Source: COLORADO STATE UNIVERSITY submitted to NRP
COOKING WITH KIDS: INTEGRATING CLASSROOM, CAFETERIA AND FAMILY EXPERIENCES TO INCREASE FRUIT AND VEGETABLE PREFERENCE AND INTAKE
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
0212371
Grant No.
2006-55215-18718
Cumulative Award Amt.
(N/A)
Proposal No.
2007-05062
Multistate No.
(N/A)
Project Start Date
May 1, 2007
Project End Date
Mar 31, 2011
Grant Year
2008
Program Code
[31.5]- Human Nutrition and Obesity
Recipient Organization
COLORADO STATE UNIVERSITY
(N/A)
FORT COLLINS,CO 80523
Performing Department
Food Science & Human Nutrition
Non Technical Summary
Does cooking and tasting fresh, affordable fruits and vegetables from diverse cultures increase childrenAEs preferences for and consumption of these foods? Will positive experiences with fruits and vegetables in the classroom supported by cafeteria promotion improve acceptance by students? Can family food preparation and eating practices be modified to support more healthful dietary patterns? Do all of these experiences contribute to more healthful food choices, and thus reduce childrenAEs risk for developing obesity and chronic diseases? In light of current dietary patterns, the growing obesity epidemic, and the dramatic decline of food preparation and cooking skills among Americans, this project aims to show that experiential food and nutrition education may feasibly provide a positive impact on childrenAEs fruit and vegetable choices and food related skills through a multi-component intervention involving children from predominantly Hispanic communities, their families, and school personnel. We will investigate the effects of two intensity levels of an innovative experiential classroom cooking program called Cooking with Kids (CWK), on fruit and vegetable intake and determinants of food choice (e.g., fruit and vegetable preference, acceptance of new foods, cooking attitudes, family food preparation and eating practices). Results will include testing of feasible strategies for enhancing food choices and skills among children and adults, and determination of effective program dissemination activities.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7036010101050%
7036050302050%
Goals / Objectives
As food preferences and acceptance patterns indicate, it is crucial to establish healthy eating habits and related behaviors early in life. Teaching healthful eating behavior through repeated practice of cooking skills and increased exposure to a variety of healthful foods has a positive long-term impact on the eating behavior of children, with corresponding implications for long-term health. This project aims to address key factors contributing to healthful food choices of elementary school-aged children through a multi-component intervention involving students, their families, and school personnel. We will investigate the effects of an innovative experiential classroom cooking program called Cooking with Kids (CWK) on fruit and vegetable intake and determinants of food choice (fruit and vegetable preference and availability, cooking attitudes and self-efficacy, and family food preparation and eating practices), involving schools serving primarily a Hispanic population. We will also test the impact of two levels of the classroom intervention on food choice: one a more intensive and presumably richer and more influential cooking experience combined with fresh fruit and vegetable tasting experience, compared to a second less intensive but perhaps more replicable tasting experience. Finally, we will apply the RE-AIM evaluation framework (Glasgow, Vogt, Boles, 1999) to measure the impact of both intervention conditions from a public health perspective, providing information about each condition's comparative reach, efficacy, adoption, implementation and maintenance. In light of current dietary patterns, the growing obesity epidemic, and the dramatic decline of food preparation and cooking skills, the significance of this project is to show that experiential food and nutrition education may feasibly provide significant positive impact on childrens food choices and eating competence. Research Hypotheses: 1. Compared to students in the control condition, students in both intervention conditions will: A. Report greater intake of and preference for fruits and vegetables, B. Report improved family food preparation and eating practices, and C. Report greater cooking self-efficacy and cooking attitudes. We expect students in the more intensive intervention will show greater scores than those in the less intensive intervention.
Project Methods
Specific aims of this project include: Phase I: refine and test CWK classroom, cafeteria, and family intervention components, refine previously piloted instruments to assess determinants of food choice through rigorous validity and reliability testing, and refine and test process and other outcome evaluation measures; Phase II: design and carry out an investigation of the effects of two versions of the CWK program: a) the full CWK classroom Cooking and Tasting curriculum + cafeteria meals + family intervention; compared with b) the CWK Tasting (only) curriculum + cafeteria meals + family intervention; and to c) control, among a cohort of approximately 675 3rd grade students and their parents for two years; and Phase III: disseminate CWK intervention and evaluation components through training and technical assistance to other school districts and community nutrition programs using the Cooperative Extension network. The design includes a research component to test and refine innovative assessment tools for both children and adults within a larger evaluation framework.

Progress 05/01/07 to 03/31/11

Outputs
OUTPUTS: Activities: Phase I: refined and tested Cooking with Kids (CWK) classroom, cafeteria, and family intervention components, refined previously piloted instruments to assess determinants of food choice through rigorous validity and reliability testing, and refined and tested process and other outcome evaluation measures. Phase II: designed and carried out an investigation of the effects of two versions of the CWK program: a) the full CWK classroom Cooking and Tasting curriculum + family intervention; compared with b) the CWK Tasting (only) curriculum + family intervention; and to c) comparison, among 2 cohorts of approximately 1,200 4th grade students and their parents. Phase III: disseminated CWK intervention and evaluation components through training and technical assistance to other school districts and community nutrition programs using the NM Cooperative Extension network. Phase IV: assessed the replication of the CWK classroom Cooking and Tasting curriculum in a new school district in CO using a randomized control design. Events: training sessions for Extension agents and nutrition educators were conducted as part of phase III described in activities above, and training evaluation staff and students on study protocol for all data collection. Services: no consulting, counseling, or tutoring was provided as part of this project. Products: These included the refinement of the CWK curriculum and development and use of new surveys, interview guides, and observation forms, administration protocols, databases and data for Phases II, III and IV. Two 50- and 10-minute videos were developed depicting CWK tasting lessons and used in training of NMSU Extension nutrition educators and for dissemination purposes. Collaborations were enhanced with CWK, Inc., Santa Fe Public School District, NMSU Extension, and a new school district (Poudre School District, Fort Collins, CO). Both the CWK, Inc. website (www.Cookingwithkids.net) and the CSU Food Science and Human Nutrition website (http://www.fshn.cahs.colostate.edu/faculty_staff/cunningham-sabo/.as px; search external grants) have been updated to include much of this information. Dissemination: Seventy-four NMSU extension staff were trained to implement the CWK tasting curriculum during Phase III of project, who in turn provided CWK lessons to elementary schoolchildren in school districts throughout the state of New Mexico; research results presented in 20 conference sessions described in the publications section of this report, and submission of 6 manuscripts for publication (4 published, 1 accepted, 1 under review). Six additional manuscripts are in preparation. In the spring of 2011, desktop training was provided to Extension agents throughout Colorado on the CWK program. A face-to-face training will take place in Routt County, Colorado in July 2011 for teachers interested in learning more about the CWK program. An integrated NIFA Obesity and Nutrition proposal was submitted in June 2011 (CWK 2.0: Plus Parents and Play) which builds on this project, expands intervention components, and adds active recess and an on-line parent components based on eating competence. PARTICIPANTS: Individuals - Project Director: Leslie Cunningham-Sabo, Co-Project Director - Lynn Walters. Consultant: Barbara Lohse. Evaluation specialists: Anne Hanika-Ortiz, Flor de Maria Oliva, Barbara Beames, Barbara Ferry, and Victoria Wallen. Graduate students: Ann Diker, Jessica Grilley Zabriskie, Catherine Vincent Lukas, Jody Swigris, April Sifford, Kate Topham, Andy Kester, and Sara Groth. Partner Organizations - Cooking with Kids, Inc.: Lynn Walters and Jane Stacey; New Mexico State University Extension: Kari Bachman as new project director and Linda Wells; Santa Fe Public Schools and Poudre School District. Training and professional development: 74 New Mexico State University Extension staff received 4 hours of training to implement the CWK tasting curriculum. Five master's student projects and 1 PhD student's dissertation are included in activities described above. Four additional graduate students gained experience with intervention implementation, data entry and analysis. TARGET AUDIENCES: Phase II target audiences included approximately 1200 4th-grade students attending school within the Santa Fe Public School District in New Mexico, 2/3rd of whom received either the cooking and /or tasting curricula including take-home materials to share with their families. Eighty-five percent of participants were Hispanic and greater than 50% qualified for free or reduce-priced school meals. Phase III target audiences included 74 Extension agents and paraprofessionals from throughout New Mexico who received formal training on CWK, as well as 4th grade students who received the CWK tasting lessons delivered by Extension staff in their classroom and have similar demographic characteristics to those students in Phase II. The Phase IV target audience was approximately 250 4th grade students attending 1 of 4 participating schools in the Poudre School District in Fort Collins, Colorado. Seventy-five percent of students were White, with an additional 17 percent Hispanic; approximately 1/3rd qualified for free or reduce-priced school meals. Half of these students received 3 cooking and 3 tasting lessons delivered in their classroom by trained graduate students, while the remaining students (schools) were randomized to a control condition. Efforts: Classroom experiential education through the Cooking with Kids curriculum, experiential training through workshops for Extension staff. Graduate students and evaluation staff received research training (formal and experiential). PROJECT MODIFICATIONS: An additional component was made to this project (Phase IV) after receiving project officer approval. This involved the implementation of an abbreviated version of the CWK intervention with a new target audience, which also allowed for a randomized control design.

Impacts
Changes in Knowledge: Results from Phase II intervention student surveys indicate that most students "do cook" (83%), whether they participated in CWK or not, and even more (90%) reported that they "make food with their family." Because the majority of students (mainly Hispanic and low-income) across all 3 conditions - cooking plus tasting, tasting classes only, or comparison - reported having cooking experience prior to the pre-test survey (and an unknown number had prior exposure to CWK), overall impact of the program on 4th graders was difficult to measure. However, fruit and vegetable preferences (FV) improved significantly more among students receiving CWK compared to students in comparison schools, and gains were greatest for students in the cooking condition. Improvements in cooking attitudes (AT) and self-efficacy (SE) were seen especially in boys in intervention schools who reported no prior cooking experience. Improvements were even greater in students from schools receiving a sample of FV to share with their family after tasting lessons. Results from Phase III training surveys indicate interactive learning techniques and curriculum lesson practice are essential training components. Training participants improved knowledge about teaching the curriculum as well as confidence, motivation, and information to teach the curriculum. Diffusion of Innovation attributes of relative advantage and trialability were positively associated with intended future curriculum use. Results from Phase IV, a randomized control trial of abbreviated CWK cooking and tasting classes, included strong evidence of intervention effectiveness. Students in intervention schools reported significantly improved FV preferences and cooking AT. Cooking SE significantly improved for all students reporting no prior general or family cooking experience, however improvements were nearly 5 times greater for non-cookers in intervention versus control. Project faculty, intervention and evaluation staff, and graduate students gained valuable food and nutrition knowledge and skill through participating in the research intervention and evaluation process. Changes in Actions: Participants (4th grade students) improved their SE and AT toward cooking and improved their preferences for FV, factors important to healthful eating and obesity prevention. Parents and school personnel all reported positive experiences participating in CWK, and many described how their own food and nutrition behaviors have been positively influenced by this experience. Similar responses were reported from Extension personnel who participated in the Phase III training and CWK tasting lesson implementation. The majority indicated they will continue to facilitate CWK programming in participating schools. Changes in Conditions: Objectives of this study did not specifically include investigation of changes in societal or health conditions, however many of the schools participating in this study are continuing CWK. In addition, it is anticipated that because of gains in cooking skills and improvements in attitudes toward FV, the health and nutritional status of adult and child participants are improved.

Publications

  • Lohse, B., Cunningham-Sabo, L., Walters, L.M., and Stacey, J.E. (2011) Valid and reliable measures of cognitive behaviors toward fruits and vegetables for children aged 9 to 11 years. Journal of Nutrition Education and Behavior; 43:42-49.
  • Lohse, B. and Cunningham-Sabo, L. 2011. Eating Competent Low-Income Parents Model Eating Behaviors Associated with Reducing Risk of Child Obesity, Electronic Conference Proceedings, Experimental Biology, Washington, D.C.
  • Cunningham-Sabo, L. and Wallen, V. 2010. Principal and Cafeteria Manager Interviews Reveal Important Components for Elementary School Nutrition Education Programs Sustainability, Electronic Conference Proceedings, American Public Health Association, Denver, Colorado
  • Cunningham-Sabo, L., Walters, L., Lohse, B. and Stacey, J. 2010. Impact of Cooking with Kids Program on Cooking Self-Efficacy, Attitudes, and Fruit and Vegetable Preferences, Electronic Conference Proceedings, Society for Nutrition Education, Reno, Nevada
  • Wallen, V., Cunningham-Sabo, L., Hanika-Ortiz, A. 2010. Development and Use of a Cafeteria Observation Form as a Brief Validation Measure of Child Recall, Electronic Conference Proceedings, Society for Nutrition Education, Reno, Nevada
  • Cunningham-Sabo, L., Walters, L., Lohse, B. and Stacey, J. 2010. Cooking with Kids: Integrating Classroom, Cafeteria, and Family Experiences to Increase Fruit and Vegetable Preference and Intake, United States Department of Agriculture/National Institute of Food and Agriculture Program Directors Meeting, Denver, Colorado
  • Diker, A., Cunningham-Sabo, L., Bachman, K., Stacey, J., Walters, L., and Wells, L. (2011) Promoters of and Challenges to Adoption and Implementation of an Elementary School Experiential Foods Curriculum. Health Promotion and Practice (pending).
  • Lukas C.V. and Cunningham-Sabo, L. (2011) Qualitative Investigation of the Cooking with Kids Program: Focus Group Interviews with Fourth Grade Students, Teachers, and Food Educators. Journal of Nutrition Education and Behavior (accepted).
  • Diker, A., Cunningham-Sabo, L., Bachman, K., Stacey, J., Walters, L., and Wells, L., (2011) Effective Training Design: Use of Theory and Formative Assessment. Health Promotion Practice; doi: 10.1177/1524839910386909.
  • Cunningham-Sabo, L., Lohse, B. and Groth S. 2011. Experiential Foods Program Positively Impacts Fruit and Vegetable Preferences, Cooking Attitudes and Self-Efficacy among 4th-Graders, Electronic Conference Proceedings, Society for Nutrition Education, Kansas City, Missouri
  • Topham, K. and Cunningham-Sabo, L. 2011. A Food Educators Perspective: Understanding Students and Teachers Perceived Values of an Elementary School Experiential Foods Curriculum, Electronic Conference Proceedings, Society for Nutrition Education, Kansas City, Missouri
  • Zabriskie, J. and Cunningham-Sabo, L. 2009. Impact of an Elementary School Experiential Foods Program in the Family Eating Environment, Electronic Conference Proceedings, American Dietetic Association, Denver, Colorado
  • Cunningham-Sabo, L., Sifford, A., Hanika-Ortiz, A., and Walters, L. 2009. Teacher Responses to Experiential Foods Program Provide Evidence of Different Levels of Intervention Implementation, Electronic Conference Proceedings, American Dietetic Association, Denver, Colorado
  • Wallen, V., Cunningham-Sabo, L., and Auld, G. 2009. Sensitivity of a Classroom-Administered Dietary Recall Instrument for Children, Electronic Conference Proceedings, American Dietetic Association, Denver, Colorado
  • Diker, A., Cunningham-Sabo, L., and Walters, L. 2009. Factors Contributing to Adoption and Use of Experiential Foods Curriculum: Cooking with Kids, Electronic Conference Proceedings, Society for Nutrition Education, New Orleans, Louisiana
  • Cunningham-Sabo, L., Walters, L., Lohse, B. and Stacey, J. 2009. Cooking with Kids: Integrating Classroom, Cafeteria, and Family Experiences to Increase Fruit and Vegetable Preference and Intake, United States Department of Agriculture Cooperative State Research, Education, and Extension Services National Research Initiative Program Directors Meeting, Baltimore, Maryland
  • Cunningham-Sabo, L., Hanika-Ortiz, A., Walters, L., Stacey, J., and Lohse, B. 2008. Process Evaluation Measures of Experiential Foods Program for Elementary Schoolchildren, Electronic Conference Proceedings, American Public Health Association, San Diego, California
  • Cunningham-Sabo, L., Walters, L., Stacey, J., Calvin, C. and Lohse, B. 2006. Cooking With Kids: Integrating Classroom, Cafeteria, and Family Experiences to Increase Fruit and Vegetable Preference and Intake, United States Department of Agriculture Cooperative State Research, Education, and Extension Services National Research Initiative Program Directors Meeting, Houston, Texas
  • Lohse, B., Cunningham-Sabo, L., Walters, L., and Stacey, J. 2008. Surveys of Fruit and Vegetable Preference, Attitude, and Self-Efficacy for Food Preparation Show Test-Retest Reliability for Fourth and Fifth Graders, Electronic Conference Proceedings, Society for Nutrition Education, Atlanta, Georgia
  • Wallen, V., Cunningham-Sabo, L., and Auld, G. 2008. Use of Cognitive Interviews to Modify a Diet Recall Questionnaire for Elementary School Students, Education Electronic Conference Proceedings, Society for Nutrition, Atlanta, Georgia
  • Cunningham-Sabo, L., Hanika-Ortiz, A., and Diker, A. 2008. Development and Inter-Observer Reliability of Classroom and Cafeteria Observation Forms, Electronic Conference Proceedings, Society for Nutrition Education, Atlanta, Georgia
  • Cunningham-Sabo, L., Walters, L., Lohse, B. and Stacey, J. 2008. Cooking with Kids: Integrating Classroom, Cafeteria, and Family Experiences to Increase Fruit and Vegetable Preference and Intake, United States Department of Agriculture Cooperative State Research, Education, and Extension Services National Research Initiative Program Directors Meeting, Albuquerque, New Mexico
  • Cunningham-Sabo, L., Walters, L., Lohse, B. and Stacey, J. 2007. What Children Have to Say: Use of Cognitive Interviews to Develop Research Instruments, Electronic Conference Proceedings, Society for Nutrition Education, Chicago, Illinois
  • Cunningham-Sabo, L., Walters, L., Lohse, B. and Stacey, J. 2007, What Children Have to Say: Use of Cognitive Interviews to Develop Research Instruments, U.S. Department of Agriculture Cooperative State Research, Education, and Extension Services National Research Initiative Program Directors Meeting, Washington, D.C.
  • Diker, A., Walters, L.M., Cunningham-Sabo, L., and Baker S. (2011) Factors Influencing Adoption and Implementation of an Experiential School-Based Nutrition Education Curriculum: Cooking With Kids. Journal of Extension; 49:1-13.
  • Wallen, V., Cunningham-Sabo, L., Auld, G., and Romaniello, C. (2011) Validation of a group-administered pictorial dietary recall with 9-11 year old children. Journal of Nutrition Education and Behavior; 43:50-54.


Progress 05/01/09 to 04/30/10

Outputs
OUTPUTS: All Phase I formative assessment activities (refine and test intervention components, refine and test process and impact/outcome measures) were completed and reported in previous reports. All Phase II intervention activities and most data collection for the impact/outcome study in Santa Fe, NM were completed by May, 2009. Primary evaluation activities for this reporting period included: 1) continued data entry and preliminary analysis of the student survey to assess FV preferences, and cooking attitudes and cooking self-efficacy for 2 cohorts of 4th grade students; 2) data entry and preliminary analysis of the Day in the Life Questionnaire dietary and activity recall with the 2nd cohort of students; and 3) collection and data entry of cohort 2 parent surveys assessing FV availability at home, parent attitudes toward and modeling of FV preparation, and parents' eating competence (using previously tested instruments). Entry and analysis of process evaluation measures continued, including classroom and cafeteria observations to determine fidelity and responses to the intervention. Other measures included transcription and analysis of focus group interviews with student participants from all 3 testing conditions, intervention teachers and CWK food educators, and collection and analysis of surveys with teachers, cafeteria staff and managers. Phase III dissemination activities included: 1) analysis of formative assessment interviews and secondary data from web-based surveys to explore factors contributing to adoption and implementation of CWK; 2) the development and implementation of regional trainings for NMSU Cooperative Extension who then began statewide implementation of CWK tasting classes; and 3) collection, data entry and preliminary analysis of pre-training, post-training, and follow-up surveys. Phase IV - limited testing of the effectiveness of CWK on student FV preferences, cooking attitudes and self-efficacy was planned and implemented in a new site in Colorado (300 4th grade students in 4 schools randomized to intervention or control). Three master's student projects and 1 PhD student's dissertation are included in activities described above. Two additional graduate students gained experience with intervention implementation, data entry and analysis. Events included providing CWK tasting lessons training to NMSU Extension nutrition para- and professionals, and training student staff on study protocol for all data collection. Products included the development and use of new surveys, interview guides, and observation forms, administration protocols, databases and data for Phases III and IV. The 50- and 10-minute videos depicting CWK tasting lessons described in the previous report were completed and used in training of NMSU Extension nutrition educators and for dissemination purposes. Collaborations were enhanced with CWK, Inc., and NMSU Extension. Dissemination activities included training 74 NMSU extension staff to implement the CWK tasting curriculum, research results presented in 5 conference sessions described in the publications section of this report, and submission of 4 manuscripts for publication (2 accepted, 2 under review). PARTICIPANTS: Individuals - Project Director: Leslie Cunningham-Sabo, Co-Project Director - Lynn Walters. Evaluation specialists: Anne Hanika-Ortiz, Flor de Maria Oliva, Barbara Beames, Barbara Ferry, and Victoria Wallen. Graduate students: Ann Diker, Jessica Grilley Zabriskie, Catherine Hogan, Jody Swigris, April Sifford, Kate Topham, and Andy Kester. Partner Organizations - Cooking with Kids, Inc.: Lynn Walters and Jane Stacey; New Mexico State University Extension: Kari Bachman as new project director and Linda Wells; Santa Fe Public Schools. Training and professional development - 74 New Mexico State University Extension staff received 4 hours of training to implement the CWK tasting curriculum. TARGET AUDIENCES: Phase II target audiences included approximately 900 4th-grade students attending school within the Santa Fe Public School District in New Mexico, 2/3rd of whom received either the cooking and /or tasting curricula including take-home materials to share with their families. 85% of participants were Hispanic and greater than 50% were from low-income homes. Phase III target audiences are from throughout New Mexico and have similar demographic characteristics. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Analyses are not yet complete therefore limited evaluation results are available to describe the scope and nature of changes in knowledge, actions and conditions as a result of this project. Preliminary analyses of student surveys from Phase II of this project yielded acceptable internal reliabilities for FV preferences (FV, Chronbach alpha = .79) and cooking self-efficacy (SE, .70), with marginal results for cooking attitudes (AT, .64) with a sample of 852 4th grade students from both cohorts (school year 2007-2008 = Cohort 1 and 2008-2009 = Cohort 2).When comparing student baseline to post-intervention survey results, SE increased more consistently than AT, with FV preference change not specific to school type. Univariate analyses with gender and cooking background in the model revealed students (especially boys) with limited prior cooking experience had greater gains overall. Students in both intervention groups (cooking plus tasting lessons V. tasting lessons only) reported greater gains in FV preferences compared to controls (n = 871; P = 0.025). Post-intervention gains in FV preferences were also greater for all students who took home FV samples (n = 901; P = 0.003). Analysis of parent surveys is pending. Future analyses will reveal the extent of impacts and outcomes for participating students and parents related to study hypotheses and specific aims, as well as lessons learned to support program sustainability and dissemination. Results from Phase III formative work include curricula developed for use in schools should emphasize experiential methods and ease of use to increase adoption and implementation; perceived simplicity of the curriculum predicted intended use; and ensuring that users have adequate information and planning time to overcome barriers is essential for implementation and sustainability. Preliminary results from Phase III training surveys indicate interactive learning techniques and curriculum lesson practice are essential training components. Training participants improved knowledge about teaching the curriculum as well as confidence, motivation, and information to teach the curriculum. The Diffusion of Innovation attributes of relative advantage and trialability were correlated with intended future curriculum use. In addition, project faculty, staff, and graduate students gained knowledge and skill (change in actions) through participating in the research and evaluation processes. Implementation of Phase IV is still in progress.

Publications

  • Lohse, B.; Cunningham-Sabo, L. PhD, RD; Walters, L.M., MS; Stacey, J.E., BS. (2010). Valid and reliable measures of cognitive behaviors toward fruits and vegetables for children aged 9 to 11 years. Journal of Nutrition Education and Behavior. (accepted)
  • Wallen, V., Cunningham-Sabo, L., Auld, G., and Romaniello, C. (2010). Validation of a group-administered pictorial dietary recall with 9-11 year old children. Journal of Nutrition Education and Behavior. (accepted)
  • Diker, A., Walters, L.M., and Cunningham-Sabo, L. (2009). Perceived Diffusion Attributes of Nutrition Education Curricula, American Dietetic Association Food and Nutrition Conference, Denver, CO. (oral presentation)
  • Vincent, C., Cunningham-Sabo, L., and Hanika-Ortiz, A. (2009). Using Student Focus Group Interviews to Enhance Understanding of Survey Results for a Classroom-Based Experiential Foods Program. American Dietetic Association Food and Nutrition Conference, Denver, CO. (poster presentation)
  • Cunningham-Sabo, L., Sifford, A., Hanika-Ortiz, A., and Walters, L.M. (2009). Teacher Responses to Experiential Foods Program Provide Evidence of Different Levels of Intervention Implementation. American Dietetic Association Food and Nutrition Conference, Denver, CO. (oral presentation)
  • Zabriskie, J.N., and Cunningham-Sabo, L. (2009). Impact of an Elementary School Experiential Foods Program in the Family Eating Environment. American Dietetic Association Food and Nutrition Conference, Denver, CO. (poster presentation)
  • Wallen, V., Cunningham-Sabo, L., and Auld, G. (2009). Sensitivity of a Classroom-Administered Dietary Recall Instrument for Children. American Dietetic Association Food and Nutrition Conference, Denver, CO. (poster presentation)


Progress 05/01/08 to 04/30/09

Outputs
OUTPUTS: We have nearly completed implementation of two years of study. Recent intervention activities include implementation of enhanced family component - distribution of 5 samples of fruits and vegetables (FV) promoted in Cooking with Kids (CWK) tasting classes to 225+ participating families, shopping tips and recipes; and enhanced cafeteria component-school lunch promotion of FV emphasized in tasting classes. Evaluation activities included 1) pre- and post-test administration of student survey to assess FV preferences, and cooking attitudes and cooking self-efficacy to 675 4th grade students; 2) pre- and post-test classroom-administration of previously validated dietary and activity recall with same students; and 3) distribution of surveys to parents assessing FV availability at home, and parent attitudes toward and modeling of FV preparation. Process evaluation measures conducted include classroom and cafeteria observations to determine fidelity and responses to the intervention using previously tested protocols (46 cooking classes, 65 tasting classes, 45 CWK cafeteria meals, and 23 FV reinforcement cafeteria meals observations have been completed this school year). Other measures included 22 focus group interviews with student participants from all 3 testing conditions (5 conducted in Spanish), 8 parent focus groups (4 conducted in Spanish), interviews with 4 principals, and surveys distributed to 32 4th grade teachers. In May, 2 focus groups will be conducted with teachers and 2 with CWK food educators, and surveys will be distributed (in Spanish and English) to cafeteria staff and managers. Dissemination activities included interviews with 27 nutrition educators nationwide to identify facilitators and barriers to successful adoption and implementation of CWK. Regional trainings in August for NMSU Cooperative Extension will facilitate statewide implementation of CWK tasting classes. Three master's student projects (2 theses and 1 professional project) and 1 PhD student's dissertation are included in activities described above. Two additional graduate students gained experience with data entry and analysis. Events - training evaluation staff to follow study protocol for all data collection (surveys, observations, interviews). Products - surveys, interview guides, and observation forms, administration protocols, databases and data. Databases were developed and maintained in ACCESS. A 50- and a 10-minute video depicting CWK tasting lessons are in production, to during training of NMSU Cooperative Extension nutrition educators. Enhanced collaborations have been developed with CWK, Inc., and NMSU Cooperative Extension to carry out the current intervention and evaluation and to disseminate the project through the NMSU Cooperative Extension network in the final year of the project. Dissemination activities included research results presented in 4 sessions at 2 separate conferences as described in the publications section of this report, and submission of 1 manuscript for publication (status pending). PD was an invited presenter at the USDA CSREES-sponsored grant writing workshop in Las Vegas, NV in March. PARTICIPANTS: Individuals - graduate students: Ann Diker, victoria Wallen, Jessica Grilley Zabriskie, Catherine Hogan, Jody Swigris, April Sifford Evaluation specialists: Anne Hanika-Ortiz, Flor de Maria Oliva, Barbara Beames, Barbara Ferry Partner Organizations - Cooking with Kids, Inc., New Mexico State University Cooperative Extension - Kari Bachman as new project director; Santa Fe Public Schools TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Project implementation has not yet concluded and thus limited evaluation results are available to determine the scope and nature of changes in knowledge as a result of this project. Analyses of student surveys from the first year show somewhat promising results: FV preferences and confidence in cooking abilities (self-efficacy) increased in children participating in the cooking classes compared with children in non-treatments schools. Future analyses will reveal the extent of outcomes for participating students and parents related to study hypotheses and specific aims, as well as lessons learned from project implementation that can support program sustainability and dissemination. In addition, project faculty, staff, and graduate students gained knowledge and skill (change in actions) through participating in the research and evaluation processes.

Publications

  • Diker, A., Walters, L.M., and Cunningham-Sabo, L. (2009). Perceived Diffusion Attributes of Nutrition Education Curricula, American Dietetic Association Food and Nutrition Conference, Denver, CO. (abstract accepted)
  • Vincent, C., Cunningham-Sabo, L., and Hanika-Ortiz, A. (2009). Using Student Focus Group Interviews to Enhance Understanding of Survey Results for a Classroom-Based Experiential Foods Program. American Dietetic Association Food and Nutrition Conference, Denver, CO. (abstract accepted)
  • Cunningham-Sabo, L., Sifford, A., Hanika-Ortiz, A., and Walters, L.M. (2009). Teacher Responses to Experiential Foods Program Provide Evidence of Different Levels of Intervention Implementation. American Dietetic Association Food and Nutrition Conference, Denver, CO. (abstract accepted)
  • Zabriskie, J.N., and Cunningham-Sabo, L. (2009). Impact of an Elementary School Experiential Foods Program in the Family Eating Environment. American Dietetic Association Food and Nutrition Conference, Denver, CO. (abstract accepted)
  • Wallen, V., Cunningham-Sabo, L., and Auld, G. (2009). Sensitivity of a Classroom-Administered Dietary Recall Instrument for Children. American Dietetic Association Food and Nutrition Conference, Denver, CO. (abstract accepted)
  • Wallen, V., Cunningham-Sabo, L., Auld, G., Barrett, K., and Romaniello, C. (2008). Use of Cognitive Interviews to Modify a Diet Recall Questionnaire for Elementary School Students. 41st Annual Conference of the Society for Nutrition Education, Atlanta, GA,. JNEB Vol 40, No 45, p S60 (abstract).
  • Cunningham-Sabo, L., Diker, A., Walters, L.M., Stacey, J., Lohse, B., and Hewitt-Redl, C. (2008). Development and Inter-Observer Reliability of Classroom and Cafeteria Observation Forms. 41st Annual Conference of the Society for Nutrition Education, Atlanta, GA,. JNEB Vol 40, No 45, p S84 (abstract).
  • Cunningham-Sabo, L., Hanika-Ortiz, A., Diker, A., Walters, L., Stacey, J., Lohse, L. 2008. Process evaluation measures of experiential foods program for elementary schoolchildren. Page 144, final program (abstract), 136th American Public Health Association Annual Meeting & Exposition, San Diego, CA.
  • Wallen, V., Cunningham-Sabo, L., Auld, G., and Romaniello, C. (2009). Validation of a group-administered pictorial dietary recall with 9-11 year old children. Journal of Nutrition Education and Behavior. (manuscript pending)
  • Lohse, B., Cunningham-Sabo, L., Walters, L.M., and Stacey, J. (2008). Surveys of Fruit and Vegetable Preference, Attitude, and Self-Efficacy for Food Preparation Show Test-Retest Reliability for Fourth and Fifth Graders. 41st Annual Conference of the Society for Nutrition Education, Atlanta, GA,. JNEB Vol 40, No 45, p S28-29 (abstract).


Progress 05/01/07 to 04/30/08

Outputs
OUTPUTS: Based on formative assessment results - including reliability testing and refinement of the student assessment instrument and identification of additional family and cafeteria-focused activities, the first year of the full-scale intervention was successfully completed. Activities included refinement and implementation of the family component: distribution of 5 samples of fruits and vegetables promoted in CWK tasting classes to 251 participating families along with information about each sample, and distribution of classroom recipes to the families of 205 students in the cooking schools; and refinement and implementation of the cafeteria component: identifying and piloting promotion of FV emphasized in tasting classes in school lunches. Evaluation activities included 1) determining acceptable reliability of surveys measuring student fruit and vegetable preferences and food preparation attitude and skills; 2) administration of these surveys 3 times during 2007-2008 school year to 680 4th grade students; 3) development and administration of a survey to 32 teachers; 4) interviews conducted with 7 principals, 11 cafeteria managers, and 8 CWK food educators; and 5) validation of a classroom-administered dietary and activity recall with 125 students. Process measures included development, inter-observer reliability testing, and administration of classroom and cafeteria observations forms. Events included training of evaluation staff to follow study protocol for all data collection (surveys, interviews, observations). Products included the surveys, interview guides, and observation forms described above, their administration protocols, databases and data. Enhanced collaborations were developed with CWK, Inc., NMSU Cooperative Extension, and the Integrated Nutrition Education Program in Denver, CO. Dissemination activities included presentation of student survey development (through cognitive interviews) at the 2007 Society for Nutrition Education annual conference. PARTICIPANTS: Nothing significant to report during this reporting period. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Because the first full year of project implementation is just concluding, limited evaluation results are available. Refinement and testing of the surveys measuring student fruit and vegetable preferences and food preparation attitude and skills through cognitive interviewing and conducting test-retest reliability assessments produced not only valid and reliable instruments to use for this project's elementary student participants, but have generated interest and potential use within another children's nutrition program (Pennsylvania state FSNE program). Other activities included the development and testing of feasible and replicable observation forms to assess fidelity of implementation of classroom and cafeteria components of the program. Inter-observer reliability analysis revealed strong agreement between observers but also areas where further revision to observation forms and further data recording training was required. In addition, project faculty, staff, and graduate students gained knowledge and skill through participating in the validity and reliability assessment processes. They also gained knowledge and skill in the development and administration of process evaluation measures and strategies (observations of intervention activities, surveys of teachers and parents, interviews with principals, cafeteria managers, and CWK food educators).

Publications

  • 1. Cunningham-Sabo, L., Lohse, B., Walters, L., Stacey, J. and Hewitt-Redl, C. 2007. What Children have to Say: Use of Cognitive Interviews to Develop Research Instruments. Society for Nutrition Education 40th Annual Conference, Chicago, IL, Journal of Nutrition Education, July-August supplement.
  • Three abstracts have also been accepted for presentation at the 2008 Society for Nutrition Education annual conference in Atlanta in July (one oral presentation and two posters). A fourth abstract has been accepted to the 2008 American Public Health Association annual conference in San Diego in October. Manuscripts are in preparation related to the formative assessment phase of the project.