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From a workshop at "Farms & Food: Teaching the Hudson Valley from the Ground Up," July 2014, Hyde Park, NY, for more information, www.TeachingtheHudsonValley.org "Empowered Eaters: Making Connections through Food & Nutrition Education." Let’s think broadly about food and nutrition education for the next generation. Explore ways to inspire youth to care about how choices influence their health, that of the planet, and the lives of everyone working with food from farm to plate. We’ll also review how to empower students to create practical action plans to successfully make real changes in their day-to-day food choices. Pam Koch, professor of nutrition education and executive director, Laurie M. Tisch Center for Food, Education & Policy, Teachers College, Columbia University
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Nutrition EducationDESIGN Procedure
Pamela Koch, EdD, RDProgram in Nutrition
Teachers College Columbia University
With Isobel Contento, PhD, Emily Abrams PhD, & Ana Islas EdD
Social /Environmental Determinants:
Social/ culturalenvironment:•Social relations•Cultural practices•Social structures•Public policy
Informational environment
Economicenvironment•Resources•Price•Time
• Food availability• Built environment
•Advertising•Media
Biologically determined behavioral
predispositions:•Taste/pleasure •Sweet, sour, salt, bitter•Hunger/satiety mechanisms•Sensory specific satiety
Experience with Food: Associative conditioning
Physiological conditioning:•Familiarity: learned safety •Conditioned food preferences•Conditioned satiety
Social conditioning:
Person-Related Determinants
•Motivations & values•Personal meanings•Knowledge & skills
FOOD CHOICE AND DIET-RELATED BEHAVIORS
•Social norms•Cultural norms•Social affective
context•Parenting practices
•Perceptions•Attitudes•Beliefs
Inter-person factors
Family & social networks
Intra-person factors
Physical/ builtenvironment
.
Social /Environmental Determinants:
Social/ culturalenvironment:•Social relations•Cultural practices•Social structures•Public policy
Informational environment
Economicenvironment•Resources•Price•Time
• Food availability• Built environment
•Advertising•Media
Biologically determined behavioral
predispositions:•Taste/pleasure •Sweet, sour, salt, bitter•Hunger/satiety mechanisms•Sensory specific satiety
Experience with Food: Associative conditioning
Physiological conditioning:•Familiarity: learned safety •Conditioned food preferences•Conditioned satiety
Social conditioning:
Person-Related Determinants
•Motivations & values•Personal meanings•Knowledge & skills
FOOD CHOICE AND DIET-RELATED BEHAVIORS
•Social norms•Cultural norms•Social affective
context•Parenting practices
•Perceptions•Attitudes•Beliefs
Inter-person factors
Family & social networks
Intra-person factors
Physical/ builtenvironment
Nutrition Education
.
Social /Environmental Determinants:
Social/ culturalenvironment:•Social relations•Cultural practices•Social structures•Public policy
Informational environment
Economicenvironment•Resources•Price•Time
• Food availability• Built environment
•Advertising•Media
Biologically determined behavioral
predispositions:•Taste/pleasure •Sweet, sour, salt, bitter•Hunger/satiety mechanisms•Sensory specific satiety
Experience with Food: Associative conditioning
Physiological conditioning:•Familiarity: learned safety •Conditioned food preferences•Conditioned satiety
Social conditioning:
Person-Related Determinants
•Motivations & values•Personal meanings•Knowledge & skills
FOOD CHOICE AND DIET-RELATED BEHAVIORS
•Social norms•Cultural norms•Social affective
context•Parenting practices
•Perceptions•Attitudes•Beliefs
Inter-person factors
Family & social networks
Intra-person factors
Physical/ builtenvironment
Nutrition Education
.
DEFINING NUTRITION EDUCATION
Is “Nutrition Education” The Wrong Term?
DEFINING NUTRITION EDUCATION
Nutrition education is any combination of educational strategies, accompanied by environmental supports, designed to facilitate voluntary adoption of food choices and other food and nutrition-related behaviors conducive to health and well-being (of individuals, community, planet)
DEFINING NUTRITION EDUCATION
Promoting environmental supports for actionWhen and where to take action
Enhancing motivation to act
Why-to take action
Facilitating ability to act
How-to take action
Selecting the behavior change or action
* Alternative names: Behavior Change Communication (BCC); Food and Nutrition Communication and Education (FNCE);Nutrition Education and Promotion (NEP).
DESIGN Procedure Overview
The DESIGN Procedure creates behavioral, theory-based nutrition education lessons tailored to the target audience.
DESIGN Procedure Overview
Decide behavior change goals of the program based on:• analyzing issues of concern for audience• identifying and prioritizing behaviors
contributing to issues of concern
DESIGN Procedure Overview
Explore determinants of behavior change or action based on a variety of data sources
DESIGN Procedure Overview
Select theory/ create appropriate model based on determinants• Clarify educational philosophy• Articulate perspectives on content
DESIGN Procedure Overview
Identify general objectives for key determinants of behavior change or action
DESIGN Procedure Overview
Generate educational / program plans based on:• strategies to address determinants of
change• sequencing for implementation
DESIGN Procedure Overview
Nail down evaluation plan:• specify outcomes• create indicator(s) and tool(s) to measure
outcomePlan process evaluation• create tool(s) to measure how
implementation went
DESIGN Procedure Overview
Nail down evaluation plan:
Outcomes /objectives
Indicators for outcomes
Tools for indicators
Mediators
Behaviors
Environmental factors
Health
Food, Health & Choices
An innovative intervention for 5th grade students that involved classroom nutrition curriculum and wellness activities
Food, Health & Choices
Step 1: Decide issue & behavior
• Decide health issue: - Childhood obesity
• Decide audience: - Beginning independence
• Decide on goal behaviors: - Choose more and choose less behaviors (Based on literature & survey)
Food, Health & Choices
Step 1: Decide behavior
Choose more: Choose less: • Fruits & vegetables • Sweetened drinks• Physical activity • Processed packaged snacks
• Fast food• Recreational screentime
Food, Health & Choices
Step 1: Decide behavior
Choose more: Choose less: • Fruits & vegetables • Sweetened drinks• Physical activity • Processed packaged snacks
• Fast food• Recreational screentime
Food, Health & Choices
Step 2: Explore audience motivators
Student comment Mediator
• Good at sport • Outcome expectations: physical • See friends eat • Outcome expectations: social• Feeling good about self choosing healthy
• Outcome expectations: self-evaluative
• Not confident knowing healthier snacks
• Self-efficacy
Food, Health & Choices
Step 2: Explore audience knowledge & skills
Student comment Mediator
• Did not know sugar in drinks • Factual knowledge• Do not use food labels • Food skills • Do not select salad bar • Behavioral skills • Never set action goals for healthier eating or PA
• Self-regulation skills
Food, Health & Choices
Step 3: Select theory, philosophy & components
• Select theory: - Social cognitive and self-determination theories
• Select philosophy: - System-blame, not person-blame approach
• Select program components: - Classroom curriculum & wellness - Family support
Food, Health & Choices
Step 3: Select theory, philosophy & Components
Food, Health & Choices
Step 4: Indicate general objectives
Mediators Objectives
• Outcome expectations • Explain why energy balance is important
• Outcome expectations • Describe health benefits of F&V /PA/ healthy snacks
• Social norms • Explain how food ads influence us
• Perceived/ actual barriers
• Describe how environment makes it hard to do FHC behaviors
Food, Health & Choices
Step 4: Indicate general objectives
Mediators Objectives
• Factual knowledge • State how much F, V, sugar, fat is recommended
• Skills • Identify ‘right size’ for foods
• Action goal-setting skills • Create a personal action plan
• Self-regulation skills • Monitor progress towards goals
• Autonomous motivation • State personal desire/ policy to eat healthier and be more active
Food, Health & Choices
Step 5: Generate educational plans
• Teacher lesson plans
• Student worksheets • Supplemental pages for teachers • Case study skit that students would read in class • Goal setting and self-monitoring sheets
Food, Health & Choices
Overview Curriculum Units
Unit 1: Success through science: energy balance Unit 2: ‘Choose more’ behaviors Unit 3: ‘Choose less’ behaviors Unit 4: Summarizing & sharing: ‘Just right’ eating/ PAUnit 5: Sustaining ‘just right’ balance Unit 6: Change agents
Food, Health & Choices
Step 5: Generate educational plans
Teacher Educational Plans • Create activities to address determinants
of change
• Sequence activities for implementation
Food, Health & Choices
Step 5: Generate educational plans
Food, Health & Choices
Step 6: Nail down evaluation plan
Outcomes / objectives
Indicators for outcomes Tools for indicators
Determinants/ mediators
Mediators for each of the 6 behaviors
87-item survey
Behaviors Frequency & portion size, duration intensity of PA
49-item survey
Health BMI Height, weight
Food, Health & Choices
Step 6: Nail down evaluation plan
Food, Health & Choices
Step 6: Nail down evaluation plan
Food, Health & Choices
Step 6: Nail down evaluation plan
Heights &Weights
Nutrition Education DESIGN Procedure
Nutrition Education DESIGN Procedure
Nutrition Education DESIGN Procedure
Conclusions
• Provides a systematic way to design nutrition
education sessions and environmental supports
• Behavior focused, based on strong assessment
• Uses theory as a tool or framework for designing
the intervention
• Can be brief or comprehensive depending on need
Nutrition Education DESIGN Procedure
Conclusions
• Provides a systematic way to design nutrition education sessions and environmental supports
• Behavior focused; strong needs assessment
• Uses theory as a tool for designing the intervention
• Can be brief or comprehensive depending on need