Retention of nutrition knowledge and changes in fruit and vegetable preferences in 4th-5th grade students
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Background: An increased intake in fruits and vegetables (F&V) is associated with a decrease in certain chronic diseases and most children do not consume adequate amounts of F&V. Most nutrition related chronic diseases are typically seen in adulthood, but nutritional habits start in childhood. Therefore, many efforts have been made to implement nutrition education (NE) as prevention for certain chronic diseases. Objective: To evaluate the 6-month retention of nutrition knowledge, changes in F&V preferences and cooking and eating self-efficacy, using questionnaires collected from children who underwent a nutrition education intervention (NEI) in a previous study. Study Design, Settings, Participants: This is a prospective cohort study among 102 4th and 5th grade students in Lubbock, Texas Title I elementary schools, who previously participated in a NEI. Measurable Outcome/Analysis: Data from questionnaires collected immediately post-intervention were compared with data collected 6-months post-intervention to assess nutrition knowledge retention, changes in F&V preferences and eating and cooking self-efficacy. Data analyses were performed using R version 3.5.1 and the multivariate imputation by chained equations (MICE) R package. Paired data were analyzed using one-sample t-tests on the change scores. Results: Nutrition knowledge decreased significantly (mean change= -4.55, 95% CI = [-5.67, -3.42], p=2x10-9). F&V preference, and eating and cooking self-efficacy decreases were not significant (mean change= 3.24, 95% CI = [-1.04, 7.52], p=0.13; mean change= -0.44, 95% CI = [-1.46, 0.58], p=0.38; mean change= 0.32, 95% CI = [-1.33, 1.97], p=0.69, respectively). Conclusions: Results indicate a significant loss of nutrition knowledge 6-months post NEI, but not for children’s F&V preferences, eating or cooking self-efficacy. The results of this study indicate that an ongoing NE may be needed to improve retention.