Evaluation of a Kindergarten-based Nutrition Education Intervention for Pre-school Children in China Abela, Benjamin III; De Castro, Ricardo; Hernandez, Luisa

Introduction Unhealthy behaviours – Develop in early childhood – Parental influences Education of both children and parents Pre-school period is an essential time – Formation of behaviors

Introduction Chinese nutrition – Color, smell, taste, apperance, etc. > balance of nutrition – Serve as rewards – Nutritional status improved, but morbidity and mortality haven’t (2002 China National Nutrition and Health Survey) – Morbidity rate malnutrition High in indigent areas – Morbidity rate excess nutrition High in urban and rural areas

Methods Sampling – Hefei (capital of Anhui province, Eastern China) 2 kidgergartens (East and West) 3 kindergartens (Central) Stratified randomization – Intervention (1 east – 1 west – 2 central = 4 kindergartens) » 1252 child-parent pairs – Control (1 east – 1 west – 1 central = 3 kindergartens) » 850 child-parents pairs

Methods Sampling – Total children = years old (2 nd to 3 rd grade) – Final division Intervention = 1237 Control = 831 – Informed consent

Intervention Design 4 intervention kindergartens – Monthly nutrition education sessions over 2 semesters Interventions – Monthly nutrition curriculums Nutrition graduate students – Basic nutrition information (National Dietary Guidelines for China) – Skill for food arranging and cooking – Benefits of physical activity At least 8 lectures or activities per semester during the 1 year period

Intervention Design Interventions – Illustrated book IG: Nutritional theme CG: General picture stories – Pamphlets Nutritional information IG: Healthy lifestyle behaviors (parents concerns were addressed) – 2 promotional pictures Providing information about nutrition – Unhealthy behaviors & good lifestyle behaviors

Data Collection Collection – Pre-test (baseline) Baseline, social and demographic – Age – Gender – Parental education – Family income – Mid-term (6 months) – Post-test (1 year) Self-administered questionnaires

Measures Self-administered questionnaire – 14 items w/ a 3-point scale (frequently, occasionally and no) – Parental nutritional knowledge scale – 20 items Correct = 1 Incorrect = 0 – Cronbach’s a coefficient = 0.771

Measures Parents attitudes – Child’s preferences – Nutritional value of foods – Nutritional needs of the child – Own eating habits – Cost of food – Frequency of consumption (preceding study)

Measures Body weight and body height – Pre-term, midline and post-term BMI Nutritional status – Z-scores for height-for-age and weight-for-age (WHO child growth standards)

Discussion Both genetic and environmental factors play significant roles in growth and development Adequate nutrition promotes children’s physical development and learning abilities Critical period of childhood – Eating habits and behaviours are established – Nutrition education improves children’s dietary habits and behaviours

Discussion Kindergarten-based education is a popular method for conducting nutrition intervention for pre-schoolers, and parental involvement influences the effects of any intervention in a positive manner. Parental influence is especially crucial in developing nutritional behaviours in children.

Discussion The results indicate that a one-year intervention programme produces beneficial behavioural changes among children – Decreasing unhealthy dietary behaviours – Increasing healthy lifestyle behaviours No significant effect on height and weight

Discussion All parents in the intervention group showed a statistically significant improvement in their general nutrition-related knowledge Nutrition education and promotion of child growth and development should be the focus of pre-school education to encourage children to develop good dietary habits.

Conclusion