Introduction: This dissertation investigates the critical components of school-based food and nutrition education (SBFNE) programs aimed at enhancing their impact on students’ dietary behaviors. Over the past century, significant shifts in the food landscape have altered dietary habits, with a rise in ultra-processed food (UPF) consumption and a decline in fruit and vegetable intake, particularly among children. This trend underscores the importance of SBFNE programs, which, akin to STEAM subjects, are vital for public health. Schools, where children spend much of their time, are ideal settings for implementing comprehensive, research-based SBFNE programs to reconnect students with healthy food sources and promote better eating habits.
Research Questions: This three-paper dissertation addresses several key research questions:
1. What educational and programmatic components contribute to effective SBFNE programs?
2. How can these components be synthesized into a comprehensive theoretical framework and practical program evaluation tool?
3. What insights and recommendations can be gathered from a formative evaluation of these tools?
Chapter 2 (Article 1): Objective: Identify educational and programmatic components from the research literature that make SBFNE effective in fostering positive dietary behavior among K-12 students. Methodology: An umbrella review of peer-reviewed literature reviews and government reviews on the effectiveness of SBFNE. All included reviews were assessed for methodological quality. Data Analysis: For each included review, a list was made of the components that contribute to the effectiveness of SBFNE to change dietary behavior. These components were compared across reviews. A final list of components contributing to effectiveness of SBFBE was created with their prevalence in the included reviews indicating whether the impact on effectiveness of SBFNE was positive, mixed or not assessed.
Key Findings: This umbrella review identified 20 critical components essential for effective SBFNE programs from 44 reviews, encompassing 1,115 unique primary studies conducted between 1900 and 2022. These components, such as cultural inclusivity and connections to school meals, were integrated into a structured theoretical framework based on the Socioecological Model (SEM) with the components mapped to the first four of six SEM levels: individual, interpersonal, community, and organizational. Conclusions: This study is the first to identify and map research-based critical components into an SEM framework, that influence behaviors and outcomes and can be used to further SBFNE research.
Chapter 3 (Article 2): Objective: Develop and pilot test a SBFNE program evaluation tool derived from 20 critical components that were integrated into an SEM framework. Methodology: The tool, developed in Google Sheets, employed a 0-3 scoring system to evaluate the integration of each component with an accompanying detailed rating guide. The pilot test involved component ranking exercises, concept mapping, and curriculum lesson reviews with SBFNE program developers (n=3). Data Analysis: Insights from the pilot test led to significant refinements in the tool and data collection protocol.
Key Findings: Participants found the ranking exercise uncomfortable due to component interdependencies. They found the concept mapping exercise engaging and intuitive. The program developers found the curriculum review to be tedious and insufficient with only one lesson reviewed, but they thought this type of program review provided valuable guidance for revising and improving SBFNE programs. The interviews were long, usually more than two hours, and transcription was time-consuming. Conclusions: The pilot provided data to refine the program evaluation tool and to refine the data collection protocol for a formative evaluation of the program evaluation tool.
Chapter 4 (Article 3): Objective: Conduct a formative, mixed-methods evaluation to refine the integrated SEM and program evaluation tool for SBFNE programs. Methodology: Recruited SBFNE program developers (n=9) who participated in an exercise to categorize 20 critical components for effectiveness of SBFNE, created a concept map on how the 20 components interact, underwent a program review in which programs were scored 0–3 for the 20 components, received recommendations for program improvement for components that scored less than a three, decided on which recommendations they would enact, and provided feedback on the experience. Data Analysis: Descriptive statistics and thematic analysis identified patterns and insights from qualitative responses, leading to revisions in the evaluation tool and a new practice-based tool.
Key Findings: For the categorization exercise there was a range of agreement between program developers and the literature on the critical nature of the SBFNE components, with each of the nine participants rating between four and 17 out of the 20 components as essential. The concept maps the program developers created represented the interconnectedness of the components and led to the development of a practice-based logic model. The program review process showed that programs can be scored on how they are using the components, recommendations can be made for components that did not score a three, and program developers can implement the recommendations. The feedback process indicated that program developers found the activities they did for this research useful for refining and improving their programs, to make them more effective at dietary behavior change. Conclusions: The program evaluation tool and new practice-based model showed promise to be used in future research on SBFNE.
Conclusions: This dissertation establishes a robust foundation for SBFNE, integrating critical educational and programmatic components with innovative evaluation tools. The integrated SEM and practical program evaluation tools can improve the quality of SBFNE programs, which can help to foster positive dietary behavior change among K-12 students, addressing the rise in UPF consumption and decline in fruit and vegetable intake. This research lays the groundwork for future initiatives aimed at nurturing healthier, informed, and empowered generations.
| Identifer | oai:union.ndltd.org:columbia.edu/oai:academiccommons.columbia.edu:10.7916/4dg9-ek27 |
| Date | January 2024 |
| Creators | Greaves-Peters, Natalie |
| Source Sets | Columbia University |
| Language | English |
| Detected Language | English |
| Type | Theses |
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