- Title
- Nutrition education and assessment methods for children: an investigation of methods, current nutrition education practices and opportunities in Australian primary schools
- Creator
- de Vlieger, Nienke Maria
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2020
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: In Australia, approximately 1 in 4 children have overweight or obesity. Contributing factors to this are the consumption of large portion sizes, continuous access to convenient and inexpensive energy-dense, nutrient-poor foods which displaces nutrient dense foods including fruit and vegetables. Only about half of Australian children meet the recommended daily intake for macro- and micronutrients. As children with overweight are likely to become adults with overweight, the personal and economic burden of overweight is substantial. Overweight adults are more likely to suffer from comorbidities such as type 2 diabetes, coronary heart disease and certain type of cancers. While overweight children do not suffer from chronic disease as much as adults, the stigma and bias experienced is likely to be psychologically damaging. In order to prevent overweight in children, a holistic approach is recommended. Educating children on healthy eating habits has been found to be effective in changing some eating behaviours. Given most children spend a significant portion of their time at school, the school environment is an opportune place for standardised nutrition education. However, the extent and content of nutrition education in Australian primary schools is unknown. More in-depth information is required before a curriculum-based nutrition knowledge intervention could be implemented into Australian primary schools. AIM: The purpose of my thesis was to develop a curriculum based nutrition knowledge program that teachers could use for nutrition education. Therefore, the extent and limitations of nutrition education in Australian primary schools needed to be explored and the acceptability and feasibility of a potential program informed by teachers, parents and students needed to be investigated. Hence, the current nutrition literacy and gaps in children’s knowledge were mapped in order to tailor the program. Methods: An online survey was developed specifically to explore the opinions and attitudes of teachers in regard to nutrition education in school. Year 5 and 6 students (aged 9 to 12 years) and a parent were invited to the University for an interview, a standardised food sorting task and a nutrition knowledge questionnaire. This was used to identify gaps in children’s nutrition knowledge. As a nutrition knowledge questionnaire for Australian children did not exist, one was developed by adapting an existing and validated Belgian nutrition knowledge survey. The nutrition knowledge questionnaire developed for Australian children (the CNK-AU) was tested for validity and reliability among a sample of year 5 and 6 primary school students. Furthermore, the ability of children to estimate portion sizes using different portion size estimation aids (PSEAs) was investigated in a systematic literature review. Lastly, a serious game called VitaVillage was developed and pilot tested for its impact on nutrition knowledge and likeability among a sample of year 5 and 6 students. Results: The teachers were positive towards enhancing nutrition education in schools, but indicated having a lack of time in class for teaching non-core subjects. Furthermore, other barriers identified included lack of self-efficacy concerning nutrition and no access to useful resources. Children and their parents reported they valued healthy eating and nutrition education and believe standardised nutrition education in school is essential. Children would like the nutrition education to be interactive and fun. The CNK-AU identified three gaps in the children’s nutrition knowledge: 1) Australian Guide to Healthy Eating recommendations and serving sizes, 2) nutrition label literacy and 3) nutrient functions. The CNK-AU was found to be a reliable nutrition knowledge questionnaire. Using a serious game for nutrition education was proposed as a solution to the teacher’s barriers identified in the earlier studies. In addition, for many children, playing a game is enjoyable and interactive. As serious games have been found to be effective in increasing nutrition knowledge, a new game called ‘VitaVillage’ was developed. In this game, the player takes the role of a farmer that has to increase the town’s health by completing quests for the benefit of the villagers. They have to acquire the correct food product’s seeds in the town’s shop and are able to then grow them into fruits or vegetables by answering questions about the food or its related vitamin/mineral content. They can also receive bonus points by answering single questions from the villagers about balanced meals, the AGHE serves, nutrient labels, food safety, food groups and food sources. VitaVillage was found to significantly increase children’s nutrition knowledge. In addition, the participants rated VitaVillage 70 out of 100 for overall likeability. Conclusion: Using a serious game for curriculum-based nutrition education can overcome barriers identified by teachers. A serious game developed by nutrition experts is ready-to-go, high quality, can be integrated into other subjects, is engaging and easy to use for teachers and enjoyable for children. The gaps identified in Australian children’s nutrition knowledge through my thesis can make a valuable contribution to the knowledge base in this area. These gaps need to be addressed and the point of focus in VitaVillage and future nutrition knowledge interventions. VitaVillage was found to be enjoyable and effective. Further developments of VitaVillage could focus including additional cross-curricular content, incorporating features that make the game more enjoyable and adapting the game for varying ages and cultures. Furthermore, future studies could investigate VitaVillage’s potential in influencing children’s eating behaviour.
- Subject
- nutrition; education; australia; children; primary; school; serious game; cross-curricular; game; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1423879
- Identifier
- uon:37989
- Rights
- Copyright 2020 Nienke Maria de Vlieger
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 9 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 2 MB | Adobe Acrobat PDF | View Details Download |