Barbara J. Struempler

School gardens: an experiential learning approach for a nutrition education program to increase fruit and vegetable knowledge, preference, and consumption among second-grade students.

OBJECTIVE To examine the effects of a school garden on childrens fruit and vegetable knowledge, preference, and consumption. DESIGN Self-report questionnaires, interview-style taste and rate items, lunchroom observations. SETTING An elementary school. PARTICIPANTS Second-grade students (n = 115). INTERVENTION Participants were assigned to one of 3 groups: (1) nutrition education and gardening (NE+G) treatment group, (2) nutrition education only (NE) treatment group, or (3) control group (CG). Both treatment groups received classroom instruction, and the NE+G group also received a school gardening experience. MAIN OUTCOME MEASURES Fruit and vegetable knowledge, preference, and consumption. ANALYSIS Analyses of variance (alpha = .05). RESULTS Participants in the NE+G and NE treatment groups exhibited significantly greater improvements in nutrition knowledge and taste ratings than did participants in the CG. Moreover, the NE+G group was more likely to choose and consume vegetables in a lunchroom setting at post-assessment than either the NE or CG groups. CONCLUSIONS AND IMPLICATIONS School gardens as a component of nutrition education can increase fruit and vegetable knowledge and cause behavior change among children. These findings suggest that school administrators, classroom teachers, and nutrition educators should implement school gardens as a way to positively influence dietary habits at an early age.

A Community Health Advisor Program to reduce cardiovascular risk among rural African-American women

The Uniontown, Alabama Community Health Project trained and facilitated Community Health Advisors (CHAs) in conducting a theory-based intervention designed to reduce the risk for cardiovascular disease (CVD) among rural African-American women. The multiphased project included formative evaluation and community organization, CHA recruitment and training, community intervention and maintenance. Formative data collected to develop the training, intervention and evaluation methods and materials indicated the need for programs to increase knowledge, skills and resources for changing behaviors that increase the risk of CVD. CHAs worked in partnership with staff to develop, implement, evaluate and maintain strategies to reduce risk for CVD in women and to influence city officials, business owners and community coalitions to facilitate project activities. Process data documented sustained increases in social capital and community capacity to address health-related issues, as well as improvements in the communitys physical infrastructure. This project is unique in that it documents that a comprehensive CHA-based intervention for CVD can facilitate wide-reaching changes in capacity to address health issues in a rural community that include improvements in community infrastructure and are sustained beyond the scope of the originally funded intervention.

Changes in Fruit and Vegetable Consumption of Third-Grade Students in Body Quest: Food of the Warrior, a 17-Class Childhood Obesity Prevention Program

OBJECTIVE To increase fruit and vegetable (FV) consumption of youth in Body Quest: Food of the Warrior (BQ), a childhood obesity prevention program. DESIGN Quasi-experimental. SETTING Supplemental Nutrition Assistance Program-Education eligible schools (n = 60). PARTICIPANTS Third-grade students (n = 2,477). INTERVENTION Treatment groups (n = 1,674) self-reported foods consumed through the School Lunch Program for 17 weekly assessments; they participated in BQ curriculum, iPad app education, and weekly FV tastings. Control groups (n = 803) completed only pre- and post-assessments. MAIN OUTCOME MEASURE Weekly FV consumed through School Lunch Program. ANALYSIS ANCOVA and growth modeling. RESULTS From before to after the program, the treatment group demonstrated significant, moderate increases in fruit (P < .01) and vegetable (P < .001) consumptions, increasing from 7 to 8 weekly FV servings. After the program, the treatment group consumed significantly (P < .001) more FV than the control group. Fruit and vegetable consumption increased to class 10 and then stabilized. From before to after the program, all FV predictors were significantly higher and included gender (vegetables), race (FV), and free/reduced lunch (fruit). CONCLUSIONS AND IMPLICATIONS Nutrition programs can increase FV intake. Even moderate increases in FV intake can be an initial step for the prevention of chronic disease.

Lessons Learned from the Uniontown Community Health Project.

OBJECTIVE To compile lessons learned from the Uniontown Community Health Project. METHODS Lessons-learned information was gathered from project staff and community volunteers. RESULTS Analysis led to the identification of 6 lessons: (a) Establish personal working relationships in communities; (b) find a local community coordinator to lead efforts; (c) be patient in implementing a community health advisor (CHA) model; (d) be flexible and emphasize simplicity when implementing community activities; (e) recognize that meeting research goals requires compromise; and (f) plan transfer of project activities to the community from the beginning. CONCLUSION These lessons may benefit others implementing CHA programs.

Once Upon a Time in America: Interactive Nutrition Evaluation

Participants of nutrition education classes sponsored by the State Cooperative Extension System are typically evaluated with a pencil-and-paper design.1,2 At the initial meeting, participants answer questions before any intervention. Such “testing” can generate apprehension among participants and foster an uninviting environment. The purpose of this research was to create an enjoyable first-time experience for individuals participating in Cooperative Extension education series programs.This environment helps foster a positive relationship between participants and the educator. Once Upon a Time in America (OUTIA) was developed to create an engaging, age-appropriate, easy-to-use evaluation tool for fourth and fifth grade students in a nutrition education program. The OUTIA evaluation tool is composed of 2 components used simultaneously by students. A nutrition evaluation questionnaire assesses personal nutrition knowledge and behaviors, whereas a Jeopardy-like game quizzes students’ knowledge of food history and other social science concepts.The OUTIA evaluation tool served as preand postassessments to determine changes in students’ nutrition knowledge and behavior that resulted from participation in a 6-week nutrition education program. The methods for OUTIA used cooperative learning tenets.3 Students were accountable for their own nutrition knowledge and behavior as they individually completed the questionnaire. Concomitantly, collaboration and positive interdependence were used as students answered game questions in teams. The colorful OUTIA questionnaire (Figure 1) includes 15 nutrition knowledge and 26 eating behavior questions.The questions assessed concerned (1) calcium consumption, (2) fruit and vegetable consumption, (3) Food Guide Pyramid4 knowledge, (4) breakfast consumption, (5) afterschool activities, (6) soft drink consumption, (7) nutrients in foods knowledge, and (8) functions of nutrients knowledge. The questions are yes/no, matching, and multiple choice. The Jeopardy-like game features a colorful map of the United States (Figure 2). Both preand postassessment games contain 16 game cards with point values of 25, 50, 75, and 100 and 1 bonus card. Preassessment game cards are divided into 4 categories: Foods, People, Places, and Animals. Postassessment categories are States, Symbols,Trivia, and the USA.A game question is printed on the back of 14 of the 16 game cards. Game questions are intended to reinforce fourth and fifth grade State Board of Education standards for social science concepts. A unique aspect of the game is its use of 2 game cards, called “Go To” cards. These cards instruct students to stop playing the game as a team and to complete a section of the questionnaire as an individual. Because the fronts of the “Go To” cards and the game cards are identical, students were unaware when a “Go To” card would be selected. When selected, the nutrition educator ensured that all teamwork ceased and that individuals answered questionnaire questions alone. Students answered game questions in teams to earn points. The highest scoring team was declared the winner. Approximately 45 minutes were required to complete the evaluation tool. OUTIA was created with a lowlevel readability. The Flesch-Kincaid Readability score5 for the questionnaire (1.8) was below a second grade level. For the game, the score (5.6) was higher owing to the nature of game questions. Words such as “pancakes,” “griddlecakes,” and “flapjacks” are lengthy but recognized by students. The content validity of OUTIA was determined in pilot tests involving university nutritionists, 20 nutrition educators, and 20 schoolteachers and their classes of fourth and fifth grade students. OUTIA was implemented statewide as preand postassessments among 773 students in fourth and fifth grades. Following this implementation, nutrition educators completed a process