title: Unravelling the effect of the Dutch school-based nutrition programme Taste Lessons: the role of dose, appreciation and interpersonal communication.
abstract: To unravel the effect of school-based nutrition education, insight into the implementation process is needed. In this study, process indicators of Taste Lessons (a nutrition education programme for Dutch elementary schools) and their association with changes in behavioural determinants relevant to healthy eating behaviour are studied.
  
  
  
  The study sample consisted of 392 Dutch primary school children from 12 schools. Data were collected using teacher and child questionnaires at baseline, and at one and six months after the intervention. Multilevel regression analyses were conducted to study the association between dose, appreciation and children's engagement in interpersonal communication (talking about Taste Lessons with others after the lessons), and change in knowledge, awareness, skills, attitude, emotion, subjective norm and intention towards two target behaviours.
  
  
  
  With an average implementation of a third of the programme activities, dose positively predicted change in children's subjective norm of the teacher after one month. Teachers and children highly appreciated Taste Lessons. Whereas teacher appreciation was inversely associated, child appreciation was positively associated with children's change in awareness, emotion and subjective norm of teachers after one month and in attitude and subjective norm of parents after six months. Interpersonal communication was positively associated with children's change in five determinants after one month and in attitude and intention after six months.
  
  
  
  The implementation process is related to the programme outcomes of Taste Lessons. Process data provide valuable insights into factors that contribute to the effect of interventions in real-life settings.
authors: Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands. marieke_fries@hotmail.com.
authors: Marieke C E
authors: MC
authors: Battjes-Fries
authors: Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands.
authors: Ellen J I
authors: EJ
authors: van Dongen
authors: Division of Strategic Communication, Wageningen University, 6700 EW, Wageningen, The Netherlands.
authors: Reint Jan
authors: RJ
authors: Renes
authors: Steunpunt Smaaklessen & EU Schoolfruit, Division of Food Chemistry, Wageningen University, 6700 AA, Wageningen, The Netherlands.
authors: Hante J
authors: HJ
authors: Meester
authors: Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands.
authors: Pieter
authors: P
authors: Van't Veer
authors: Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700 EV, Wageningen, The Netherlands.
authors: Annemien
authors: A
authors: Haveman-Nies
mesh_terms: D000328:Adult; D001364:Awareness; D002648:Child; D003142:Communication; D004032:Diet; D004644:Emotions; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D007398:Interpersonal Relations; D008297:Male; D009426:Netherlands; D010290:Parents; D012572:School Health Services; D000070777:School Teachers; D012574:Schools; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D013649:Taste
keywords: Effect evaluation; Implementation; Nutrition education; Primary school; Process indicators