Journal Article•
Childhood nutrition education in health promotion and disease prevention.
01 Dec 1989-Bulletin of the New York Academy of Medicine (Bull N Y Acad Med)-Vol. 65, Iss: 10, pp 1143-1160
TL;DR: Substantial changes in health care providers' attitudes and practices and in the funding and financing of health care will be needed if nutrition education delivered in the context of routine health care is to be a major force in health promotion and disease prevention for youth.
Abstract: In the last 10 to 15 years, nutrition has become a major component of health promotion and chronic disease prevention. Two widely recommended strategies for incorporating nutrition education directed toward children and youth into health promotion and disease prevention efforts are school-based nutrition education and the integration of nutritional care into health care. School-based nutrition education programs targeted toward very specific eating behaviors are showing very promising results in regard to behavior and attitude change of children and adolescents. Substantial changes in health care providers' attitudes and practices and in the funding and financing of health care will be needed if nutrition education delivered in the context of routine health care is to be a major force in health promotion and disease prevention for youth.
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781 citations
TL;DR: Analysis of effects-to-classroom hours revealed that, while relatively few hours of instruction can produce large effects for knowledge, more hours are required for the development of attitude and practice effects, and that stable effects are established for all three domains at about 40-50 classroom hours.
Abstract: A summary of important findings from the School Health Education Evaluation (SHEE) are reported. This paper focuses on the four principal outcome scores of Overall Knowledge, Attitude, Practice, and Program-Specific Knowledge. The relationship of those scores to measures of program implementation and cost also is described. A consistent pattern of findings emerged across the participating health instruction programs, suggesting that health instruction was effective in meeting program objectives as taught in the study classrooms, and that school health program effectiveness was strongly related to the level of implementation. Significant increases in Overall Knowledge and Program-Specific Knowledge were found for treatment classrooms when compared with control classrooms. Smaller, yet statistically significant, increases were found for attitudes and self-reported practices. Curriculum implementation measures were related to program effectiveness. A higher level of program implementation produced greater increases in all scores, but was most strongly related to improvement in attitudes and self-reported practices. Analysis of cost data revealed wide variation across the program. Implementation costs (those associated directly with the number of classroom instruction hours) accounted for more than 90% of the total costs and were, in turn, related to program effectiveness. Analysis of effects-to-classroom hours revealed that, while relatively few hours of instruction can produce large effects for knowledge, more hours are required for the development of attitude and practice effects, and that stable effects are established for all three domains at about 40-50 classroom hours.
361 citations
TL;DR: The data converge to suggest the feasibility and importance of parental involvement for health behavior changes with children of this age and the feasibility of a school-based and an equivalent home-based program for this age.
Abstract: This study compares the efficacy of a school-based program to an equivalent home-based program with 2,250 third grade students in 31 urban schools in Minnesota in order to detect changes in dietary fat and sodium consumption. The school-based program, Hearty Heart and Friends, involved 15 sessions over five weeks in the third grade classrooms. The home-based program, the Home Team, involved a five-week correspondence course with the third graders, where parental involvement was necessary in order to complete the activities. Outcome measures included anthropometric, psychosocial and behavioral assessments at school, and dietary recall, food shelf inventories, and urinary sodium data collected in the students' homes. Participation rates for all aspects of the study were notably high. Eighty-six per cent of the parents participated in the Home Team and 71 per cent (nearly 1,000 families) completed the five-week course. Students in the school-based program had gained more knowledge at posttest than students in the home-based program or controls. Students in the home-based program, however, reported more behavior change, had reduced the total fat, saturated fat, and monounsaturated fat in their diets, and had more of the encouraged foods on their food shelves. The data converge to suggest the feasibility and importance of parental involvement for health behavior changes with children of this age.
246 citations
TL;DR: A nutrition education curriculum was developed, based on a social learning model, that emphasized the importance of a low-salt, low-fat, and increased complex carbohydrate diet for cardiovascular health, and students participating in the nutrition education program reported a significant reduction in consumption of foods high in fat and salt and an increase in Consumption of complex carbohydrates.
Abstract: A nutrition education curriculum was developed, based on a social learning model, that emphasized the importance of a low-salt, low-fat, and increased complex carbohydrate diet for cardiovascular health. The curriculum was pilot-tested in eight third and fourth grade classrooms. Students were exposed to cartoon character role models, were reinforced for dietary changes, and practiced relevant behavioral skills. Students in eight other third and fourth grade classrooms served as controls. At posttest, students participating in the nutrition education program reported a significant reduction in consumption of foods high in fat and salt and an increase in consumption of complex carbohydrates. These assessments were confirmed by food selection measures and by 24-hour food recalls. Students in the control classrooms did not report these eating pattern changes.
98 citations
TL;DR: The nation's schools could contribute significantly and measurably toward improving the health of all Americans, if school health professionals could seize and create opportunities to work with other health and educational professionals, the public, to impel and enable schools to attain relevant national prevention objectives.
Abstract: The history and evolution, during the past decade, of the national disease prevention and health promotion strategy is recounted, culminating with a description of the national prevention objectives. Objectives that directly could be attained by: (1) school health education; (2) school health services; (3) efforts to ensure healthy school environments; and (4) school physical education programs are delineated, as are objectives that could be influenced in important ways by school health programs. The nation's schools could contribute significantly and measurably toward improving the health of all Americans, if school health professionals, individually as well as within their various organizations, could seize and create opportunities to work with other health and educational professionals, and the public, to impel and enable schools to attain relevant national prevention objectives.
71 citations