qualitative survey of nutrition Project was supervised by an RD - PDF document

3/13/2013 Pre-School Project Overview WVAND Child Nutrition Panel  Project Goal  To assess the  A series of conference call training effectiveness of pre-school sessions prepared NOIs to recruit nutrition education program pre-school classrooms and teach (using a behavioral change and the curriculum process-oriented perspective) WV PRESCHOOL AND EARLY  Only classrooms with at least 50% ELEMENTARY NUTRITION  Project was delivered in summer of students qualifying for free or 2012 at 10 sites in 7 pilot counties: reduced lunches were provided EDUCATION Grant, Hampshire, Mineral, pre-school lessons Monongalia, Raleigh, Wayne and Wood  Scripted lessons were taught daily KELLI WILLIAMS, PHD, RD, LD over a one to two week period  Education was delivered by six TIM BENDER, MS, RD, LD paraprofessional nutrition  Evaluation methods: AMY GANNON, MS, RD, LD outreach instructors  teacher feedback questionnaire  qualitative survey of nutrition  Project was supervised by an RD outreach instructors Why Pre-school Nutrition Education? Developing Healthy Habits  ¾ of children in the US spend time in organized  Pre-school nutrition education  Pre-school children are a great helps children learn about the child care age for nutrition education. basic origins of food through They are still forming nutrition books, posters, and hands-on habits and also influence on  Child care setting is ideal for promoting early experiences during formative family food purchase. years. Methods include: development of health behaviors  Having circle time with  Opportunities may exist for books about food and fun. providing nutrition training  Preschool children who are overweight are  Focusing on the basics- foods opportunities for families too. almost 5x more likely to be overweight as young and farm to start. adults  Having formal and informal education (lessons and meal time conversation)  38% of children entering kindergarten in WV are  Engaging the senses- taste, overweight or obese touch smell and manipulating new foods. The Curriculum- Show Me Nutrition Sample Books Lesson Plans Included: Lesson Titles  Germs, germs, germs* Each lesson begins with a nutrition-  related book.  Bread, bread, bread Each lesson had a behavioral and   Juicy purple pepper knowledge-based objective Lesson plans included:  Eating the alphabet*   Reading books about food and  From grass to milk* nutrition  It’s a sandwich*  Food tasting experiences  Bread and jam for Frances  Hands-on nutrition activities (food art, coloring and other  From wheat to pasta* kinesthetic activities)  Jody’s beans  Didactic material on food safety, healthy food choices and the  Little rabbit’s tooth benefits of physical activity  Handa’s surprise 1

3/13/2013 Teacher Feedback Questionnaire Teacher Feedback Questionnaire (Cont.) Observed Changes in Changes in Behavior that Children Children’s Behavior Discussed 8 8 7 7 6 6 5 5 4 4 3 3 2 2 1 1 0 0 Good Nutrition Healthier More Breakfast Try New Foods Improved Good Nutrition Healthier More breakfast Try new foods Improved hand Meal/Snack Handwashing meal/snack washing Choices choices Yes No Unsure Yes No Unsure Qualitative Teacher Feedback Teacher Feedback Questionnaire (Cont.) Please share any comments about Please list any additional comments Changes in Teacher Behaviors changes children have made: regarding things you really enjoyed 6 or any ideas you may have that “A few children refused to try new  would allow us to improve the foods until Barb’s program, which 5 nutrition education program: provided them the opportunity to 4 try...and they liked the new foods” “I thought it was great and very  engaging...absolutely would be “The children are more aware of the  3 interested in the program next year” health benefits of eating nutritious foods” “The kids really enjoyed the program. I 2  enjoyed it too. They learned a lot from “The children will try their vegetables  1 it. I did too” and tell their friends that eating their veggies are good for their hair, skin, 0 Good nutrition Healthier More breakfast Try new foods Improved Increased PA and eyes” meal/snack hand washing choices “The children are more aware of the  Yes No Already Practicing health benefits of eating nutritious foods.” Qualitative NOI Feedback Next Steps  Expand the pilot to include more counties statewide Please provide any feedback Please provide any feedback which you feel is valuable with which you feel is valuable with regard to teaching the regard to having enough time to  Collaboration between the WV Head Start program and curriculum: fully cover the information in FNP the lesson: “I found it very helpful that the  "questions" and comments in the “The pre school provided me as much  curriculum matched so nicely to the time as I needed to carry out and fully  Recruiting preschool parents for FNP’s adult class series story books. Not only did we read a cover the information in the lesson. story, we could check for However, I did discover that the to promote greater behavioral change. understanding by using the attention span for pre school fell short curriculum” of the time I was present. You can only provide them with so much “I think that the food demos need to be   Increase the number of lessons taught per series a smaller amount. It was right before information and direction before they lunch and the children didn't want to need time to process” eat their lunch after”  Strengthen the program evaluation 2

3/13/2013 Early Elementary Program Overview Marshall’s NEP Curriculum Overview Target Audience: Primarily K-2  Project Mission : To stimulate   Adapted from Missouri’s Show Me Nutrition students in five counties. behavioral change related to In 2012, NEP served 4,345 students.  curriculum healthy eating and physical activity 32 schools participated.  by creating multiple opportunities Nutrition education delivered by 5  to learn and practice program Registered Dietitians, 1 Nutrition Educator, and 10 Dietetic Interns goals.  Eight 30 minute lessons Only schools with at least 50% of   Germs  Make half your plate fruits and students qualifying for free or reduced vegetables, make at least half your lunches were provided nutrition  MyPlate Overview education. grains whole grains, and choose fat-  Grains free or low-fat dairy products every  Educators provided instruction in day. classroom settings for 30 minutes a  Vegetables  Be physically active every day as week over an eight week period.  Fruits part of a healthy lifestyle.  Evaluation Methods:  Avoid oversized portions.  Dairy  Pre/Post Testing of  Balance caloric intake from food and Participants  Protein beverages with calories expended.  Teacher Surveys  MyPlate Review  Focus Groups Evaluation Challenges Survey Development  Program goals and curriculum were reviewed to determine appropriate  School-based nutrition education programs impact childhood objectives to measure. obesity rates by promoting changes in young children’s dietary and physical activity behaviors.  Nutrition knowledge, attitude, and behavior objectives were selected.  Educators with expertise in young children were consulted to review  Age appropriate tools to evaluate nutrition knowledge, attitude, questionnaires and provide feedback on delivery methods. and behavior changes in K-2 nd grade children are limited.  To maintain continuity, pre and post tests were developed for Kindergarten through 2nd grade utilizing similar format and delivery  Initially, a tool adapted from surveys designed for older children, methods. was tested in K-2 classrooms but was deemed inappropriate for  Number of questions varies from 18 – 25. young children with limited attention spans and reading capabilities.  Survey Construction:  Identification of fruits, vegetables, MyPyramid, and MyPlate  Literature reviews yielded no examples of appropriate evaluation  Identify benefits of various food groups  Behavior questions related to food consumption, handwashing, and physical activity tools; therefore, the research team decided to create new  Attitudinal questions answered using a 3-point facial scale assessment tools, which were pilot tested in 2012. Pre/Post Test Pictures Pre/Post Test Implementation  Pre tests verbally administered prior to 1 st nutrition lesson and post tests within 2 weeks of the last lesson.  Both administered by the research team, who are trained nutrition professionals.  Flip chart notebooks with pictures were utilized to assist students with question/response comprehension and to test food recognition.  Children were taken from classrooms and met with researchers one-on-one.  Surveys were administered in 20-30 minutes per classroom with little disruption to the school day. 3