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More Than Reading, Writing, and Arithmetic
From JNEB More Than Reading, Writing, and Arithmetic It has been a long time since schools' focus was only on the big 3: reading, writing, and arithmetic. There are so many other curricula requirements, technology initiatives, and competitive electives that I am sometimes amazed that nutrition and physical activity continue to be a priority in many schools. Nutrition educators and devoted teachers and principals should receive high praise for keeping these life skills in schools as much as they have. Scherr et al1 describe the outcomes of a randomized control trial of fourth graders in 2 schools compared with 2 control schools. This multicomponent intervention was ambitious, including nutrition and physical activity; the students and the family; the school environment; school policy; and was framed in behavioral theory. The results of this careful planning and implementation were healthier children. I’m sure it wasn’t easy and the researchers, teachers, and families are to be commended for this work. Now we are challenged to replicate and implement in other schools and other age groups. These 9- to 10year-olds may be easier to work with since puberty likely would not be intruding with its emotional roller coaster. The work by Aparicio et al2 does tackle this age group. They used screening tools for emotional distress to determine if there was a relationship among mental symptoms and eating patterns. Girls with emotional symptoms were more likely to have a sweet and fatty food pattern, while in boys, high phys-
ical activity was inversely related to this eating pattern. Perhaps another module to add to a very full day in school should target skills for healthy emotional coping. Outside the school day but still at the school, interventions for after-school programs also have been shown to be effective. In a study that included 17 elementary and 1 middle schools in the Midwest, students participated in a 10-week afterschool program teaching cooking and nutrition led by chef instructors.3 Participants increase fruit and vegetable intake, nutrition knowledge, as well as self-efficacy for cooking. Parents also reported an increase in dinner conversations that included healthy food, the child helping with the cooking, and the parents' own perception of the importance of the family meal. Knowledge and self-efficacy have been reported to be the most often used measures of school-based nutrition education interventions.4 In their systematic review, Hernandez-Garbanzo et al4 reported that in 20 articles, there were 15 instruments used, with 14 studies using a theoretical framework to guide the intervention. However, only 7 instruments at that time were rigorously tested for reliability and to include low income youth. So, despite being creative and persistent, with many studies showing improvements in psychosocial areas and behavior, we still have work to complete. We now have 28 papers describing the validity and reliability of questionnaires that can be used with children in our survey validation collection. Many of you have contacted me for additional JNEB articles that could be
included as well. As we continue to develop this collection, and these measures are incorporated into our schoolbased interventions, I expect that the quality of our studies in schools will increase, and our efforts be rewarded with significant improvements in child health. Karen Chapman-Novakofski PhD, RD, LDN Editor-in-Chief
REFERENCES 1. Scherr RE, Linnell JD, Dharmar M, et al. A multicomponent, school-based intervention, the Shaping Healthy Choices Program, improves nutritionrelated outcomes. J Nutr Educ Behav. 2017;49:367-378.e1. 2. Aparicio E, Canals J, Voltas N, Valenzano A, Arija V. Emotional symptoms and dietary patterns in early adolescence: a school-based follow-up study. J Nutr Educ Behav. 2017;49: 404-413.e1. 3. Jarpe-Ratner E, Folkens S, Sharma S, Daro D, Edens NK. An experiential cooking and nutrition education program increases cooking self-efficacy and vegetable consumption in children in grades 3-8. J Nutr Educ Behav. 2016;48: 697-705. 4. Hernandez-Garbanzo Y, Brosh J, Serrano EL, Cason KL, Bhattarai R. Psychosocial measures used to assess the effectiveness of school-based nutrition education programs: review and analysis of self-report instruments for children 8 to 12 years old. J Nutr Educ Behav. 2013;45:392-403.
ical activity was inversely related to this eating pattern. Perhaps another module to add to a very full day in school should target skills for healthy emotional coping. Outside the school day but still at the school, interventions for after-school programs also have been shown to be effective. In a study that included 17 elementary and 1 middle schools in the Midwest, students participated in a 10-week afterschool program teaching cooking and nutrition led by chef instructors.3 Participants increase fruit and vegetable intake, nutrition knowledge, as well as self-efficacy for cooking. Parents also reported an increase in dinner conversations that included healthy food, the child helping with the cooking, and the parents' own perception of the importance of the family meal. Knowledge and self-efficacy have been reported to be the most often used measures of school-based nutrition education interventions.4 In their systematic review, Hernandez-Garbanzo et al4 reported that in 20 articles, there were 15 instruments used, with 14 studies using a theoretical framework to guide the intervention. However, only 7 instruments at that time were rigorously tested for reliability and to include low income youth. So, despite being creative and persistent, with many studies showing improvements in psychosocial areas and behavior, we still have work to complete. We now have 28 papers describing the validity and reliability of questionnaires that can be used with children in our survey validation collection. Many of you have contacted me for additional JNEB articles that could be
included as well. As we continue to develop this collection, and these measures are incorporated into our schoolbased interventions, I expect that the quality of our studies in schools will increase, and our efforts be rewarded with significant improvements in child health. Karen Chapman-Novakofski PhD, RD, LDN Editor-in-Chief
REFERENCES 1. Scherr RE, Linnell JD, Dharmar M, et al. A multicomponent, school-based intervention, the Shaping Healthy Choices Program, improves nutritionrelated outcomes. J Nutr Educ Behav. 2017;49:367-378.e1. 2. Aparicio E, Canals J, Voltas N, Valenzano A, Arija V. Emotional symptoms and dietary patterns in early adolescence: a school-based follow-up study. J Nutr Educ Behav. 2017;49: 404-413.e1. 3. Jarpe-Ratner E, Folkens S, Sharma S, Daro D, Edens NK. An experiential cooking and nutrition education program increases cooking self-efficacy and vegetable consumption in children in grades 3-8. J Nutr Educ Behav. 2016;48: 697-705. 4. Hernandez-Garbanzo Y, Brosh J, Serrano EL, Cason KL, Bhattarai R. Psychosocial measures used to assess the effectiveness of school-based nutrition education programs: review and analysis of self-report instruments for children 8 to 12 years old. J Nutr Educ Behav. 2013;45:392-403.