School-based Nutrition Intervention Research Articles

Contrasting mediating variables in two 5-a-day nutrition intervention programs

Background. Researchers have advocated mediational analysis for behavioral intervention studies to link the supporting theory used in an intervention with the mediating variables and with its ultimate success or failure. Few mediational analyses have been reported for school-based nutrition studies. The conduct of mediational analyses within multi-site studies may provide advantages for the standardization of methods and for the replication and generalizability of findings. Methods. This study identified mediators of two school-based nutrition interventions for 4th graders. Three variables were tested on the four criteria necessary to establish mediation of intervention effects on changes in fruit and vegetable consumption (FVC) in 4th graders (Alabama, N = 1584; Minnesota, N = 522). FVC was measured in children using 24-h dietary recalls. Mediators were assessed using questionnaires completed by children and parents. Results. All criteria were met in Alabama for a single-item measure of knowledge of the 5-a-day daily consumption guideline. Knowledge and parent consumption satisfied one criterion in Minnesota. Knowledge accounted for 9.78% of the total intervention effect in Alabama. Conclusions. Knowledge of the 5-a-day guideline for fruit and vegetable consumption may mediate intervention effects. Future work should include tests of mediational models in multi-site studies.

Assessing the dietary environment: examples from school-based nutrition interventions.

The objectives of this paper are to (1) introduce the concept of upstream and downstream public health approaches and discuss diet assessment issues in that context, and (2) provide examples of diet assessment methods and challenges in assessing environmental factors influencing eating patterns. Dietary assessment of environmental factors is discussed as they relate to nutrition interventions for school-aged children, although the issues transcend population characteristics. Examples of assessment challenges in measuring 'dietary environments' are drawn from the Child and Adolescent Trial for Cardiovascular Health (CATCH), Teens Eating for Energy and Nutrition at School (TEENS) and Trying Alternative Cafeteria Options in Schools (TACOS) studies. The healthfulness of our 'dietary environments' (which may include food availability, social norms around food choice and the effect of pricing, policy and promotion on food choice) may be more important in determining what people consume than their individual decision-making about food choice. There is a dearth of published information to inform us on how to assess these 'dietary environments'.

Gimme 5: An Innovative, School-Based Nutrition Intervention for High School Students

Gimme 5: An Innovative, School-Based Nutrition Intervention for High School Students

Testing mediating variables in a school-based nutrition intervention program.

This study identified mediators of a school-based nutrition intervention for 4th graders and their parents. Nine variables were tested for satisfying 4 conclusions necessary to establish mediation of intervention effects on changes in fruit and vegetable consumption (FVC) in 4th graders (N = 1,676). FVC was measured in children by the use of 24-hr dietary recalls. Mediators were assessed by the use of questionnaires completed by children and parents. All 4 conclusions were met for positive outcome expectancies. Knowledge, self-efficacy, and parent consumption satisfied the first 3 conclusions for mediation but the mediating effects were not statistically significant (Conclusion 4). Future mediational analyses and the creation of a national database of mediators are crucial for increasing strength and efficiency of school-based nutrition programs.

Testing mediating variables in a school-based nutrition intervention program.

Testing mediating variables in a school-based nutrition intervention program.

The Bienestar After School Health Club: A Component of a School-Based Nutrition Intervention Program

LEARNING OUTCOME:To describe an alternate method for teaching children to increase servings of fruits and vegetables and decrease servings of fatty foods in the diet. The purpose of the Bienestar (wellbeing) Health Club is to increase servings of fruits and vegetables and decrease servings of fatty foods in the diet. The weekly health club is one component of a nutrition intervention program targeting 101(m=46 f=55) fourth-grade Mexican-American children from low socioeconomic status. Three dietary recalls to include a weekend day were collected and evaluated. Servings of fruit, vegetable, and rat were 1.5, 1.1, and 7.8 respectively. The theoretical framework for the health club which is in the pilot phase is based on Social Cognitive Theory which incorporates social diffusion, reinforcement, cognitive, affective, inactive, and observational learning. A coupon incentive system increases attendance. Learning activities include games such as Healthy Choices; “making a better me”, Bienestar Feud, and Loteria, a culturally sensitive bingo which has been modified to include positive lifestyle behaviors and examples of good food choices. A creativity book presents students with scenarios such as managing a restaraunt in which they are to develop low-fat authentic mexican-american meals. Theatrical plays and puppet shows developed and performed by the students to their families address health problems and benefits of healthy choices. The characters of the puppet show are incorporated into a coloring book demonstrating positive eating and exercise habits. Students also have the opportunity to be editors in the “Bienestar Express”, a monthly newsletter sent to each students household. Exercise activities are included to educate students on techniques and benefits of physical activity. In conclusion, the school health curriculum should be enhanced with structured extracurricular programs to improve child nutrition.

Do children eat what they say? Validity of intended food choices among Native American school children.

To examine the agreement between school children's intended food choices and observed food choices. Native American students in the second through fifth grade completed a questionnaire that asked them to select from 10 paired food choices for a given meal or snack. Three weeks later students chose among foods identical to those on the questionnaire as part of their usual school lunch or breakfast over three consecutive days; afternoon snacks were also offered. Agreement between students' intended food choices and observed food choices was examined across 10 food pairs. The composite kappa coefficient between intended and observed food choices was 0.09 (95% confidence interval 0.06, 0.012), including virtually no agreement above that expected by chance. There were no differences in agreement by sex or grade. Intended food choices were not significantly associated with observed food choices. It is unclear whether intended food choices reflect nutrition knowledge, socially desirable responses, food preferences, or some other dimension of eating behavior. Although responsive to school-based nutrition interventions, the interpretation of changes in intended food choices must be clarified in future research.