|
Program
Evaluation
Healthy
Choices, Healthy Me!
Evaluation
in first and second grade classrooms: 2003-04 school year
| |
Overview
During the 2003-04 school year, the Dairy Council of California
conducted a formative evaluation of its first and second grade curriculum,
Healthy Choices, Healthy Me! (HCHM). WestEd, an independent
evaluator completed the survey development, data collection, and
analyses. Approximately 400 California first and second grade students
from 30 classrooms statewide participated.
The
HCHM program is designed to impact student outcomes through the
use of a story, The Market Mystery, and student workbook
activities that teach students to group foods, identify how nutrients
are related to healthy bodies, and make healthy choices about eating
and physical activity.
The
results suggest that the HCHM program positively impacts students'
knowledge, attitudes, and behaviors. Data collected from teachers
and in-classroom observations also provided input on how to improve
the program.
|
Study Design
This evaluation project was
designed to answer the following questions:
- To what extent are the teachers and students
satisfied with the program?
- Do students improve their knowledge and food
choices after going through the program?
- What, if any, areas of improvements exist
in the implementation and use of the program?
Both quantitative and qualitative data were
used to answer these questions. Quantitative data were collected
from both students and teachers in the form of self-administered
surveys. Qualitative data were collected on the school site through
teacher interviews and classroom observations. Dairy Council and
WestEd conducted a total of 20 observations in second grade classes
and eight observations in first grade classes. No comparison group
was used for this evaluation and therefore no causal inferences
can be made about the program.
Teachers Approve!
Teachers had very positive
responses to the curriculum. Overall, students really liked doing
the activities, playing with the food cards, and talking about foods
they like to eat. Teachers liked teaching it. It was easy to use
and easy to augment with other activities beyond the workbook. Teachers
commented that the color pictures in the student workbook were very
helpful for students. Teachers felt that their students were more
aware of the foods they eat after participating in the HCHM lessons,
and some teachers observed that students were bringing healthier
snacks to school. Below are specific comments from teachers regarding
the program.
"I
really feel that this unit
meets a large portion of District
and State guidelines for health in 2nd grade. The unit was easy
to understand and teach. My children enjoyed it and learned a lot
of important information."
"It
is easy to use. It is a great workbook for the kids and they like
it. The story is fun
and easy to integrate with other subjects
(i.e. math charting, mystery genre, science)."
"Overall
it's a great nutrition program which is much better than the lessons
in our health books. I look forward to getting another set next
year."
Second
Grade Student Results
The final second grade student
sample consists of 330 students at pre-test, 339 students at post-test,
and 292 students at the 2-month follow-up. The data presented here
are for all students who participated at any of the three aforementioned
tests. The student survey consisted of 19 questions about foods
and the relationship of food to health.
The
findings suggest that the HCHM program had an impact on gains in
knowledge and self-reported eating behaviors among second grade
students in participating classrooms.
Knowledge
The knowledge questions asked
students to:
- Classify foods into groups.
The foundation of HCHM is learning which foods belong in each
food group. Statistically significant results demonstrate the
percentage of students classifying foods into groups improved
between pre-, post-, and 2-month follow-up for all six foods with
the greatest improvement of correct answers for peanut butter,
cheese, orange juice, and candy. (See Figure 1.)
Figure
1. Percent of second grade students correctly classifying foods

Note:
All differences are statistically significant for Pre/Post and Pre/2
Month follow-up except Carrots (Pre/Post).
- Identify the function of foods
on the body. Students learned the significance of each food
group and its unique contribution to health. Results show knowledge
about the functions of foods on the body improved significantly
across all food groups between pre-, post-, and 2-month follow-up
tests. Significantly more students correctly answered that milk
products were important for building strong bones and teeth at
post-test and 2-month follow-up, compared to pre-test (p <
0.00). (See Figure 2.)
Figure 2. Percent of second grade students correctly identifying
health benefits of food groups

Note:
All differences are statistically significant for Pre/Post and Pre/2
Month follow-up.
- Identify the missing food group
in a meal. The culminating activity in the program is for
students to identify the missing food group using the Food Guide
Pyramid as their guide. They are then asked to suggest a food
to balance the meal from the food group not included in the photograph
of a meal. Significantly more students correctly classified the
foods presented and correctly identified the missing food group
from both the hamburger and turkey sandwich meals at post-test
and 2-month follow-up, compared to pre-test (p < 0.00). The
students retained at least 70 percent of their knowledge in the
2-month follow-up test in regards to the hamburger and turkey
sandwich meal tests. (See Table 1.)
Table 1. Percent of second grade students identifying correct answers
in the hamburger and turkey sandwich meal and knowledge retained at
2-month follow up.
|
|
%
Correct |
|
|
|
Pre |
Post
|
2-Month
|
Knowledge Retained (%) |
Hamburger meal |
|
|
|
|
Identified food groups in the picture |
18.7
|
41.4
|
37.5
|
82.8
|
Identified the missing food group |
41.6
|
72.9
|
64.0
|
71.6
|
Identified both |
16.8
|
38.6
|
35.0
|
83.5
|

|

|

|

|

|
| Turkey
sandwich meal |
|
|
|
|
Identified food groups in the picture |
19.4
|
38.8
|
36.4
|
87.6
|
Identified the missing food group |
38.8
|
69.9
|
60.7
|
70.4
|
Identified both |
15.8
|
36.7
|
32.1
|
78.0
|
|
Note:
All differences are statistically significant for Pre/Post and Pre/2
Month follow-up
Eating behaviors
In addition to increasing knowledge
of food groups and their nutritive benefit, putting this newly acquired
information into action is a primary outcome of the program. Progress
towards healthier eating was assessed through eating behavior questions
focused on whether students ate breakfast and what foods they typically
ate for breakfast. Students were also asked to report frequency
of new foods and food groups using three response options, "never,"
"sometimes," and "a lot" to the question "How
often do you eat 'x' food."
- More than 80 percent of students ate breakfast
most days or always for all three tests. Although difference in
frequency of breakfast consumption was negligible between the
three tests, changes in the types of foods consumed were noticeable.
(Table 2.)
- The percentage of students reporting "Never"
eating "Milk & Milk Products" decreased steadily
to 4.2 percent in the post-test and 2.8 percent in the follow-up
test compared to 6.6 percent in the pre-test. This suggests that
the program impacted students' consumption of dairy products for
breakfast over time. (Table 2.)
Table 2. Breakfast behavior for second grade students.
|
|
Pre
(%)
|
Post
(%)
|
2-Month
(%)
|

|

|

|

|
|
Had
breakfast this morning
|
86.3
|
87.9
|
83.8
|

|

|

|

|
|
Eat
breakfast
|
|
|
|
|
Never
|
3.5
|
2.5
|
2.8
|
|
Sometimes
|
28.4
|
27.6
|
29.9
|
|
Almost
every day
|
68.1
|
69.9
|
67.4
|

|

|

|

|
|
Food
groups ate this morning
|
|
|
|
|
Meat,
beans & nuts
|
6.7
|
15.3**
|
11.6**
|
|
Milk
& milk products
|
52.7
|
64.0**
|
58.2
|
|
Vegetables
|
10.3
|
12.1
|
8.6
|
|
Breads
& grains
|
33.6
|
52.8**
|
48.6**
|
|
Fruits
|
24.6
|
32.2**
|
20.6
|
|
Extras
|
7.6
|
10.6
|
10.3
|

|

|

|

|
|
Foods
from milk products ate this morning
|
|
|
|
|
Yogurt
|
7.9
|
11.8*
|
12.3*
|
|
Milk
|
41.2
|
44.0
|
51.0**
|
|
Yogurt
smoothie
|
9.4
|
11.5
|
11.0
|
|
Chocolate
milk
|
27.9
|
28.1
|
25.0
|
|
Cheese
|
5.8
|
9.4*
|
7.9
|
|
String
cheese
|
8.8
|
10.3
|
10.3
|
|
* 0.05
< p < 0.10
**p < 0.05
First Grade Student
Results
The student survey was administered
to 98 first grade students at pre-test and 101 students at post-test.
No 2-month follow-up test was administered. The primary goal of
the data collection in first grade classrooms was to assess the
efficacy and grade appropriateness of a newly created program specific
to first grade students. While the outcomes from the survey were
interesting, they were most likely not statistically reliable due
to teacher survey administration methods, and significance tests
were not conducted. For first graders, the student survey consisted
of 10 knowledge questions-five about classifying foods into correct
food groups and five behavioral questions about eating breakfast.
Knowledge
Generally, the percentage of
first grade students classifying foods into groups improved between
pre- and post-test for all six foods with the greatest improvement
of correct answers for cheese, peanut butter, candy bar, and orange
juice. (See Table 3.)
Table
3. Percentage of first grade students correctly classifying foods
|
|
Pre (%) |
Post (%) |

|

|

|
Carrots |
96.9 |
96.0 |
Cheese |
54.2 |
95.0 |
Peanut Butter |
46.4 |
72.3 |
Orange juice |
66.7 |
84.2 |
Candy bar |
79.4 |
98.0 |
Bread |
90.1 |
94.0 |
|
Eating behaviors
- Eighty-nine percent of students reported
that they had eaten breakfast in the morning before the pre-test,
93.9 percent in the morning before the post-test. (See Table 11.)
Percentage difference of students reporting that they ate breakfast
sometimes or almost everyday was not statistically significant
at post-test.
- Similar to second graders, among the first
graders who reported eating breakfast the day of the survey, consumption
of each of the food pyramid groups increased for each group (except
Fruits) in the post-test compared to the pre-test. (See Table
4.)
- The greatest increases from pre- to post-test
were in the "Milk & Milk Products" (30.4%) and "Breads
& Grains" (11.8%) groups. (See Table 4.)
Table
4. Breakfast behavior for first grade
|
|
Pre
(%) |
Post
(%) |

|

|

|
Had breakfast this morning |
89.4 |
93.9 |

|

|

|
Eat breakfast |
|
|
Never |
1.0 |
1.0 |
Sometimes |
15.5 |
23.7 |
Almost every day |
83.5 |
75.3 |

|

|

|
Food groups ate this morning |
|
|
Meat, beans & nuts |
5.1 |
9.9 |
Milk & milk products |
43.9 |
74.3 |
Vegetables |
6.1 |
6.9 |
Breads & grains |
35.7 |
47.5 |
Fruits |
17.4 |
13.9 |
Extras |
14.3 |
18.8 |
|
Next Steps
Dairy Council of California believes that an important part of program
evaluation is acting on educators' comments on how to improve our
programs for classrooms. Program revisions are in progress based
on teacher feedback on the program and in the 2004-05 school year
a unique workbook will be available for first and second grade students.
This will better reinforce basics skills to first grade students
such as classifying foods into food groups. Revisions will allow
for second grade students to build on these foundation skills and
connect to more core curriculum areas such as through the Market
Mystery story and more advanced lessons such as using Venn
diagrams.
If you
are a first or second grade teacher in California you may order
Healthy Choices, Healthy Me! free of charge. Feel free to submit
this electronic order form or call 1-877-324-7901.
Click here to learn more about ordering materials from outside California.
|