Evaluating OzHarvest’s primary-school Food Education and Sustainability Training (FEAST) program in 10–12-year-old children in Australia: protocol for a pragmatic cluster non-randomized controlled trial

Abstract

Background The promotion of healthy eating is a public health priority. Poor dietary behaviours, including low fruit and vegetable (F&V) consumption are of particular concern among children. Novel nutrition promotion strategies are needed to improve F&V consumption. Sustainability education could be used to support nutrition education within the school context. The purpose of this paper is to report the protocol for impact and process evaluation of the school-based Food Education and Sustainability Training (FEAST) program, designed to educate children about sustainability, food waste and nutrition, using hands-on cooking activities. Methods A pragmatic, parallel, cluster non-randomized controlled trial with pre- and post-measures, will be implemented among 20 primary schools (10 intervention vs 10 wait-list-control) within NSW, Australia, involving children in Grades 5–6. FEAST is a curriculum-aligned program, delivered as a 1.5-h lesson/week, for a 10-week unit of inquiry, incorporating theory and cooking. FEAST was developed using theoretical frameworks which included Social Cognitive Theory and the Precede-Proceed Planning model. Primary outcomes include children’s self-reported F&V intakes (serves/day). Food literacy constructs such as: nutrition knowledge, food preparation and cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours and food production knowledge, will be assessed as secondary outcomes. Process evaluation will assess program reach, adoption, implementation, maintenance, satisfaction and perceived benefits by teachers and students. An online survey (including quantitative and qualitative questions) was developed for administration at baseline (impact evaluation) and immediately post-intervention (impact and process evaluation). Intervention effects on quantitative study outcomes will be estimated with ​generalised linear mixed models, including random effects and will follow the intention-to-treat principles. Open-ended questions embedded within the surveys will be analysed qualitatively using content and thematic analyses. Discussion Results from this trial will provide valuable information on the value of adding environmental sustainability strategies to nutrition education in schools. Results will inform the design of future research and programs focused on primary-school children’s nutrition, sustainability-related behaviours and experiential school-based interventions. Trial registration Trial registered 14th December 2020 with the Australian and New Zealand Clinical Trials Registry (ACTRN12620001347954).

School lunchboxes as an opportunity for health and environmental considerations: a scoping review

“…Seven of the included studies took place in primary schools ( Dresler-Hawke et al , 2009 ; Goldberg et al , 2015 ; Wickramasinghe et al , 2016 ; Folta et al , 2018 ; Boulet et al , 2019 ; Antón-Peset et al , 2021 ; Karpouzis et al , 2021 ) and three of the studies were in preschools or early childhood centres ( Edwards et al , 2013 ; Boyd, 2015 ; Morris et al , 2018 ). Authors of included studies utilized a range of methods to achieve their aims including direct observation for quantification of food waste or food packaging ( Dresler-Hawke et al , 2009 ; Goldberg et al , 2015 ; Antón-Peset et al , 2021 ), questionnaires ( Morris et al , 2018 ; Boulet et al , 2019 ; Antón-Peset et al , 2021 ; Karpouzis et al , 2021 ), interviews ( Boyd, 2015 ) and focus groups ( Edwards et al , 2013 ; Folta et al , 2018 ; Morris et al , 2018 ).…”

“…Seven of the included studies took place in primary schools ( Dresler-Hawke et al , 2009 ; Goldberg et al , 2015 ; Wickramasinghe et al , 2016 ; Folta et al , 2018 ; Boulet et al , 2019 ; Antón-Peset et al , 2021 ; Karpouzis et al , 2021 ) and three of the studies were in preschools or early childhood centres ( Edwards et al , 2013 ; Boyd, 2015 ; Morris et al , 2018 ). Authors of included studies utilized a range of methods to achieve their aims including direct observation for quantification of food waste or food packaging ( Dresler-Hawke et al , 2009 ; Goldberg et al , 2015 ; Antón-Peset et al , 2021 ), questionnaires ( Morris et al , 2018 ; Boulet et al , 2019 ; Antón-Peset et al , 2021 ; Karpouzis et al , 2021 ), interviews ( Boyd, 2015 ) and focus groups ( Edwards et al , 2013 ; Folta et al , 2018 ; Morris et al , 2018 ). Some of the included studies utilized a theoretical framework, including the socio-ecological model ( Edwards et al , 2013 ; Boyd, 2015 ), social cognitive theory ( Goldberg et al , 2015 ; Wickramasinghe et al , 2016 ), the theory of reasoned action ( Karpouzis et al , 2021 ) and funds of knowledge ( Morris et al , 2018 ); others considered various approaches including behavioural ( Boulet et al , 2019 ) and social marketing practices ( Folta et al , 2018 ).…”

“…Authors of included studies utilized a range of methods to achieve their aims including direct observation for quantification of food waste or food packaging ( Dresler-Hawke et al , 2009 ; Goldberg et al , 2015 ; Antón-Peset et al , 2021 ), questionnaires ( Morris et al , 2018 ; Boulet et al , 2019 ; Antón-Peset et al , 2021 ; Karpouzis et al , 2021 ), interviews ( Boyd, 2015 ) and focus groups ( Edwards et al , 2013 ; Folta et al , 2018 ; Morris et al , 2018 ). Some of the included studies utilized a theoretical framework, including the socio-ecological model ( Edwards et al , 2013 ; Boyd, 2015 ), social cognitive theory ( Goldberg et al , 2015 ; Wickramasinghe et al , 2016 ), the theory of reasoned action ( Karpouzis et al , 2021 ) and funds of knowledge ( Morris et al , 2018 ); others considered various approaches including behavioural ( Boulet et al , 2019 ) and social marketing practices ( Folta et al , 2018 ). Study characteristics based on extrapolation of data has been tabulated in Table 1 which also includes aims and main findings.…”

“…Three varying definitions relating to content of lunchboxes were used across the included studies: (i) Natural/whole/unprocessed vs. packaged/junk/processed foods ( Boyd, 2015 ; Goldberg et al , 2015 ; Folta et al , 2018 ; Morris et al , 2018 ; Karpouzis et al , 2021 ); (ii) Food choices that follow advice based on guidelines and policies ( Dresler-Hawke et al , 2009 ; Boyd, 2015 ); (iii) Nutrient-rich vs. nutrient-poor quality of lunchbox foods (mainly saturated fats, salt and sugar) ( Dresler-Hawke et al , 2009 ; Edwards et al , 2013 ; Goldberg et al , 2015 ; Wickramasinghe et al , 2016 ; Folta et al , 2018 ). Two studies ( Boulet et al , 2019 ; Antón-Peset et al , 2021 ) had neither an explicit definition or an indirect reference to one for healthy foods or healthy eating as they were food waste focussed.…”

A cross-sectional exploratory study of food literacy among Saudi parents of adolescent children aged 10 to 19 years

“…Intriguingly, it has been established that helping with family meal preparation improves adolescents' food quality and eating behaviors (33). Programs or interventions that teach cooking skills to adolescents could be good initiatives to improve their nutrition status; of these programs are OzHarvest's primary-school Food Education and Sustainability Training (FEAST) program (34), Food Sensation for Schools (FSS) (35), Fuel Your Future (FYF) (36), Teens CAN: Comprehensive Food Literacy in Cooking, Agriculture, and Nutrition (37), Cook IT UP (38), and Food Literacy Project's Youth Community Agriculture Program (YCAP) (39). Ensuring adequate parental food literacy could positively impact everyone in the community by improving the health and nutritional status of the parents and their children.…”