The Effect of Nutrition Education on the Improvement of Psychosocial Factors Related to Vegetable and Fruit Intake of Elementary School Children in Pre-Action Stages

Suh, Yoonsuk; Chung, Young-Jin

doi:10.4163/kjn.2010.43.6.597

Korean J Nutr. 2010 Dec;43(6):597-606. Korean.
Published online Dec 31, 2010.
https://doi.org/10.4163/kjn.2010.43.6.597

Original Article

The Effect of Nutrition Education on the Improvement of Psychosocial Factors Related to Vegetable and Fruit Intake of Elementary School Children in Pre-Action Stages

Yoonsuk Suh and Young-Jin Chung

Author information

Author notes

Copyright and License

- Department of Food and Nutrition, College of Human Ecology, Chungnam National University, Daejeon 305-764, Korea.
To whom correspondence should be addressed. (Email: yjchung@cnu.ac.kr )

Received August 25, 2010; Revised October 14, 2010; Accepted November 05, 2010.

Abstract

This study investigates the change of level of psychosocial factors of decisional balance, processes of change, and self-efficacy after nutrition education on vegetable and fruit intake of children in pre-action stages. Forty-seven 5th grade elementary school children in Yeongi-Gun, Chungnam-Do were categorized into pre-action stages from a total of 71 children by four-stage questions, and then finally into two stages of precontemplation and contemplation & preparation. After 6 weeks nutrition education, recognition of both of pros and cons of vegetable intake were improved in the two groups of precontemplation and contemplation & preparation. In fruits intake, however, recognition of pros was not changed after nutrition education in either stage, but recognition of cons was improved only in the precontemplation stage. However, no difference in any psychosocial variables was found between precontemplation stage and contemplation & preparation stage. After the nutrition education, the score of consciousness raising of vegetable intake belonging to cognitive process of change increased in the subjects of the precontemplation stage, wheres the scores of dramatic relief, self-reevaluation, environment reevaluation and social liberation increased in the group of contemplation & preparation. In fruit intake, however, no change was found except in the environment reevaluation in the precontemplation group. The behavioral process of change of vegetable and fruit intake did not show any change in either group after nutrition education. Self-efficacy scores of vegetable intake of keeping the foods at hand, eating the recommended number of servings and making time to eat increased in the precontemplation group, while in the contemplation & preparation group, self efficacy scores of shopping for a variety of vegetables, instead of keeping the foods at hands, as well as the scores of the rest two items of eating the recommended number of servings and making time to eat increased after nutrition education. However, in case of fruits intake, no difference was shown in the precontemplation stage except an item of keeping the foods at hand. The results indicated that the stage of change was progressed in the pre-action stage after nutrition education and the scores of many psychosocial factors increased in both pre-action stages. It is suggested that the recognition of cons as well as the cognitive process of change and self-efficacy could be best used as indicators of the assessment of nutrition education program for vegetable intake.

Keywords

nutrition education; stage of change; vegetables and fruits intake; psychosocial factors; elementary school children

Tables

Table 1
Distribution of stage of change of the subjects after 6 weeks nutrition education on vegetable and fruit intake N (%)

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Table 2
The general characteristics of the subjects of precontemplation stages & contemplation and preparation stage before nutrition education

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Table 3
Pros and cons of the two stages of initial and after nutrition education on vegetable and fruit intake

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Table 4
Cognitive process and behavioral process of two stages of change of initial and after nutrition education on vegetable intake

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Table 5
Cognitive process and behavioral process of two stages of change of initial and after nutrition education on fruit intake

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Table 6
Self-efficacy of two stages of change of initial and after nutrition education on vegetable intake

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Table 7
Self-efficacy of two stages of change of initial and after nutrition education on fruit intake

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References

1. Ahn YK, Ro HK. A survey on preferences for vegetable cooking methods and vegetable-aversion-related factors among elementary school students in Kwangji and Chonnam regions. Korean J Community Nutr 2009;14(5):531–544.
1. Hong YJ. A study on a relation of food ecology to obesity index of 5th grade children in Cheju city (II). Korean J Food Cult 1998;13(2):141–151.
1. Lee HS, Lee KE, Shanklin CW. Elementary student' food consumption at lunch does not meet recommended dietary allowance for energy, iron and vitamin A. J Am Diet Assoc 2001;101(9):1060–1063.
1. Ku UH, Seo JS. The status of nutrient intake and factors related to dislike of vegetables in elementary school students. Korean J Community Nutr 2005;10(2):151–162.
1. Jun SN, Ro HK. A study on eating habits and food preference of rural elementary school students. Korean J Food Cult 1998;13(1):65–72.
1. American Dietetic Association; Dietitians of Canada. Vegetarian diet. J Am Diet Assoc 2003;103(6):748–765.
1. The Korean Nutrition Society. Dietary Reference Intakes for Koreans. 1st revision. Seoul: 2010.
1. Ministry for Health, Welfare and Family Affairs. Comprehensive plans for national health promotion 2010. 2005.
1. The third Korea national health and nutrition examination survey (KNHANES III), Dietary reference intakes for Korean. 2005.
1. Ministry for Health, Welfare and Family Affairs. 2007 Korea national health and nutrition examination survery. Korean Centers for Disease Control and Prevention; 2008.
1. Schwartz NE. Nutrition knowledge, attitude and practices of high school graduates. J Am Diet Assoc 1975;66(1):28–36.
  PubMed
1. Brush KH, Woolcot DM, Kawash GF. Evaluation of an effective based adult nutrition education program. J Nutr Educ 1986;18(6):258–264.
  CrossRef
1. Lee SW, Sung CJ, Kim MH. A study on nutritional attitude, food behavior and nutritional status according to nutrition knowledge of Korean middle school students. Korean J Community Nutr 2000;5(3):419–431.
1. Prochaska JO, Velicer WF. The Transtheoretical Model of health behavior change. Am J Health Promot 1997;12(1):38–48.
  PubMed
  
  CrossRef
1. Sun KS. In: The effect of web-based osteoporosis prevention program on the osteoporosis knowledge, self efficacy, health belief, stage of change in female college students [Dissertation]. Gwangju: Chonnam National University; 2003.
1. Greene GW, Fey-Yensan N, Padula C, Rossi S, Rossi JS, Clark PG. Differences in psychosocial variables by stage of change for fruits and vegetables in older adults. J Am Diet Assoc 2004;104(8):1236–1243.
1. Henry H, Reimer K, Smith C, Reickes M. Association of decisional balance, processes of change, and self-efficacy with stage of change for increased fruit and vegetable intake among low-income, African-American mothers. J Am Diet Assoc 2006;106(6):841–849.
1. Chung SJ. Application of stage of change model and precede-procede model; The Korean Society of Community Nutrition Workshop; 2006. pp. 1-10.
1. Cullen KW, Bartholomew LK, Pareel GS, Koehly L. Measuring stage of change for fruits and vegetable consumption in 9 to 12 year old girls. J Behav Med 1998;21(3):241–254.
  PubMed
  
  CrossRef
1. Suh YS, Choi AS, Chung YJ. Psychosocial factors related with the intake of vegetables and fruits by the stage of change of elementary school children in Chungnam province. Korean J Nutr 2009;42(7):639–649.
  CrossRef
1. Block G, Wakimoto P, Metz D, Fujii ML, Feldman N, Mandel R, Sutherland B. A randomized trial of the little by little CD-ROM: Demonstrated effectiveness in increasing fruit and vegetable intake in a low-income population. Prev Chronic Dis 2004;1(3):A08.
1. Chung SJ. In: Validity and reliability of stage of change instruments and processes of change to eat fruits and vegetables [Dissertation]. East Lansing: Michigan State University; 2001.
1. Frenn M, Malin S, Bansal NK. Stage based interventions for low fat diet with middle school students. J Pediatr Nurs 2003;18(1):36–45.
1. Baranowski T, Simons-Morton B, Hooks P, Henske J, Tieman K, Dunn JK, Burkhalter H, Harper J, Palmer J. A center based program for exercise change among Black-American. Health Educ Q 1990;17(2):179–196.
1. Luszczynska A, Tryburcy M, Schwarzer R. Improving fruit and vegetable consumption: a self-efficacy intervention compared with a combined self-efficacy and planning intervention. Health Educ Res 2007;22(5):630–638.
1. Brinley C, Barrar C, Cotugna N. Stages of change tools to increase fruit and vegetables consumption in high school students. J Nutr Educ 2001;33(1):57–58.
1. Nothwehr F, Snetselaar L, Yang J, Wu H. Stage of change for healthful eating and use of behavioral strategies. J Am Diet Assoc 2006;106(7):1035–1041.
1. Greene GW, Rossi SR, Reed GR, Willey C, Prochaska JO. Stages of change for reducing dietary fat to 30% of energy or less. J Am Diet Assoc 1994;94(10):1105–1110.
1. Contento IR. In: Nutrition education-Linking research, theory and practice. Sudbury, MA: Jones and Barlett Publishers; 2007. pp. 88-108.
1. Kim SR. In: Relationships among nutritional knowledge, eating behavior and dietary self-efficacy of elementary school students in Chonbuk province [Thesis]. Jeonju: Chonbuk National University; 2003.
1. Tuuri G, Zanovec M, Silverman L, Geaghan J, Solmon M, Holston D, Guarino A, Roy H, Murphy E. "Smart Bodies" school wellness program incresed children's knowledge of healthy nutrition practices and self-efficacy to consume fruit and vegetables. Appetite 2009;52(2):445–451.