Theresa Spezzano

The Shaping Healthy Choices Program: Design and Implementation Methodologies for a Multicomponent, School-Based Nutrition Education Intervention

OBJECTIVE To provide a framework for implementation of multicomponent, school-based nutrition interventions. This article describes the research methods for the Shaping Healthy Choices Program, a model to improve nutrition and health-related knowledge and behaviors among school-aged children. DESIGN Longitudinal, pretest/posttest, randomized, controlled intervention. SETTING Four elementary schools in California. PARTICIPANTS Fourth-grade students at intervention (n = 252) and control (n = 238) schools and their parents and teachers. Power analyses demonstrate that a minimum of 159 students per group will be needed to achieve sufficient power. The sample size was determined using the variables of nutrition knowledge, vegetable preference score, and body mass index percentile. INTERVENTION A multicomponent school-based nutrition education intervention over 1 academic year, followed by activities to support sustainability of the program. MAIN OUTCOME MEASURES Dietary and nutrition knowledge and behavior, critical thinking skills, healthy food preferences and consumption, and physical activity will be measured using a nutrition knowledge questionnaire, a food frequency questionnaire, a vegetable preferences assessment tool, the Test of Basic Science Process Skills, digital photography of plate waste, PolarActive accelerometers, anthropometrics, a parent questionnaire, and the School and Community Actions for Nutrition survey. ANALYSIS Evaluation will include quantitative and qualitative measures. Quantitative data will use paired t, chi-square, and Mann-Whitney U tests and regression modeling using P = .05 to determine statistical significance.

A Multicomponent, School-Based Intervention, the Shaping Healthy Choices Program, Improves Nutrition-Related Outcomes

Objective: To evaluate the effectiveness of the Shaping Healthy Choices Program (SHCP). Design: A clustered, randomized, controlled intervention lasting 1 school year. Setting: Schools in northern and central California. Participants: Fourth‐graders (aged 9–10 years) at 2 control schools (n = 179) and 2 intervention schools (n = 230). Intervention: Garden‐enhanced education, family, and community partnerships; increased regionally procured produce in the lunchroom; and school‐site wellness committees. Main Outcome Measures: Changes in body mass index (BMI) percentiles/Z‐scores; nutrition knowledge, science process skills, and vegetable identification and preferences; and reported fruit and vegetable intake. Analysis: Student t test, chi‐square, ANOVA of change, and multilevel regression mixed model to evaluate change in outcomes with school as a random effect to account for cluster design effects. Statistical significance was set at P < .05. Results: There was a greater improvement in BMI percentile (−6.08; P < 0.01), BMI Z‐score (−0.28; P < .001), and waist‐to‐height ratio (−0.02; P < .001) in the intervention compared with the control schools. Conclusions and Implications: The SHCP resulted in improvements in nutrition knowledge, vegetable identification, and a significant decrease in BMI percentiles. This supports the concept that the SHCP can be used to improve the health of upper elementary school students.

Healthalicious Cooking: Learning about Food and Physical Activity: Lesson 6. Make It Fun: Eat and Share!

Author(s): Smith, Dorothy; Horowitz, Marcel; Neelon, Marisa; Spezzano, Theresa; Lippitt, Nancie; McMurdo, Tammy J.; Kaiser, Lucia | Abstract: Lesson 6. Make It Fun: Eat and Share! This after-school curriculum is a great setting to promote a healthy lifestyle with good foods and physical activity, helping kids build health skills that will last a lifetime.

Healthalicious Cooking: Learning about Food and Physical Activity: Lesson 4. Make It Colorful: Choose Fruits and Veggies by Color!

Author(s): Smith, Dorothy; Horowitz, Marcel; Neelon, Marisa; Spezzano, Theresa; Lippitt, Nancie; McMurdo, Tammy J.; Kaiser, Lucia | Abstract: Lesson 4. Make It Colorful: Choose Fruits and Veggies by Color! This after-school curriculum is a great setting to promote a healthy lifestyle with good foods and physical activity, helping kids build health skills that will last a lifetime.

Healthalicious Cooking: Learning about Food and Physical Activity: Lesson 1. Let's Make It Clean: Wash Up!

Author(s): Smith, Dorothy; Horowitz, Marcel; Neelon, Marisa; Spezzano, Theresa; Lippitt, Nancie; McMurdo, Tammy J.; Kaiser, Lucia | Abstract: Lesson 1. Lets Make It Clean: Wash Up! This after-school curriculum is a great setting to promote a healthy lifestyle with good foods and physical activity, helping kids build health skills that will last a lifetime.