in a pre-post design (3 months) to investigate if teens’ food literacy skills (i.e., functional, relational and systems competencies) change favorably (objective 3). Conclusions Findings from this work will help clarify how gender-based mechanisms influence teens’ eating practices. This knowledge will aid in the development of gender inclusion food literacy programs for teens Funding Sources This work is a part of A Deslippe's doctoral dissertation. Her studies are funded by the University of British Columbia.

Application of a sustainability framework to enhance Australian food literacy programs in remote Western Australian communities.

Food literacy programs aim to build individuals' knowledge, skills and self-efficacy to adopt healthy food choices conducive to reducing the risk of chronic diseases, such as obesity. Foodbank WA's (FBWA) Healthy Food for All® nutrition programs have supported the improvement of food literacy knowledge and skills among vulnerable people living in the Pilbara. A Sustainability Framework containing ten sustainability factors was overlaid with social ecological model (SEM) levels of influence to form a matrix. The use of this matrix facilitated sustainability strategy appraisal within three food literacy programs delivered in remote WA. Programs included multiple sustainability strategies across levels of influence; all programs addressed all ten sustainability factors at community and organisational SEM levels of influence. Few sustainability strategies were employed at the public policy level of influence. No program employed formal governance structures to guide program direction, such as steering groups; however, school and parent program staff developed Memoranda of Understanding to ensure the continuation of program delivery between the FBWA teams' regional visits. This study has showcased the comprehensive assessment of food literacy program sustainability across levels of influence and identified gaps for improvement by FBWA teams. SO WHAT?: The sustainability of food literacy programs aiming to increase knowledge and skills could be enhanced by conducting a similar analysis, during program planning or at program review. Using the matrix provides the opportunity to focus resources to address sustainability; supporting health promotion practitioners to transform the impacts of short-term food literacy interventions into long-term sustained outcomes.

Sustainable food literacy: A measure to promote sustainable diet practices

Sustainable diets and food systems are considered essential aspects of food literacy. Food literacy advocates also suggest food literacy programs be enhanced to develop knowledge, skills, and attitudes to address sustainability issues. However, previous food literacy assessment tools cannot effectively measure the knowledge and abilities required to implement sustainable diets. To overcome such flaws, this study developed and validated a new food literacy scale highlighting important issues of healthy food consumption and environmental sustainability and for possible use as a tool in evaluating an individual's ability to practice sustainable diets. Following a four-stage scale development approach, this study performed web-based questionnaire surveys to develop a sustainable food literacy scale. A total of 968 valid questionnaires collected from Taiwanese residents were received. The results revealed the sustainable food literacy scale exhibits good reliability and validity. Four critical dimensions containing 26 items of sustainable food literacy were identified, including sustainable food knowledge, food skills, attitudes, and action intent and action strategies. This study further examined the relationship between all subscales and the socio-demographic characteristics. The findings suggested gender and education were not found to be related to sustainable food literacy. Both the frequency of cooking and food purchase were significantly associated with all subscale scores. Monthly household income was a significant correlate of all subscales except attitudes. The scale validated in this study not only helps scholars test theories relating to sustainable diet but also assists food policy makers and educators to gage individuals’ sustainable food literacy across genders.

Who Eats, Where, What, and How? COVID-19, Food Security, and Canadian Foodscapes

Who Eats, Where, What, and How? COVID-19, Food Security, and Canadian Foodscapes

Agrifood systems literacy: Insights from two high schools’ programs in Ontario

Following the increased industrialization and globalization of the prevailing agrifood system, researchers and practitioners have highlighted the detrimental impacts of this model on human health, food security, and the environment. As such, experts and citizens are calling for an increased awareness, through food literacy (FL), to improve health and justice and to transition towards sustainable agrifood systems. Building on field research, critical pedagogy, and existing FL analyses, we argue for incorporating both health and well-being, and agrifood systems dimensions into FL programming. By doing so, FL can contribute to promote individual health, as well as more sustainable agrifood systems policies and practices based on the principles of food sovereignty. Through qualitative research with students and teachers in two Ontario high schools, we explore the content and approaches taken in food-related programming. Aspects of FL among students are also explored in order to highlight their strengths and limitations. Further, we point to the challenges faced by teachers in delivering food-related courses. We propose a conceptual framework that highlights the benefits of including the multiple dimensions of FL as a way to test and improve existing FL programs, and eventually train future generations of teachers, students, and citizens.

The Validation and Improvement of a Food Literacy Behavior Checklist for Food Literacy Programs.

Food literacy is a multidimensional construct required to achieve diet quality. The Food Sensations® for Adults (FSA) program aims to improve the food literacy of low to middle-income adults living in Western Australia and is funded by the Western Australian Department of Health. The original published behavior checklist used to measure change in food literacy has been revised based on experience of the facilitators and the iterative development of the program. This research sought to assess the validity and reliability of the improved food literacy behavior checklist. A total of 1,359 participants completed the checklist over an 18-month period. Content, face, and construct validity were considered in the re-development of the checklist. An exploratory factor analysis of the checklist identified three factors: (1) Plan and Manage, (2) Selection, and (3) Preparation. Cronbach’s alpha coefficients of 0.883, 0.760, and 0.868 were found for each of the three factors respectively. These coefficients indicated good internal consistency and were higher than those found in the original checklist analysis. An external validation was undertaken with the original food literacy behavior checklist, and a strong positive relationship between the two tools was found. In addition to being used to evaluate FSA, this revised and extensively validated tool could provide guidance to others evaluating similar food literacy programs and contribute to international measurement research.

Food Insecurity on College and University Campuses: A Context and Rationale for Solutions

Food Insecurity on College and University Campuses: A Context and Rationale for Solutions

Effectiveness of Foodbank Western Australia's Food Sensations® for Adults Food Literacy Program in Regional Australia.

Background: Food Sensations for Adults, funded by the Western Australian Department of Health, is a four-week nutrition education program focused on food literacy, with demonstrated success amongst Western Australians. In the last two years, 25% of programs have been in regional and remote areas and therefore the aim of this research is to explore the impact of the program in regional areas. Methods: Participants answered validated pre- and post-questionnaires to assess change in food literacy behaviours (2016–2018). Results: Regional participants (n = 451) were more likely to live in low income areas, have lower education levels, and identify as Aboriginal, than metropolitan participants (n = 1398). Regional participants had statistically significantly higher food literacy behaviours in the plan and manage and preparation domains, and lower selection behaviours at baseline than metropolitan participants. Post program, regional participants showed matched improvements with metropolitan participants in the plan and manage, and preparation domains. Food selection behaviour results increased in both groups but were significantly higher in regional participants. Conclusions: The program demonstrates effective behaviour change in all participants; however, the increased disadvantage experienced by people residing outside of major cities highlights the need for additional government support in addressing regional specific barriers, such as higher food costs, to ensure participants gain maximum benefit from future food literacy programs.

O33 Healthy Eating Perspectives and Food Literacy Needs of Parents Living with Food Insecurity

<h3>Background</h3> A healthy home depends on parents' health behaviors, nutrition knowledge, food literacy skills, and confidence in making healthy choices. Parents who lack these foundational skills are ill-equipped to model and encourage healthy family habits. Additionally, when parents also face economic barriers that limit food access while struggling with foundational food knowledge and skills, the ability to create a healthy home is diminished even further. Therefore, parental nutrition education programs delivered within an emergency food pantry (EFP) are valuable in targeting food insecure populations. Despite the value of nutrition education programs, little is known about parents' perspectives and barriers that influence their understanding and application of nutrition education to successfully provide a healthful home food environment. <h3>Objective</h3> To explore the barriers to, perspectives on, and nutrition education needs to support healthy eating identified by food-insecure parents within an EFP. <h3>Study Design, Setting, Participants</h3> In Spring 2019, a qualitative descriptive study was conducted using focus groups with low-income parents recruited from a parenting class run by Catholic Social Services in southeastern Pennsylvania. <h3>Measurable Outcome/Analysis</h3> Interviews were audio-recorded and transcribed verbatim. Qualitative data were analyzed using a constant comparative method. <h3>Results</h3> Nine parents participated in the focus group (2 males and 7 females). Most were under 40 years-of-age, high school graduates, received federal nutrition assistance, and experienced food insecurity. Four themes emerged: 1) Cooking Confidence Deficit; 2) Healthy Meal Preparation Barriers; 3) Healthy Meal Acceptance Barriers; and 4) Meal Planning, Management, and Adaptability. <h3>Conclusion</h3> Emergent themes support the notion that limited food literacy impairs parents' ability to meet personal and familial nutrition needs. These findings also emphasize the need to develop and evaluate comprehensive and population-specific food literacy programs to promote community health within EFP settings.

Food Literacy Interventions in Elementary Schools: A Systematic Scoping Review.

Childhood is a critical period for developing food-related skills and knowledge, known as food literacy (FL). Schools may be an important setting for interventions aiming to improve FL in children. This systematic scoping review aimed to characterize food literacy interventions in elementary schools. Databases (PubMed, Web of Science, and EBSCO) were searched for FL interventions in elementary schools (students aged 4-12 years). Studies were assessed according to design, duration, theoretical underpinning, and ascertainment of FL outcome(s). Interventions were assessed according to FL competencies (functional, interactive, and critical). After exclusions, 116 studies were eligible for review, including 105 original interventions. Interventions ranged from 45 minutes to 4 years. Social cognitive theory was the most referenced theory and common interventions included; classroom lessons, games, school gardens, food preparation, and cooking classes. Most studies measured FL outcomes quantitatively (96%, N=111). All studies addressed functional FL (N=116), while 77% (N=89) addressed interactive FL and 28% (N=32) addressed critical FL. This first international review of FL programs in elementary schools found great heterogeneity in school-based FL intervention design and measurement of FL. Few interventions addressed critical FL, which should be a focus for future interventions.

Exploring Feeding Practices and Food Literacy in Parents with Young Children from Disadvantaged Areas.

Early childhood provides an opportunity to optimize growth and development and parents play a fundamental role in forming healthy eating habits in their children. A healthy diet improves quality of life and wellbeing and reduces the risk of chronic disease. The aim of this research was to explore parents’ experiences of feeding 0–5-year-old children and food literacy behaviors. This qualitative study employed a general inductive inquiry approach. Participants were recruited through community-based parenting organizations in disadvantaged areas. Eight focus groups were conducted with 67 parents (92.5% female) living in socially disadvantaged areas within metropolitan Perth of Western Australia. Ten themes emerged from the preliminary analysis and were aligned with domains of relatedness, autonomy, and competence within the self-determination theory. Themes included relatedness (1) feeding is emotional, (2) variations in routine and feeding structures, (3) external influences, autonomy (4) power struggles, (5) it must be quick and easy, (6) lack of strategies for feeding autonomy, competency (7) whatever works, (8) healthy is important but for some unattainable, (9) improvements in food literacy skills, and (10) conflicting information overload. This research informed the development of a food literacy program for parents. Parents faced many challenges when trying to provide healthy food. This research has shown parents would benefit from support to achieve healthy eating practices for their families.