Understanding the State of Nutrition Education in the Preschool Environment through the Development of Integrated Education and Evaluation Methods

More than 20% of preschool children in the United States are considered overweight or obese. Effective educational programs aimed at the early prevention of childhood obesity are deemed essential for preventing obesity across the lifespan. Theoretically, the earlier a child is exposed to nutrition education, the greater the opportunity for establishing healthy habits. Unfortunately, limited research exists to support investigators who are developing and implementing nutrition education programs for preschool teachers and children. Therefore, the purpose of this dissertation is to examine the state of nutrition education in the preschool environment using qualitative and quantitative methodologies. Study 1 assessed Head Start teacher experiences related to the incorporation of nutrition education in their classrooms (needs assessment). Adding to the gap in the current literature, researchers proposed a substantive-level model to establish a framework for understanding the state of nutrition education in the preschool environment. The model revealed teachers need more opportunities for training/education in effective teaching methods and nutrition content; financial support for materials; and clear, supportive policies/regulations. Study 2 presents the development and pilot-test of a hands-on, integrative nutrition education curriculum (PEAS: Preschool Education in Agricultural/Nutrition Science) using teachers to identify program strengths, weaknesses, and barriers to implementation. Teachers reported they were willing to repeat and recommend to other teachers the majority of the activities (97%) they observed. They also stated the activities implemented in their classrooms were "Easy" to implement and for their children to understand. Teachers commented positively about the curriculum's ability to expose children to fruits and vegetables and integrate other knowledge/skills. Outcomes indicated PEAS was well received by teachers and feasible in the preschool setting. Overall, the researcher developed educational resource aims to improve methods teachers currently use to incorporate nutrition into their classrooms. Study 3 investigates the reliability and validity of a pictorial method to assess food preferences among preschool children. The approach was developed to serve as a method to assess the long-term impact of the curricular intervention on children's health behaviors (outcome evaluation). The measure demonstrated strong internal reliability (alpha=0.80). Test re-test reliability (Kappa=0.04-0.33) and concurrent validity outcomes were weak to moderate (rs=- 0.25-0.26). Preference responses appeared to be more stable within the measure (i.e. transformed versus whole FV photographs). Preliminary evidence suggests pictorial FV methods may be useful for nutrition educators when establishing baseline preferences among young children. Generally, each individual study served as a step to gather information that will aid in the development of a larger nutrition education intervention for Head Start preschool teachers and children. The nutrition education instruction and evaluation developed approaches have the potential to positively influence current and future programs aimed at improving educational and health outcomes of preschool children. Further, findings from the proposed work can be used to leverage funding for development, implementation, and evaluation of integrative nutrition education programs for preschool children and teachers.