Good Nutrition Key to Healthy Children A multi-country school - - PowerPoint PPT Presentation
Good Nutrition Key to Healthy Children A multi-country school nutrition intervention in SEA: Malaysia experience Prof Dr Norimah A Karim On behalf of Malaysia Technical Committee of GNKHC Multi-country initiative of Implemented in
On behalf of Malaysia Technical Committee of GNKHC
3 July 2019 34th Scientific Conference of Nutrition Society of Malaysia
Multi-country initiative of Implemented in Malaysia by
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Southeast Asia Public Health Nutrition (SEA-PHN) Network comprises of five nutrition societies in Southeast Asia (Indonesia, Malaysia, Philippines, Thailand dan Vietnam), and dedicated to promoting public health nutrition among the population and alleviating nutrition problems in the region.
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Food and Nutrition Society of Indonesia Nutrition Society of Malaysia Nutrition Foundation of the Philippines, Inc Nutrition Association
under the Patronage of Her Royal Highness Princess Maha Chakri Sirindhorn Vietnam Nutrition Association
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Network Meetings Dedicated Website Programme GNKHC 1st SEA-PHN conference Food-Based Dietary Guidelines
NPAN of SEA countries – a review
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A multi-country nutrition education programme for school- going children, conducted by teachers, utilising a specially designed nutrition teaching module developed by members
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In Malaysia, GNKHC programme is conducted by the Nutrition Society of Malaysia (NSM) in two selected schools (SK Padang Jawa & SK Puchong) with the permission of Ministry of Education Malaysia.
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countries, including Malaysia.
students experienced overweight and obesity:
secondary school students.
and Vitamin D.
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for school students, i.e. they may not be able to achieve optimum growth.
communicable diseases (NCDs) such as heart disease, diabetes and cancer in the future.
their academic performance.
eating and sedentary lifestyles.
i.e. amongst primary school children.
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i.e. to provide nutrition education to school children To decrease the prevalence of overweight and obesity
parties including NSM) has been proven to be effective in improving the nutritional knowledge of students.
initiative, namely GNKHC to empower students with knowledge about healthy eating and an active lifestyle. To ensure that the growth and development, as well as the learning potential of the students are achieved
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physical activity.
and active living among school children.
improving nutrition knowledge of school children.
PHN Network nutrition module for future promotion to other school children.
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To empower school children with appropriate nutrition knowledge to enable them to adopt healthier eating habits and be physically active.
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appointed by NSM
year
physical education class
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For each teacher Teacher’s Guidebook Gantt Chart Student Attendance Form CD (Teaching Slides and & Interactive Activity Slides of Topic 9) Materials for interactive activities Teacher’s Feedback Form For each school Parents’ Consent Form Student’s Workbook Pre-lesson & Post-lesson KAP Survey Form Student’s Feedback Form Parent’s Leaflet Parent’s Feedback Form
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Topic 1 The Healthy Way of Eating: From Pyramid to Plate Topic 2 Be Active, Be Healthy Topic 3 Cereals, Cereal Products & Tubers for Energy Topic 4 Veggies & Fruits for Health Topic 5 Protein Foods Make You Grow Stronger Topic 6 Limit Fats, Sugar & Salt for Health Topic 7 Choose Safe and Healthy Foods especially when Eating Out Topic 8 Use Food Labels for Healthier Food Choices Topic 9 Review: Eat Smart and Be Active
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color theme.
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Answer Scheme Teaching Slides with Notes Feedback Form Objectives, Preparations, Activities Flow, Evaluation
Each topic consists of:
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Game Cards (31 pieces) Folding Card
There are interactive activities for each topic.
Activity 1: Build Your Food Pyramid Activity 2: Healthy Plate
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Folding Card Game Cards (8 pieces)
Jumping rope (3)
Circuit-Training Activity Activity: From Farm to Table
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Folding Card Game Cards (8 pieces)
Activity: Veggies & Fruits Riddles
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Game Cards (5 pieces)
Activity: Food Bingo
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Game Cards (17 pieces)
Activity: Food Investigator Game
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Game Cards
Activity: My Smart Menu Choices
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Folding Card Game Cards (7 pieces)
Activity: Detective of Food Packaging Label
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Game Cards (2 pieces)
Activity: Eat Smart and Be Active Quiz
Quiz Slides (saved in CD)
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PowerPoint file for teaching slides of 9 topics will be saved in CD.
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lesson for each topic.
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Learning Slides Worksheet
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understand what their children have learned in school.
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The English module lessons (master version) was translated to Bahasa Malaysia, to be used in National Schools (Sekolah Kebangsaan)
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Training-of-Trainers Nutrition Workshop
(30 & 31 May) Roll-out of nutrition lessons (9 Topics)
Introduction Session Interactive Session Education Session Practice Session
Roll-out of nutrition education/lessons in school
(Jun – Sep) 1. Post-lesson KAP Survey 2. Measurement of weight and height 1. Pre-lesson KAP Survey 2. Measurement of weight and height
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School 1: SK Padang Jawa School 2: SK Puchong TOT workshop 30 & 31 May 2018 30 & 31 May 2018 Pre-activity KAP survey 11 Jul 2018 27 Jun 2018 Roll-out of nutrition education/lessons in schools Jul – Nov 2018 Jun – Oct 2018 Post-activity KAP survey 15 Nov 2018 21 Nov 2018
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Training-of-Trainers (TOT) Nutrition Workshop
Teachers from SK Padang Jawa and SK Puchong
Nutrit ition Mo Module le B Brie iefin ing Interactiv ive S Sessio ion Q&A S Sessio ion Interactiv ive S Sessio ion Anthropometric M Meas asurem emen ent Gr Group P Photo 32
Conducted on 30 & 31 May 2018 Selangor State Library
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Schools: SK Padang Jawa & SK Puchong
Me Measurin ing h height Me Measurin ing w weight Pre re-le lesson K KAP S Survey 33
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School 1: SK Padang Jawa
Nutrit ition L Lessons 34
Roll-out in Malaysia: June – September 2018
School 2: SK Puchong
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Table 1.2: Distribution of students (post-activity) N = 131
Gender SK Padang Jawa, n (%) SK Puchong, n (%) Total, n (%) Boys 36 (43.9) 16 (32.7) 52 (39.7) Girls 46 (56.1) 33 (67.3) 79 (60.3) Total 82 (100.0) 49 (100.0) 131 (100.0)
Table 1.1: Distribution of students (pre-activity) N = 131
Gender SK Padang Jawa, n (%) SK Puchong, n (%) Total, n (%) Boys 36 (43.9) 16 (32.7) 52 (39.7) Girls 46 (56.1) 33 (67.3) 79 (60.3) Total 82 (100.0) 49 (100.0) 131 (100.0)
were involved in this programme.
are more girls than boys.
Year 3 classes, and are 9 years old.
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Table 2.1: Nutritional status of students (pre-activity) N = 131
Variables Sk Padang Jawa, n (%) Sk Puchong, n (%) Total, n (%) Underweight 23 (28.1) 16 (32.7) 39 (29.8) Normal 38 (46.3) 22 (44.8) 60 (45.7) Overweight 10 (12.2) 7 (14.3) 17 (13.0) Obese 11 (13.4) 4 (8.2) 15 (11.5) Total 82 (100.0) 49 (100.0) 131 (100.0)
Table 2.2: Nutritional status of students (post-activity) N = 131
Variables Sk Padang Jawa, n (%) Sk Puchong, n (%) Total, n (%) Underweight 24 (29.2) 25 (51.0) 49 (37.4) Normal 35 (42.7) 20 (40.8) 55 (42.0) Overweight 10 (12.2) 4 (8.2) 14 (10.7) Obese 13 (15.9) 13 (9.9) Total 82 (100.0) 49 (100.0) 131 (100.0)
Comparing the pre- & post- activity data, there were no improvement to their BMI results and the prevalence of underweight and overweight/obese were still high. As the measurement of pre-activity BMI and post- activity BMI was about 6 months apart, any changes to BMI cannot be attributed to the effect of the module.
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KAP Score Categories SK Padang Jawa, n (%) SK Puchong, n (%) Total students, n (%)
Increase 52 (63.4) 19 (38.8) 71 (54.2) Maintain 9 (11.0) 8 (16.3) 17 (13.0) Decrease 21 (25.6) 22 (44.9) 43 (32.8) Total 82 (100.0) 49 (100.0) 131 (100.0)
Increase 37 (37.1) 26 (53.1) 63 (48.1) Maintain 14 (17.1) 7 (14.3) 21 (16.0) Decrease 31 (37.8) 16 (32.6) 47 (35.9) Total 82 (100.0) 49 (100.0) 131 (100.0)
Increase 33 (40.2) 22 (44.9) 55 (42.0) Maintain 6 (7.3) 5 (10.2) 11 (8.4) Decrease 43 (52.5) 22 (44.9) 65 (49.6) Total 82 (100.0) 49 (100.0) 131 (100.0)
Table 3.1: Changes in KAP score of SK Padang Jawa and SK Puchong students
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Knowledge, attitude and practice (KAP) scores of students:
schools) showed an improvement following the module implementation as indicated from the percentage of students who increase in their scores.
may be due to multiple factors influencing the practice of the students, i.e. foods prepared by parents, availability foods in cafeteria, etc.
by the students but they do not practise consistently in their daily life.
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Teachers' feedback on the module:
topics are easy to handle (scale of 3 – 5, i.e. fair to good). However, a teacher concluded that topic 1 delivery was slightly difficult to handle (scale of 2, i.e. poor). This is probably because it is the first topic and the execution wasn’t smooth.
students to understand the topic better (scale of 3 - 5). Interactive activity is a form of active learning which can attract the students’ attention.
– 5, fair to good). This could be due to various interactive and fun components of the module.
delivered in these topics easily (scale of 3 – 5) but can be improved especially for topic 1 (3 teachers ranked scale of 3), topic 3, 8 & 9 (2 teachers ranked scale of 3).
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Teachers' feedback on the overall programme:
sufficient while there was a teacher (25%) who felt that the time was too short. It may be because the teacher needed more time to ensure that the students focus and understand the lessons in the module.
students gained nutrition knowledge from this module, interactive activities were useful, the module is suitably prepared and they will use this module in the future to teach other students.
could be due to the execution of the topics and the students’ interest in selected topics.
programme which included
teacher is high.
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the teachers were easy to understand. This showed that the module is appropriate for this age group.
gave to their parents. Less than half (41.2%) discussed the nutrition information with their parents. As parents usually make decisions on the type of foods to be provided for the kids, it is important that parents have knowledge on nutrition.
This is probably because the kids love physical activities and the topic is easy to understand and can be practised in daily life.
(10.7%). As this topic taught the students to reduce fats, sugar and salt, it involved limiting their favourite foods, hence they dislike this topic.
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country nutrition society visited and monitored the lessons being conducted by teachers from time to time.
conditions of the school cafeteria.
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actual conduct of the lessons by the teachers and the response of the
by the teachers.
lessons
whether the students are able to practise healthy eating in schools.
than healthy
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receive 22 (16.8%) completed forms from the parents. As the students have to bring home the forms and return the next day, they may have misplaced the forms or did not inform their parents about the forms.
that there were slight improvements in their child in terms of nutrition and food
were already familiar with their daily habits.
busy, or they already have the nutrition knowledge.
leaflets easily. The leaflets have simple information and interesting graphics.
all the information are received by the parents.
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The Good Nutrition Key to Healthy Children (GNKHC) Module were implemented by the trained teachers.
TOT workshop and the actual teachers who conducted the lessons were not the same.
The mean score of the nutrition knowledge and attitude of students showed improvement following implementation of the lessons by the teachers. However, the number of students decrease in their practice scores increased.
factors, including parents’ decisions, food choices in cafeteria, etc., the practice of the students cannot be fully controlled by the students.
will be able to make healthier choices when they can decide on their foods in the future. Most of the teachers agreed that the content of the module was suitable for year 3 students (9 years old) and appropriate for teachers to teach students about nutrition.
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lessons should be taken into consideration when planning for future programmes.
workload, they may have felt on the burden to implement it effectively.
disturb the classes
teachers who implement this module
should be continued to promote healthy lifestyle as this will help to prevent increasing prevalence of childhood overweight and obesity, as well as underweight.
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– Dr Tee E Siong (Chair of TWG) – Prof Dr Norimah A Karim – Dr Zawiah Hashim – Assoc Prof Dr Chin Yit Siew
– SK Padang Jawa – SK Puchong
the module.
planning, implementation, monitoring and evaluation and preparation of this report
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Enquiries and further information:
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Website: https://sea-phn.org Dr Tee E Siong Chairman, SEA-PHN Network President, Nutrition Society of Malaysia president@nutriweb.org.my Muhaini Hussin/Yvonne Chwee Versacomm Sdn Bhd Secretariat SEA-PHN Network secretariat@sea-phn.org