Significant effects of implementation of health-promoting schools on schoolteachers’ nutrition knowledge and dietary intake in Taiwan

Abstract

Objective: Although teachers are the key participants in health-promoting schools (HPS) programme delivery, it is still unknown whether teachers are appropriate health information resources and role models for students with respect to healthy diets. The present study aimed to investigate the effects of implementing HPS programmes on teachers' nutrition knowledge and diets. Design: One HPS programme aiming at dietary intervention (HP-D) and one HPS not aiming at dietary intervention (HP-ND) were selected, along with two nonhealth-promoting (NHP) schools matched for school size and urbanization level with the two HPS. All 361 teachers in the four schools were invited to participate, yielding a 78?4 % overall valid response rate. A structured, self-reported questionnaire was administered, with regression models used for statistical analysis. Results: Teachers in the HP-D group had a mean score of 21?1 on a range of 0-30 for nutrition knowledge, which was significantly higher than the mean scores of 18?5 in the HP-ND group and 19?1 in the NHP group (P , 0?001). Better dietary behaviours were also observed among HP-D teachers. Further, being a 'health education' course instructor was associated with significantly higher scores on nutrition knowledge (b 5 2?6, P , 0?001) and vegetable and fruit consumption (b 5 1?4, P 5 0?02) in the HP-D group than in the NHP group. The HP-ND and NHP groups exhibited similar patterns of non-significant differences compared with the HP-D group. Conclusions: Implementation of a coordinated HPS framework on nutrition and diet was positively correlated with schoolteachers' nutrition knowledge and dietary intake. Inadequate diet and nutrition can slow growth in childhood and increase the risk of health conditions such as obesity, hypertension and certain cancers in adulthood (1,2) . Many children exhibit intakes of food and nutrients below the recommended levels, both internationally and in Taiwan (3)(4)(5)(6)(7) . Educators have recognized the importance of promoting a healthy diet and various nutrition-education programmes have been implemented in schools (8)(9)(10) . In these school-based programmes, teachers play a central role in providing accurate nutrition information to students and responding to students' concerns about diet, nutrition and weight control. In order for schoolteachers to be a valuable source of health information, however, they must be equipped with adequate knowledge (11) . Teachers' knowledge of nutrition affects their willingness and confidence to teach a course on healthy diets (12) , which could influence the implementation of a nutritioneducation programme in their schools. In addition, teachers' unhealthy eating behaviours at school may make them inappropriate role models for students. In a study reported by Kubik et al. (13) , 62 % of teachers reported purchasing beverages from vending machines. In addition, 54 % of teachers did not consume five servings of fruits and vegetables daily. Among physical education teachers, 20 % of women and 13 % of...

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