A Pilot School-Based Healthy Eating and Physical Activity Intervention Improves Diet, Food Knowledge, and Self-Efficacy for Native Canadian Children

Abstract

The Sandy Lake school-based diabetes prevention program is a culturally appropriate intervention for Ojibway-Cree students in the 3rd, 4th, and 5th grades. This paper reports the results of the program in changing dietary intake behaviors and related psychosocial factors. Physical activity results are not included. The study was a pretest/post-test, single-sample design conducted during the 1998-1999 school year. A total of 122 students completed all 4 measurements (anthropometry, 24-h dietary recall, and 2 questionnaires), at baseline and follow-up. There were significant increases (P < 0.0001) in dietary intention, dietary preference, knowledge, and dietary self-efficacy, and in the curriculum knowledge scale between baseline and follow-up. Intervention exposure was significantly associated with being in the highest category for knowledge about foods that were low in dietary fat [Medium Exposure odds ratio (OR): 3.4; P < 0.05; High Exposure OR: 6.4; P < 0.05], being in the highest category for dietary self-efficacy (Medium Exposure OR: 3.7; P < 0.05; High Exposure OR: 3.9; P < 0.1), being in the highest category for knowledge about curriculum concepts (Medium Exposure OR: 3.4; P < 0.05; High Exposure OR: 9.4: P < 0.01), and for having met the age + 5 g dietary fiber intake/d (Medium Exposure OR: 2.9; P < 0.1; High Exposure OR: 11.0; P < 0.01). Exposure to the intervention was not associated with dietary intent or the percentage of energy from dietary fat. This program was associated with improved knowledge and the psychosocial factors related to healthy eating and dietary fiber intake of students in a remote First Nations community.

Nutrition interventions for the prevention of type 2 diabetes

“…food service at schools Results: Repeated measures between 1994 and 2002 showed increases in BMI and skinfolds; PA, fitness and TV watching showed improvements by 1999 but these improvements were not maintained by 2002; key high-fat high-sugar foods decreased but so did fruit and vegetables Conclusion: Long-term results disappointing NEEMA* (18,73) Fifty-eight children, 4th grade from six schools, > 40% African-American enrolment Design: pretest and post test, single sample design, 7 weeks Aim: the objectives were to decrease dietary saturated fat intake, increase fibre intake and increase PA in African-American children; regarded as pilot study for African-Americans Intervention: health class and physical education curriculum sessions, school cafeteria intervention, family programme, after-school health club; based on social cognitive and social ecological theory and culturally adapted Results: Fitness laps increased, fasting capillary glucose and percentage body fat decreased Conclusion: The NEEMA pilot study provided teacher feedback useful for revising the NEEMA health curricula and positive preliminary impact of the PA class on children's fitness and blood glucose levels Zuni Pueblo of New Mexico (45) Seventy-two Zuni pupils, thirty-seven Anglo pupils (English-speaking Caucasians), two high schools, native American youth Design: multiyear cross-sectional evaluation of 4 years, comparison of Zunis with Anglos Aim: To change behaviours known to influence DM risk, i.e. food intake, PA and knowledge of DM Intervention: development of a youth fitness centre with equipment and instructors at the school; school food service improved healthy foods available and water cooler bottles replaced sugared soft drinks; DM prevention was addressed by the school curriculum Results: Plasma glucose values normal at baseline and no differences between Zuni and Anglos; fasting and 30 min insulin were significantly higher in Zuni at baseline but decreased; at 3 years males (only) values were same as Anglos Conclusion: intervention can improve insulin levels Junior high school (20) Seventy-three children (forty-nine in intervention group, twenty-four in control group), 8th grade, one junior high school, predominantly Hispanic Design: RCT Aim: to evaluate the effects of a 3-4 month intervention of health, nutrition and PA on DM risk Intervention: classroom curriculum of fourteen sessions of 45 min each on nutrition education and PA. Three PA sessions per week Results: reduction in body fatness, insulin resistance and C-reactive protein and IL-6 Conclusion: short-term intervention is beneficial and affects multiple DM risk factors Sandy Lake Diabetes Prevention Programme (15) 122 Ojibway-Cree children; 3-5th grade students from a Native North American reserve in Ontario, Canada Design: pretest and post-test, single sample design, 2 years Aim: focus on knowledge and skill development related to healthy eating, PA and DM education Intervention: mainly a DM prevention curriculum of sixteen weekly 45 min teacher-led sessions; a family and peer component, environment and school meal components; based on social cognitive and social ecological theory and culturally adapted Results: increases in dietary intention, preference, knowledge and self-efficacy and in curriculum knowledge scale after the intervention; % energy from fat decreased in boys; increased exposure to intervention was associated with meeting the fibre recommendation Conclusion: intervention associated with improved knowledge and psycho-social factors related to healthy eating and dietary fibre intake Bienestar (Well-Being)…”

“…In a review of school-based diabetes prevention programmes (14) most of the six programmes were aimed at minority groups in the USA and Canada (15)(16)(17)(18)(19)(20) . All these studies were considered to be pilot studies and were done in one or two schools and few had control groups or randomly-assigned subjects to treatment.…”

Diabetic Mario: Designing and Evaluating Mobile Games for Diabetes Education

“…To measure lifestyle knowledge enhancement, we used the health knowledge questionnaire developed by Saksvig and colleagues [29], based on previous work from the CATCH Health Behaviors Program [30] and the Kahnawake Schools Diabetes Prevention Program [31]. The questionnaire aims to measure change in diet and physical activity psychosocial constructs in children over time.…”

Effect of a School-based Nutrition Education Program on the Nutritional Status of Primary School Children

“…Some other studies also did not observe any differences in healthy nutritional behaviors between the intervention and control groups after the nutrition education intervention (24)(25)(26). In previous studies, using behavioral changes models and theories resulted in acceptable changes in children, and their constructs can act as mediators to translate knowledge to behavior (27,28). These models and constructs can be used in future studies in children to help them changing their behaviors more successfully.…”