- Title
- Nutrition across the primary school curriculum: development and evaluation of an integrative nutrition and portion size education program
- Creator
- Follong, Berit Maura
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2022
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: One out of four Australian children have overweight or obesity and are therefore at risk of multiple comorbidities. Although many factors contribute to the development of childhood obesity, poor dietary habits play a key role. Over the years, the consumption of large portion sizes has become an issue, particularly for energy-dense, nutrient-poor foods. Continuous intake of large portions may lead to a sustained positive energy balance and further contribute to developing childhood overweight and obesity. Given that eating habits established during childhood track into adulthood, early interventions to promote healthy eating patterns and lifestyles are essential. Primary schools present an opportune setting to target children from a young age. Nutrition education in schools has been found to be effective in improving nutrition knowledge and some aspects of dietary behaviours. However, uptake of nutrition education in the classroom remains low as teachers face several barriers, of which the lack of time is most prevalent. In order to efficiently use classroom time, an integrative approach that incorporates both nutrition and traditional primary school subjects has been frequently suggested. Yet, much is unknown about the use and effectiveness of this promising teaching strategy. More research is required to find out how this approach can address teachers’ time constraints and simultaneously support positive changes in children’s healthy eating. Aim: The purpose of this thesis was to design and develop a cross-curricular nutrition and portion size education program. This program aligns with the mathematics learning objectives of the Australian primary school syllabus whilst also addressing the nutrition components of the personal development, health and physical exercise curriculum. In working towards this aim, theoretical grounding was sought from the current literature on integrative nutrition education and mathematics teaching principles among Australian primary school teachers were examined. Methods: A scoping review was conducted to explore the use and effectiveness of integrative teaching in primary school-based nutrition education programs. As a natural potential synergy between nutrition and mathematics exists, teachers’ classroom practices for mathematics teaching were examined to gain insight in the fit for an integrative nutrition curriculum. This was used to inform the development of a teaching unit on portion size and volume measurements for Year 3 and/or 4 school children. The Cross-curricular Unit on Portion Size (CUPS) intervention program was designed to investigate the effect of six integrated lessons on children’s nutrition knowledge and portion size estimation skills. Lessons were based on food groups, portion/serve size, and volume and capacity, with pedagogy grounded in experiential learning through the use of food models and mathematics cubes. A pilot cluster randomised controlled trial was used to evaluate the effects of the CUPS program on relative estimation errors for portion size and nutrition knowledge. A comprehensive program evaluation was undertaken using teacher interviews and students focus groups. Results: Nutrition education programs were often aligned with curricular standards for mathematics, science and literacy. However, the use of this approach was not commonly defined and lacked a detailed description. Furthermore, limited data was available on the effectiveness of nutrition integration on teacher and student outcomes. Teachers reported the use of mathematics linking cubes and nutrition-related examples when teaching volume and capacity concepts. These resources can facilitate the integration of portion size estimation activities with mathematics teaching practices and formed the foundation of the CUPS program. Findings of the CUPS program showed that an integrative teaching approach improves children’s nutrition knowledge, but not their accuracy for portion size estimation. In addition, teachers and students enjoyed the program, specifically the nutrition content and hands-on materials. Further improvements to the mathematics content were suggested in order to enhance student learning and address the time barrier teachers’ face when teaching nutrition. Conclusions: Due to the explorative nature of the scoping review, heterogeneity amongst the included programs was high and firm conclusions on the effectiveness of nutrition integration could not be drawn. However, together with the findings from the CUPS program, some evidence supports a positive impact of integrative nutrition education on children’s nutrition knowledge. To fully understand the effectiveness of portion size education and estimation aids, larger fully-powered trials are needed. Challenges and successes of implementing a cross-curricular nutrition program identified by the process evaluation should be taken into account. Future integrative nutrition education interventions in primary schools should be conducted to further explore potential impact on both teacher and student outcomes.
- Subject
- healthy eating; education; integration; primary school; mathematics; portion size; nutrition knowledge; Australia; children
- Identifier
- http://hdl.handle.net/1959.13/1453378
- Identifier
- uon:44661
- Rights
- Copyright 2022 Berit Maura Follong
- Language
- eng
- Full Text
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