Kinesiology, Health and Sport Studies Wayne State University Teacher’s Self-Efficacy Regarding Nutrition Education Increases After In-service Training Mariane Fahlman, Nate McCaughtry, Jeffrey Martin, Bo Shen, Sara Flory, Amy Tischler Kinesiology, Health and Sport Studies Wayne State University ABSTRACT METHODS SUMMARY OF THE RESULTS Introduction: Unhealthy dietary patterns that cause disease have been identified by the Centers for Disease Control (CDC) as one of the seven behaviors that contribute to the leading causes of morbidity and mortality. An effective Health Curriculum in school systems is one way to address these patterns among youth; however, one of the common barriers to effective instruction is lack of proper training for teachers, resulting in low teacher self-efficacy and subsequent curricular implementation. Purpose: The purpose of this research was to determine the effectiveness of nutrition in-service training guided by adult learning and constructivist theories on both teaching self-efficacy and intentions to teach nutrition education. Methods: The study was conducted in a large metropolitan setting and approved by the IRB. Two groups of teachers responsible for Health Education participated. The intervention group (n=30) participated in a day-long training designed to prepare them to teach the Michigan Model for Nutrition Education, grades 7-8. The control group (n = 29) was a similar group of teachers that received no training. A 42-item valid and reliable questionnaire was used to determine differences, consisting of questions assessing self-efficacy, (the person’s belief about his or her capability to perform a certain behavior), outcome expectancy (that the behavior will lead to a desired outcome) and outcome value (that the outcome is meaningful). Demographic questions addressed years of experience teaching health, lessons most often taught, and intent to teach topics in the future. Each set of questions was totaled giving a subscale score which was analyzed separately using a 2-groups (Intervention vs. Control) by 2-times (pre-post) ANOVA with repeated measures on the time factor. Results: There were 2 significant main effects for time and group and a significant group x time interaction in self-efficacy and outcome expectancy. There was also a significant time main effect for outcome value and intent to teach. Post hoc analysis revealed that the intervention group scored significantly higher than the control group in all four areas, post-intervention. Conclusion: Results of this study indicate that in-service training increased the number of lessons the intervention teachers intended to teach, as well as their self-efficacy. Because self-efficacy has been strongly linked to teacher effectiveness, efforts should be directed at providing continual training for teachers based on the CDC risk behaviors. INSTRUMENT DEVELOPMENT: The University’s Institutional Review Board approved all aspects of this study. The survey instrument was developed over the course of one year and involved multiple steps designed to insure acceptable reliability and validity.   Survey Instrument Development: Instrument was adapted from that used in previous studies of self-efficacy and health teachers. Review by a panel of experts Pilot tested on a group of health teachers Final Version Adapted  Survey Instrument Content:   42 items 14 demographics and other descriptive information including the number of years teaching health and the curriculum taught 1 item, measuring outcome value, asked respondents to “rank the importance of the skills that students will need as an adult to function adequately in society” from 1 (least important) to 6 (most important). 16 questions addressed self-efficacy expectancy 11 questions addressed outcome expectancy Instrument Reliability and Validity: Construct validity was established using a principal components factor analysis. The subscales were totaled giving a composite score for each factor and tested for internal reliability using Cronbach’s alpha. Efficacy expectancy (.94) and outcome expectancy (.92) were found to be reliable. Since only one item assessed outcome value it was not tested for internal reliability. In order to examine test-retest reliability, the test was administered to fifteen health educators on two occasions, two weeks apart. The stability reliability correlation coefficient was .88 for efficacy expectancy, .89 for outcome expectancy and .94 for outcome value. Statistical Analysis:  Each set of questions was totaled giving a subscale score which was analyzed separately using a 2-groups (Intervention vs. Control) by 2-times (pre-post) ANOVA with repeated measures on the time factor. Individual questions were also analyzed separately using a 2-groups (Intervention vs. Control) by 2-times (pre-post) ANOVA with repeated measures on the time factor. The statistical package used to run all analysis was SPSS (Ver. 16.0), Chicago, IL. Statistical significance was set at p < 0.05. Subjects:  The subjects in this study were 59 health education teachers. Participation was voluntary and schools were selected based on the health teacher’s willingness to participate in the study, undergo in-service training in the curriculum and implement the curriculum during the study time frame. Control schools were selected from a convenience sample of volunteers. Recruitment took place at a state conference attended by health teachers. There were 2 significant main effects for time and group and a significant group x time interaction in self-efficacy and outcome expectancy. There was also a significant time main effect for outcome value and intent to teach. Post hoc analysis revealed that the intervention group scored significantly higher than the control group in all four areas, post-intervention. Table 4. Outcome Value Question Intervention Control p Pre Post Rank the importance of the skills that students will need as an adult to function adequately in society Computer skills 5.4 + 0.7 5.8 + 0.51 4.8 + 0.5 3.3 + 0.62 .023 Conflict resolution skills 3.4 + 0.8 3.7 + 0.51 3.3 + 0.6 2.2 + 0.52 .018 Math skills 1.0 + 0.7 1.5 + 0.51 1.1 + 0.7 1.6 + 0.92 .040 Personal health skills 4.0 + 0.7 4.4 + 0.62 4.2 + 0.9 2.1 + 0.82 .026 Reading skills 5.4 + 0.8 5.5 + 0.61 5.4 + 0.5 3.4 + 0.42 .000 Writing skills 2.4 + 0.8 1.6 + 0.61 2.2 + 0.8 2.3 + 0.42 .001 1 = least important; 6 = most important Like numbers indicate significant difference at post. Table 2. Self-Efficacy Question Intervention Control p Pre Post I believe I can do a good job teaching students about: nutrition 2.4 + 0.71 1.8 + 0.51,2 2.2 + 0.5 2.3 + 0.62 .023 the food pyramid 2.4 + 0.81 1.7 + 0.51,2 2.3 + 0.6 2.2 + 0.52 .018 the health benefits of each food group 2.0 + 0.71 1.5 + 0.51,2 2.1 + 0.7 2.0 + 0.92 .030 serving sizes 1.4 + 0.61,2 2.2 + 0.9 2.1 + 0.82 .026 to read food labels 1.5 + 0.61,2 2.4 + 0.5 2.4 + 0.42 .000 words on packages such as: “lite”, “lean”, etc. 1.6 + 0.61,2 2.2 + 0.8 2.3 + 0.42 .001 evaluate nutritional information for accuracy 2.1 + 0.71 1.6 + 0.51,2 2.0 + 0.6 2.1 + 0.22 .032 healthy weight 2.3 + 0.71 1.6 + 0.71,2 2.4 + 0.92 .004 healthy body images 2.6 + 0.71 1.7 + 0.61,2 2.8 + 0.9 2.7 + 0.72 the role that heredity, food selection, and activity level play in weight control 1.8 + 0.61,2 2.6 + 0.5 2.6 + 0.82 .002 nutrient density 2.2 + 0.81 .297 eating healthy while at a fast food restaurant 2.0 + 0.61 1.3 + 0.61,2 2.6 + 0.2 2.5 + 0.62 .016 I understand health education content well enough to be effective 2.5 + 0.8 2.6 + 0.8 .207 I understand health education theory well enough to be effective 2.2 + 0.71 2.0 + 0.8 2.6 + 0.6 2.5 + 0.7 .105 I know the steps necessary to teach health effectively 2.1 + 0.5 2.2 + 0.4 2.2 + 0.6 .137 I believe I can stimulate students to ask thoughtful question 3.2 + 0.5 3.1 + 0.5 3.4 + 0.6 3.2 + 0.8 .114 1 = strongly agree; 5 = strongly disagree Like numbers (1,2) indicate significant group and time effect. Table 5. Intent to Teach Question Intervention Control p Pre Post I currently teach students about: the food pyramid 2.0 + 0.6 2.3 + 0.6 2.1 + 0.5 2.2 + 0.6 .123 the food groups 2.3 + 0.9 2.5 + 0.6 2.2 + 0.5 .218 to interpret food labels 2.2 + 0.71 1.0 + 0.61,2 2.1 + 0.7 2.0 + 0.92 .030 what product claims such as: “lite”, “low fat” etc mean 3.5 + 0.81 1.7 + 0.61,2 3.2 + 0.9 3.1 + 0.82 .026 about the influences on body image 3.8 + 0.81 1.8 + 0.81,2 3.7 + 0.5 3.6 + 0.42 .000 about the factors that contribute to weight control 3.4 + 0.71 3.3 + 0.8 3.3 + 0.42 .001 how to eat healthy while in a fast food restaurant 3.6 + 0.81 1.9 + 1.01,2 3.2 + 0.6 3.1 + 0.22 .032 How to have a healthy body image 3.5 + 0.91 1.9 + 0.81,2 3.4 + 0.6 3.4 + 0.92 .004 1 = strongly agree; 5 = strongly disagree Like numbers (1,2) indicate significant group and time effect. INTRODUCTION Unhealthy dietary patterns that cause disease have been identified by the Centers for Disease Control (CDC) as one of the seven behaviors that contribute to the leading causes of morbidity and mortality. An effective Health Curriculum in school systems is one way to address these patterns among youth; however, one of the common barriers to effective instruction is lack of proper training for teachers, resulting in low teacher self-efficacy and subsequent inadequate curricular implementation. Bandura’s theory of self-efficacy deals with an individual’s perception of being able to accomplish a specific task. The three essential components of self-efficacy are expectancy (the person’s belief about their capability to perform a certain behavior), outcome expectancy (that the behavior will or will not lead to a desired outcome) and outcome value (that the outcome is meaningful). The level of teacher preparation has been shown to significantly impact teachers’ self-efficacy to deliver high quality health education. Previous research has shown that the more prepared teachers felt, the more health lessons they taught. Teachers with more preparation in health education were more confident and competent in fulfilling their responsibilities Therefore, teacher preparation represents a critical factor for implementing health education programs that result in behavior change in students Table 1. Subject Characteristics (mean + SEM) Intervention Control n=30 n=29 Number of Schools 22 Mean Age (SD) 45.4 + 12.0 47.3 + 7.8 Years in Teaching 18.3 + 3.0 16.8 + 5.2 Average Class Size 42 28 n % Gender Female 18 60 16 55 Male 12 40 13 45 Race Black 19 63 2 7 Asian White 11 37 26 90 Other 1 3 Table 3. Outcome Expectancy Question Intervention Control p Pre Post I believe I can do a good job teaching, the students I teach will be more likely to: to maintain a normal weight 2.0 + 0.61 1.3 + 0.61,2 2.1 + 0.5 2.2 + 0.62 .023 eat according to the food pyramid 2.3 + 0.91 1.5 + 0.61,2 2.3 + 0.6 2.2 + 0.52 .018 eat 5 fruits and vegetables a day 2.2 + 0.71 1.6 + 0.61,2 2.1 + 0.7 2.0 + 0.92 .030 read food labels 2.5 + 0.81 1.7 + 0.61,2 2.2 + 0.9 2.1 + 0.82 .026 to eat a diet low in fat 2.8 + 0.81 1.8 + 0.81,2 2.7 + 0.5 2.6 + 0.42 .000 eat a diet high in whole grains 2.4 + 0.71 2.3 + 0.8 2.3 + 0.42 .001 maintain a healthy weight 2.6 + 0.81 1.9 + 1.01,2 2.2 + 0.6 2.1 + 0.22 .032 have a healthy body image 2.5 + 0.91 1.9 + 0.81,2 2.4 + 0.6 2.4 + 0.92 .004 select nutrient dense foods 2.3 + 0.81 1.7 + 0.71,2 2.5 + 0.9 2.5 + 0.72 eat healthy while at a fast food restaurant 2.6 + 0.5 2.6 + 0.82 .002 change their eating habits 2.3 + 0.4 1 = strongly agree; 5 = strongly disagree Like numbers (1,2) indicate significant group and time effect. CONCLUSIONS Results of this study indicate that in-service training increased the number of lessons the intervention teachers intended to teach, as well as their self-efficacy. Because self-efficacy has been strongly linked to teacher effectiveness, efforts should be directed at providing continual training for teachers based on the CDC risk behaviors. ACKNOWLEDGEMENTS PURPOSE This study was conducted as part of a larger project called the Detroit Healthy Youth Initiative funded by a Carol M. White Physical Education Program (PEP) grant. The contents of this report were developed under a grant from the Department of Education. However, those contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the Federal Government. The purpose of this research was to determine the effectiveness of nutrition in-service training guided by adult learning and constructivist theories on both teaching self-efficacy and intentions to teach nutrition education.