title: Nutrition education intervention improves vegetable-related attitude, self-efficacy, preference, and knowledge of fourth-grade students.
abstract: BACKGROUND
  Impact of a classroom-based, standardized intervention to address limited vegetable consumption of fourth graders was assessed.
  
  
  METHODS
  A 4-lesson, vegetable-focused intervention, revised from extant materials was repurposed for Pennsylvania fourth graders with lessons aligned with state academic standards. A reliability-tested survey was modified, then examined for face and content validity and test-retest reliability. Lessons and evaluation materials were modified through an iterative testing process with educator feedback. A nonequivalent control group design was stratified by local Supplemental Nutrition Assistance Program Education (SNAP-Ed) partnering organizations with random assignment of participating elementary schools as control (N = 68) or intervention (N = 72) treatments. Independent t-tests compared control and intervention group changes. A mixed effects model was created to account for classroom effects from the nested sampling method of selecting classrooms within SNAP-Ed partnering organizations. General linear model univariate analyses of variance were conducted to assess intervention effects considering gender, and food preparation/cooking experience.
  
  
  RESULTS
  During a 3- to 5-week time frame, 57 intervention classrooms (N = 1047 students) and 51 control classrooms (N = 890) completed pre- and post-testing. Intervention students improved in vegetable-related attitude, self-efficacy, preference, and knowledge scores (p < .001). For example, intervention vegetable preference increased 1.56 ± 5.80 points; control group mean increase was only 0.08 ± 4.82 points. Group differences in score changes were not affected by gender or interactions between gender and food preparation/cooking experience with family.
  
  
  CONCLUSIONS
  A defined intervention delivered in a SNAP-Ed setting can positively impact mediators associated with vegetable intake for fourth-grade students.
authors.affiliation: Pennsylvania State University, 135 E. Nittany Ave., Suite 405, State College, PA 16801, USA. dew177@psu.edu
authors.forename: Denise E
authors.initials: DE
authors.lastname: Wall
authors.forename: Christine
authors.initials: C
authors.lastname: Least
authors.forename: Judy
authors.initials: J
authors.lastname: Gromis
authors.forename: Barbara
authors.initials: B
authors.lastname: Lohse
mesh_terms: D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002664:Child Nutritional Physiological Phenomena; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D010414:Pennsylvania; D015397:Program Evaluation; D012574:Schools; D020377:Self Efficacy; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D014675:Vegetables