1. Feasibility Study on Implementing Garden and
Cooking Nutrition Education in Poudre School
District
May 1, 2015
JTC 300 Section 2
Kara Lechtenberg
karalec@comcast.net
(970) 214-4738
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2. Table of Contents
Executive Summary……………………………………………………………………3
Introduction……………………………………………………………………………4
Background of the Issue of Children’s Obesity………………………………..5
Current Public School Food Requirements…………………………………….6
Overview of Proposed Nutrition Program……………………………………..7
Criteria Discussion and Method of Analysis…………………………………………...7
Student Interest………………………………………………………………..7
Teacher acceptance…………………………………………………………….8
Health Impact ………………………………………………………………....8
Financial Impact……………………………………………………………….9
Criteria Results………………………………………………………………………...9
Student Interest…………………………………………………………….….9
Teacher Acceptance…………………………………………………………..11
Health Impact ………………………………………………………….….…12
Financial Impact…………………………………………………………..….14
Conclusion……………………………………………………………………......…..14
Recommendations…………………………………………………………….….…..16
References………………………………………………………………...…….……17
Appendices…………………………………………………………….……….…….20
Glossary ……………………………………………………………………….……..20
List of Illustrations
Figure 1.1………………………………………………………………………………5
Figure 1.2………………………………………………………………………………12
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3. Executive Summary:
The study proposes implementing a nutrition education program that will incorporate
gardening and cooking lessons to teach the most important nutrition concepts. Nutrition
education is of growing importance in the United States due to the increasing child obesity rates.
The next generation of children is at a higher risk for cardiovascular disease, diabetes and cancer
due to obesity (“Childhood Obesity Facts”). It is essential that the United States address this
issue before the life expectancy rate of children decreases. One beneficial, preventive measure is
educating young children about the importance of a healthy lifestyle (“Childhood Obesity
Facts”). This study introduces a nutrition program that incorporates the interactive elements of
gardening and cooking to help teach children where food comes from, how to eat healthy and the
importance of health.
The purpose of this study is to determine the feasibility of implementing gardening and
cooking enhanced nutrition program in Poudre School District (PSD) of Colorado. The study
discusses student interest, teacher acceptance, health impact and financial impact of the nutrition
education program. Student interest was evaluated by reviewing similar studies done with
nutrition education programs. In many studies students were evaluated on their amount of
participation and interest in the program and subject matter. Teacher acceptance was determined
by looking over teachers’ opinion in similar studies. These studies interviewed teachers asking
them their thoughts of the program and whether they would continue the program in their
classrooms. The health impact of the education program was difficult to determine due to a lack
of data available about the correlation between nutrition programs and the improvement
children’s long term health. Therefore, the health impact was evaluated by reviewing the
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4. improvement of children’s food choices after the completion of similar nutrition education
programs.
The evaluation of student interest in such a program showed that students’ attitudes to
nutrition were positive which aided in improving healthy food choices and knowledge of
nutrition. The evaluation of teacher acceptance showed that despite the effectiveness of the
program it is unfeasible for teachers to implement. Finally, the evaluation of health impact was
inconclusive. Some studies found a significant improvement in student’s food choices and
knowledge which leads to following a healthier lifestyle. Despite the questionable feasibility of
the proposed program, nutrition education is a valuable method to prevent the increasing obesity
rates and improve children’s health in the United States.
Introduction:
Children’s nutrition has been a growing issue in the current years, especially in the
United States. Children’s obesity/overweight rate is increasing steadily, while the nutrition value
of children’s food is steadily decreasing. Moreover, many health issues such as diabetes and
heart disease are associated with obesity. This puts our children at risk for contracting more
health problems due to an unhealthy diet and lifestyle. In order to manage this issue,
improvement of the dietary standards of school lunches and increased awareness has been
implemented. However, the food intake of children overall still fails to meet the national
recommendations for children (Morris, briggs, Zidenberg-Cherr). Nutrition education is a
possible avenue to prevent the increasing obesity rates and improve children’s health in the
United States.
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5. Background of the Issue of Children’s Obesity:
According to the United States Centers for Disease Control and Prevention (CDC), child
obesity rates have more than doubled in children and quadrupled in adolescents in the last 30
years (“Childhood Obesity Facts”). This means each new generation is more and more
susceptible to become obese. Obesity is now defined as a disease among health professional,
meaning that obesity causes health effects that can significantly affect and decrease a person’s
quality of life. The CDC states that obese youth are considerably more prone to have high risk
factors for cardiovascular disease, which includes high cholesterol, high blood pressure and
prediabetes (“Childhood Obesity Facts”). Unfortunately, those who are obese at a younger age
are also more likely to be obese as adults; therefore, these health concerns become long term
illnesses. For example, heart disease, type 2 diabetes, stroke, several types of cancer and
osteoarthritis are all health problems associated with obesity which can ultimately lead to death if
not addressed properly (“Childhood Obesity Facts”). The following is a graph showing the rise
in obesity rate over the last 30 years: Figure 1.1
(“Growth in Childhood Obesity”)
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6. The CDC discusses the key to preventing obesity is adopting a healthy lifestyle, which
incorporates healthy eating and physical activity (“Childhood Obesity Facts”). The United
States is reaching a point where nearly one in three children are at risk for the preventable
diseases mentioned above because of obesity (“Childhood Obesity Facts”). If this issue is
ignored and no preventative measures are taken, health professionals have expressed that our
current generation of children may have a shorter life span than their parents (“Childhood
Obesity Facts”). At this point, adoption of a healthy lifestyle and dietary requirements for school
meals are improving; however, there is an insufficient amount of education associated with
teaching healthy behavior. It is vital that public schools begin to implement new programs to
educate children on the importance of a healthy lifestyle.
Current Public School Food Requirements:
Dietary recommendations for public school meals have been steadily improving since
2010, when President Obama signed the Healthy, Hunger-Free Kids Act (United States). The
new Act changed the state of school nutrition drastically. Since this was the first change in
school meal requirements in over 15 years, the department of Agriculture (USDA) was forced to
update the standards of school meals and abide by the most recent dietary recommendation for
children (United States). According to the USDA, “now meals for children grades K and above
must include: a daily serving of fruits, a daily serving of vegetables plus a weekly requirement
for dark green, red/orange, beans/pea, starchy, and “other” vegetables and daily/weekly
minimum requirements for meat/meat requirements” (United States). These changes in meal
pattern became available in the summer of 2012 (United States). Although the dietary
requirements have improved, children have a large range of choice in meals at school.
Unfortunately, children fail to make healthy food choices when given the option due to poor
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7. nutrition education. The offering of healthy dietary options is not sufficient; children need the
knowledge to ensure they make the healthier decision and create a healthy sustainable lifestyle.
Overview Proposed Nutrition Program:
The nutrition program proposed incorporates gardening and cooking lessons with
nutrition lessons to enhance nutrition education. Elementary school students would be the
participants in a weekly nutrition program, lasting 12 weeks. Each lesson will have a specific
focus which will alternate every week. The first four weeks would be hands on lessons with
planting vegetables and discussing where these vegetables come from. The next four weeks
would be interactive cooking lessons to teach children how to cook simple snacks with
vegetables and fruits. The last four weeks would focus on taste testing new fresh foods and
teaching children how to make healthy food choices in the cafeteria.
Nutrition and healthy lifestyle need to be topics discussed in schools in new and creative
ways to educate children on the importance of making healthy choices. The purpose of this study
is to determine if implementing a garden and cooking enhanced program is feasible and
beneficial to Poudre School District in Colorado. The study discusses the student interest,
teacher acceptance, health benefits and financial impact of the nutrition education program.
Criteria and Methods of Analysis:
Student Interest:
Students’ interest of the nutrition program has a substantial impact on the feasibility and
effectiveness of the program. It is essential that students embrace the nutrition program in order
to ensure they learn to make healthier food choices in the future. In order to engage students in
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8. the nutrition lesson the activities need to be interactive and relatable. Students’ interest in the
nutrition program was evaluated by researching children’s involvement and improvement in
similar nutrition programs. These studies collected data through student surveys and with teacher
interviews.
Teacher Acceptance:
In addition to students, teachers’ acceptance and interest of the nutrition program has an
even more significant impact on the success of the program. Teachers’ have an important role in
employing the program because they are responsible for teaching, planning time and committing
to the program guidelines. Auld, Heimendinger, Hambridge, and Romaniello conducted a study
discussed in the article “Outcomes from a school-based nutrition education program alternating
special resource and classroom teachers.” The study stated, “Teachers are critical classroom
“gatekeepers,” influencing whether or not nutrition education occurs and its ultimate success.”
This statement demonstrates the importance of teacher’s ‘buying in’ to the nutrition education
program. If they invest and believe it is an important concept for students to grasp then the
teachers will commit time and energy to the lessons. The amount of teacher acceptance of the
nutrition education program was evaluated by researching teacher’s attitude towards the program
in similar studies. These studies interviewed teachers to determine their thoughts, perspectives,
and interests of the teaching nutrition in an elementary school. In addition Nicole Turner-
Ravana, PSD Nutrition Coordinator, was interviewed about her views on teacher acceptance.
Health Impact:
The purpose of the nutrition education program is to improve children’s health and
decrease the rate of childhood obesity. The actual health impact of the program is essential to
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9. determine whether or not it is beneficial for students. However, children’s obesity is a more
recent problem that has only developed in the last 30 years. Therefore, there is a lack of research
on the effectiveness of preventive measures because only a specific generation has been involved
in these studies. This generation has not aged enough to adequately determine if nutrition
education programs aide in the prevention of obesity. In order to evaluate the health impact of
nutrition education, children’s food choices were monitored in studies to determine if there was
an increase in healthy, more nutritious choices.
Financial Impact:
The overall cost of the nutrition education program will affect if the program is feasible
to implement into the school system. The financial cost of the program includes employees,
equipment, and food. The nutrition education program financial needs would have to fit within
the perimeters of PSD’s budget in order for it to be feasible. The financial impact of the nutrition
education program was determined through an interview with Nicole Turner-Ravana, PSD
Nutrition Coordinator.
Criteria Results:
Student Interest:
In several nutrition education programs studied that are similar to the one proposed in this
report students responded well to the interactive curriculum. Overall, children responded with
positive attitudes to the lessons and demonstrated a desire to learn the content. The article
“Cooking with Kids Posititvely Affects Fourth Garders’ Vegetable Preferences and Attitudes and Self-
Efficacy for Food and Cooking,” discusses a study that introduced a cooking with kids program to
improve fruit and vegetable preference and attitudes towards food and cooking (Cunningham-
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10. Sabo and Lohse). The results were assessed through multiple surveys throughout the program to
differentiate between attitudes and preferences before and after the program. The study found,
“attitudes toward cooking were more positive” especially among female students and students
with prior cooking experience (Cunningham, Lohse). In addition, the study found that students
with less cooking experience developed an enjoyment and positive attitude toward cooking by
the end of the program (Cunningham, Lohse).
The overall participation of children in the nutrition education program is an indicator of
children’s interest in the program. Auld, Heimendinger, et al. conducted a study in which they
developed a nutrition education program that incorporated cooking classes and vegetable and
fruit taste testing with nutrition lessons. This study determined that children gained a stronger
knowledge of major nutrition concepts (Auld, Heimendinger, et al.). There was an outstanding
participation by students in this particular study, it was observed that “all children actively
participated in the lessons and tasted the food” (Auld, Heimendinger, et al.). The researchers of
the study attributed the success of the program to the participation of both students and teachers.
Children’s improvement during the nutrition education program also suggests they found the
topic of nutrition interesting (Auld, Heimendinger, et al.). After the study, children “knew more
about the Food Guide Pyramid and were more likely to recognize which foods could be added to
existing meals to increase fruit and vegetable intake” (Auld, Heimendinger, et al.). Not only did
the children’s knowledge of nutrition improve but so did their attitude toward nutrition and food
in general. The study found that students “had more positive attitudes toward school lunches”
(Auld, Heimendinger, et al.). Their interest in nutrition education program helps to show it will
be an effective teaching tool and will be beneficial to students in the PSD school system.
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11. Teacher Acceptance:
The teacher’s acceptance of nutrition education programs varied among and within
studies. In the study by Auld, Heimendinger, et al. teachers were required to participate in
interviews to determine their overall acceptance of the program. The interviews spanned 20
minutes and covered the following information: opinion on teaching nutrition in elementary
schools, perspective on alternating weekly lessons, the teacher’s interest and confidence in
providing nutrition education and perception on the effectiveness of the program (Auld,
Heimendinger, et al.). Eighteen teachers out of the nineteen teachers participated in the
interviews after the program. All of those teachers interviewed supported the addition of
nutrition lessons in elementary schools because they believed it is an important health concept
and has potential to influence children’s food habits (Auld, Heimendinger, et al.). When asked
about the effectiveness of the program, teachers praised the “experiential nature of the
curriculum” and believed its interactiveness helped students connect with the subject material
(Auld, Heimendinger, et al.). Some teachers even mentioned that children seemed to be
discussing what they ate and were bringing healthier snack items to school (Auld, Heimendinger,
et al.).
However, despite teacher’s overall acceptance of the program they expressed some
barriers that would inhibit the success of the program. When asked about the future of the
program teachers mentioned that, “they were unlikely to teach nutrition as frequently or
elaborately . . . because of a lack of preparation time, resources (money, materials), and help”
(Auld, Heimendinger, et al.). In addition, in an interview with Nicole Turner-Ravana, she stated
“it is a challenge to teachers to find extra time for new things, even when they believe in the
concepts”( “Nicole Turner-Ravana Interview”). Teachers’ acceptance of nutrition education
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12. programs in studies is high; however, teachers feel unable to teach these interactive programs
again due to the time commitment of the curriculum. Such programs are effective for students
but not feasible to implement due to the external obstacles teaches face.
Health impact:
After reviewing past studies, there are varied results about the tangible health benefit of
introducing nutrition education programs. In the study by Auld, Heimendinger, et al. children’s
knowledge of the Food Guide Pyramid and food was more expansive in the group of student who
participated in the nutrition program. A stronger knowledge of nutrition hopefully will lead these
children to continuously make healthy choices and improve health. In addition, the study found
that children’s food choices were healthier after the nutrition program (Auld, Heimendinger, et
al.). Plate waste data was evaluated to determine that children “ate slightly more fruit, [and]
about 30% more vegetables” (Auld, Heimendinger, et al.). Children’s healthier eating choices
suggests the nutrition education program caused a behavior change which is likely to continue
throughout life; ultimately progressing overall health (Auld, Heimendinger, et al.). The table
below shows the data of children’s food choices and knowledge from the study conducted by
Auld, Heimendinger, et al. Figure 1.2
Knowledge, Attitudes and Behavior “Scores” at Posttest According to Group
Measurement- 1 standard mean
Variable Treatment Group Control Group
Knowledge of FGP
(max=9)
Knowledge of Food at
Meals (max=3)
7.0
2.3
3.5
2.0
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13. Attitude Toward:
School Lunches
Whole Grains
Self-Efficacy (prep)
Self-Efficacy (eating five
a day)
0.9
1.4
1.6
1.2
0.0
0.8
1.1
1.0
Serving Eaten:
Fruits
Vegetables
Fruits and Vegetables
0.44
0.67
0.96
0.34
0.49
0.60
Serving Difference:
Fruits
Vegetables
Fruits and Vegetables
-0.05
0.04
0.00
-0.14
-0.16
-0.35
(Auld, Heimendinger, et al.)
However, results from the Child and Adolescent Trial for Cardiovascular Health found there to
be no difference in children’s fruit and vegetable consumption after a three year program with
more than 50 nutrition studies (Auld, Heimendinger, et al.). This study suggests that nutrition
education must be narrowly focused to impact children’s behavior that will improve their health.
Alternatively, a study conducted in Greece found tangible evidence of a positive correlation
between improved health and nutrition education (Manios, Moschanreas, et al.). The study
introduced nutrition education classes in elementary schools and conducted health examinations
on the students three years after the program (Manios, Moschanreas, et al.). The results showed
lower lipid levels, lower BMI compared to the control group, an increase in physical activity and
an increase in health knowledge (Manios, Moschanreas, et al.). Overall the study concluded that
“continuation and expansion of such a program may prove to be beneficial in initiating long-term
[health] changes” (Manios, Moschanreas, et al.). It is evident that nutrition education programs
have a beneficial impact on student’s food choices and knowledge. However, the correlation
between nutrition education programs and improved health is still uncertain due to a deficiency
of specific evidence.
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14. Financial Impact:
The program’s cost would have a significant impact on PSD. In addition, acquiring the
funding to introduce the nutrition program in PSD would be a challenge. Nicole Turner-Ravana
stated “the health standards do not have any state accountability through testing, therefore there
is less emphasis on topics like nutrition” (“Nicole Turner-Ravana Interview”). Since nutrition is
not considered a health standard the district receives less funding for these programs. Nicole
Turner-Ravan mentioned that the majority of funding for the nutrition programs at PSD comes
from grants. She said, “We have been able to apply for grant funds and offer resources to schools
to voluntarily use” (“Nicole Turner-Ravana Interview”). PSD fails to have proper funding in the
area of nutrition which makes the introduction of a nutrition education program a challenge.
Conclusion:
Nutrition education is a valuable method to prevent the increasing obesity rates and
improve children’s health in the United States. The proposed nutrition education program would
be advantageous to students at PSD. Despite the benefit to students, the nutrition education
program is not feasible to implement in the whole PSD due to the barriers that prevent teachers’
from committing to the program.
Student Interest:
The evaluation of student interest showed the children respond well to interactive
learning similar to the program proposed in the study. Students’ attitudes to nutrition were
positive which aided in improving healthy food choices and knowledge of nutrition. Overall,
children embrace nutrition programs with an interest in the subject and positive outlook. The
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15. knowledge gained by students in the nutrition programs hopefully will lead to a healthier
lifestyle and decrease the risk of obesity.
Teacher Acceptance:
The evaluation of teacher acceptance showed that despite the effectiveness of the
program it is unfeasible for teachers to implement. Many teachers were in support of nutrition
programs and believed they could impact student health. However, external complications cause
them to feel unable to continue such an extensive and interactive program. One study stated,
“Common barriers cited by teachers include lack of time, training, materials and administrative
support” (Auld, Heimendinger, et al.). Unfortunately the nutrition education program is
impossible to implement with teachers current belief that participation would be a challenge
given the external obstacles.
Health Impact:
The evaluation of health impact was inconclusive. Some studies found a significant
improvement in student’s food choices and food knowledge which suggests students are
following a healthier lifestyle. These studies discussed that children who follow a healthy
lifestyle are more likely to continue it throughout life which will decrease the risk of obesity and
obesity related diseases. Another study in Greece, found a tangible health benefit from
implementing a nutrition education program. However, the evidence only demonstrated
immediate health improvement. The long term health benefit of introducing nutrition education
programs remains unclear. Many studies emphasized the need for the nutrition education
program to be narrowly focused and for main points to be reinforced in order to impact
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16. children’s behavior to improve health. Therefore, the health impact of a nutrition program
depends on the quality, focus and consistency of the lessons.
Financial Impact:
The evaluation of the financial impact showed that the program proposed would exceed
the budget available at PSD. This is due to the fact the PSD has a minimal amount of funding for
programs in the area of nutrition. Grants are the way PSD has funded prior nutrition programs.
However, the process of writing and applying for grants is extensive and costly. Therefore grants
fail to provide a reliable source of funding. More formal funding would be necessary in order to
introduce a nutrition education program district-wide at PSD.
The student interest, teacher acceptance and promising health benefit of nutrition
education program demonstrates it would be a valuable addition to the PSD curriculum.
However, the lack of time, cost and resources within PSD would act as hindrances in the
feasibility of program. In order for a nutrition program enhanced with gardening and cooking
lessons to be feasible the public school system would have to increasing funding. Without
appropriate resources, money and time these beneficial programs are unable to be introduced.
Nutrition education programs would significantly benefit students overall health in the future. In
an age where the children’s obesity epidemic is growing preventive measures, such as the one
proposed in this study, need to be introduced into the public school system.
Recommendations:
The critical question of how to implement a nutrition education in a public school system
remains a challenge. In order to introduce these beneficial programs, public school systems need
to follow several recommendations. The implementation of these programs is impossible without
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17. proper funding and classroom time. Public school systems, like PSD, would need to make
funding and resources available to teachers. An increased awareness of the importance and need
for this program would impact the amount of funding the public school system would attribute to
nutrition education. Volunteers with a nutrition background, for example college students, would
be an effective way to aid these programs. These volunteers would save precious class time
because of their ability to teach the lessons with more confidence and ease than regular teachers.
References:
Auld, G., Heimendinger, J., Hambidge, M., Romaniello, C., Hambidge, C. (1999) “Outcomes
from a school-based nutrition education program alternating special resource and classroom
teachers.” Journal of School Health, 69:403-408.
Bandura, A. "Self-Efficacy." Encylopedia of Human Behavior 4 (1994): 71-81. Print.
Berlin L, Norris K, Kolodinsky J, Nelson A. “The role of social cognitive theory in farm-to-
school-related activities: implications for child nutrition.” Journal of School Health 83
(2013): 589-595. Web.
"Childhood Obesity Facts." Centers for Disease Control and Prevention. Centers for Disease
Control and Prevention, 11 Dec. 2014. Web. 10 Apr. 2015.
Cunningham, L., Lohse, B. “Cooking with Kids Posititvely Affects Fourth Garders’ Vegetable
Preferences and Attitudes and Self-Efficacy for Food and Cooking.” Childhood Obesity 9.6
(2013): 549-556. Web.
"Diagnosing Diabetes and Learning About Prediabetes." American Diabetes Association. N.p.,
22 Sept. 2014. Web. 30 Apr. 2015.
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18. Growth in Childhood Obesity, 1971 to Present. Digital image. MACDEP News. CDC National
Center for Health Statistics, June 2010. Web. 10 Apr. 2015.
Gutherie, Joanne, and Constance Newman. "Eating Better at School: Can New Policies Improve
Children's Food Choices?" Superintendent of Documents (2013): 12-19. Proquest. Web. 10
Apr. 2015.
"Healthy Diet Cost." New Scientist 220.2947 (2013): 6. Proquest. Web. 10 Apr. 2015.
Manios, Yannis, Moschanreas, Joanna, Hatzis, Christos, Kafatos, Anthony. “Evaluation of a
Health and Nutrition Education Program in Primary School Children of Crete over a Three-
Year Period.” Preventative Medicine.2 8.2 (1999): 149-159.
Morris, Jennifer, Briggs, Marilyn, Zidenberg-Cherr, Sheri. (2002) “Development and Evaluation
of a Garden-Enhanced Nutrition Education Curriculum for Elementary Schoolchildren.” The
Journal of Child Nutrition and Education. 2. Web.
“Nicole Turner-Ravana Interview.” E-mail interview. 20 Apr. 2015
United States. United States Department of Agriculture. Food and Nutrition Service. Questions
& Answers on the Final Rule, “Nutrition Standards in the National School Lunch and School
Breakfast Programs”. N.p., 4 Aug. 2014. Web. 10 Apr. 2015.
"What Is Cardiovascular Disease?" What Is Cardiovascular Disease? N.p., 18 Dec. 2014. Web.
30 Apr. 2015.
"What is Obesity." Obesity.org. N.p., Oct. 2014. Web. 30 Apr. 2015.
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19. Appendices:
1.1
Interview results with high levels of agreements among teachers at End of School Year
Positive Responses to Integrated Nutrition Program (INP)
• Competence of resource teachers.
• Supported other education disciplines (health, math, science, literacy) and English as a
second language programs.
• Extremely popular with children.
• Increased children’s interest in nutrition and confidence in choosing healthier foods.
• Resource teacher support of regular classroom teacher’s nutrition education efforts.
• Role modeling by the resource teacher.
• Classroom lessons/activities were well-designed, age-appropriate, fun and successful.
• Increased teacher confidence and interest in teaching nutrition.
• Increased likelihood that teacher would do more nutrition on own.
Negative Response to INP
• Institutional barriers will prevent full implementation of program by classroom teacher
(lack of money, time for preparing, classroom support).
• Classroom activities still required significant preparation and planning time by teachers.
• Teachers needed adult support when doing classroom activities.
1.2
Interview Questions for Nicole Turner-Ravana
1) Do you think incorporating gardening and cooking lessons is an effective way to teach
children about nutrition?
2) Do you believe the interactive element of the program would improve children’s interest?
3) Do you think teachers would embrace a more interactive nutrition education plan?
4) Is a new nutrition education plan a financially feasible option in the PSD school sytem?
Glossary:
1) BMI- A measure of body fat based on height and weight ("What is Obesity").
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20. 2) Cardiovascular Disease- Heart and blood vessel disease associated with plaque buildup in
the walls of the arteries which leads to blood clots and obstruction of blood flow which
can lead to heart attack or stroke ("What Is Cardiovascular Disease?").
3) Diabetes- A chronic condition that affects the way the body processes blood sugar
(glucose) ("Diagnosing Diabetes and Learning About Prediabetes").
4) Lipid levels- A blood test is conducted to screen for a lipid profile to determine the total
cholesterol, “bad” cholesterol, “good” cholesterol and triglycerides (Manios,
Moschanreas, et al.).
5) Obesity- A disorder involving excessive body fat that increases risk of health conditions
("What is Obesity”).
6) Overweight- Having an excess amount of body fat and weight than is healthy compared
to height ("What is Obesity").
7) Prediabetes- A condition in which blood sugar is high, but not high enough to cause type
2 diabetes ("Diagnosing Diabetes and Learning About Prediabetes").
8) Self efficacy- The extent the one believes in one’s ability to complete tasks and reach
goals (Bandura, A.).
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