Quality Health Education Increases Students' Nutritional Knowledge and Behaviors

Introduction: Some of the risk factors identified by the Centers for Disease Control most strongly related to morbidity and mortality are unhealthy dietary behaviors and schools are an ideal site for targeted interventions. Early research suggests that school interventions may improve student knowledge, efficacy and behaviors regarding healthier eating. Purpose: This research was part of a multi-year project to decrease nutritional risk factors in middle school children by determining the impact of a quality nutrition curriculum, taught by trained teachers, on children's nutritional knowledge, behaviors and self-efficacy. Methods: The study was conducted in a large metropolitan setting and approved by the IRB. The participants for this study were divided into two groups: an intervention group (n = 1476) and a control group (n = 656). Certified teachers underwent in-service training in the curriculum, and subsequently taught this curriculum in their health classes to students in the intervention group. The control teachers and students received no training or intervention. A 43-item valid and reliable questionnaire was used to determine pre-post differences; it consisted of questions assessing eating habits, knowledge, and self-efficacy. Each set of questions was totaled giving a subscale score except for the subscale “eating behavior” which was divided into food groups for analysis. The analysis was conducted using 2-groups (Intervention vs. Control) by 2-times (pre-post) ANOVA with repeated measures on the time factor. Analysis/Results: There were significant group and time main effects and group x time interaction for self-efficacy and knowledge. As expected, the intervention group scored higher than the control group at post. There was also a significant group main effect for eating behaviors. Subsequent post-hoc analysis revealed that the intervention group was more likely to eat fruits, vegetables and grains, and less likely to eat junk food and meat than both the control group and their own ‘pre' score. Conclusions: The results of this study suggest that a quality nutrition curriculum, delivered by trained professionals, resulted in significant positive changes in both nutritional knowledge and behaviors in middle school children. School systems should provide such interventions to their students, given their potential to significantly impact many aspects of their nutrition.