w z wz 16(2) : 183~194, 2011 Korean J Community Nutr 16(2) : 183~194, 2011 DOI:10.5720/kjcn.2011.16.2.183 초등학교 3 학년을대상으로한영양교육의효과평가 «wáw 1) Á½x 2) ƒm w w œ, 1) w y w w t w, 2) ƒm w y w t w œ Evaluation of a Nutrition Education Program for 3rd Grade Elementary School Students %VL)B,XPO4VOH/JN)BO )ZF,ZFPOH,JN Nutrition Education, Graduate School of Education, The Catholic University of Korea, Bucheon, Korea 1) Department of Food and Nutrition, Seoul National University, Seoul, Korea 2) Department of Food Science & Nutrition, The Catholic University of Korea, Bucheon, Korea "CTUSBDU This study examined the effects of a nutrition education program on nutrition-related knowledge, eating habits, and dietary behavior. Subjects were 3rd grade elementary school students in Anyang, Gyeonggi-do. A 5-week nutrition education program was implemented to 28 children and another 26 children were included in the study as a control group. A self-administered questionnaire was used to assess the effects of nutrition education program. Mean nutrition related knowledge score was improved after education (p < 0.001). There was a significant improvement in knowledge of nutrient source (p < 0.05), role of protein (p < 0.05), food tower (p < 0.001), getting information from nutrition labeling (p < 0.05), and proper way of snacking (p < 0.001). Eating habits and self-efficacy also tended to improve by nutrition education, especially eating habit of snack and self-efficacy on balanced diet reached significant improvement (p < 0.05). Food consumption frequency was not changed significantly, only consumption of sea weeds which is considered as a reluctant food among children was increased after education (p < 0.05). In addition, the number of leftover food items and total amount of leftover at school lunch reduced significantly after education when compared with the same 10-day menu prior to education (p < 0.01). This result suggests that unbalanced dietary behavior has been changed with the nutrition education program. In conclusion, the nutrition education program was found to be effective in improving nutrition-related knowledge, eating habits, and dietary behavior. (Korean J Community Nutr 16(2) : 183~194, 2011) KEY WORD : elementary school childrenánutrition educationánutrition-related knowledgeáschool lunch leftover 서 #: l #45 # vp# #k p#l l #e #e~r# q #m #~ p# # qp#t #e #mk p#rr # # n rp +Wudkpv#5333,/#p #o # #q #mk r p=#5344 #5o#4:p#r rp=#5344 #6o#54p# r }ˆp=#5344 #6o#63p#}ˆ Corresponding author: Hye-Kyeong Kim, Department of Food Science & Nutrition, The Catholic University of Korea, 43-1 Yeokgok 2-dong, Wonmi-gu, Bucheon, Gyeonggi-do 420-743, Korea Tel: (02) 2164-4314, Fax: (02)2164-4314 E-mail: hkyeong@catholic.ac.kr 론 #m #ed p# p# n#tn 1#l # p#e d p# q# o #k #pv /# l # #m p# #k r#p +Nrr# #5339,1 # k p# #mkp#tn p#pe v# #e ˆl #mk # l# n~# p#mk r # # #p 1#533; # mks l# l #9 44 l# # #k p#mk # eˆl # dp# q p#9615(/# p# p#8613( # t l# # p# p# m 1# /# + p#57314(,/# v+ q p#4<919(,/#p+ q p#45918(,# p#mk #mk tp p # p # ˆ #mk p# r #re l +Plqlvwu # iru# Khdowk/# Zhoiduh# dqg# Idplo # Diidluv +PKZID,# )# Nruhd# Fhqwhuv# iru# Glvhdvh# Frqwuro 183
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«wáw Á½x Á185 Table 1. Summary of nutrition education program Session Topics Activities & Materials 1 Nutrients 2 3 4 5 Nutritional problems Solution to nutritional problem What is the role of nutrients? Food sources of nutrients Why is it harmful to have too much sugar? What can I do to reduce sugar intake? Why is it unhealthy to have too much fat? Which food contains a lot of fat? What is trans fat? Why childhood obesity is harmful? Let's check my obesity index What is balanced diet? What can we find in nutrition labeling? Proper food selection skills 6 Let's play with food tower 7 8 How to improve eating habits? Let's talk about good eating habits Importance of not skipping breakfast Let's talk about good eating habits Balanced diet, not being picky PPT, quiz Worksheets PPT, song PPT, Health signal lights PPT, song cartoons, website PPT, song Food tower model Food stickers PPT, website Videos PPT, website Videos 9 Good food choices for a snack Booklets 10 I can do! Let's talk about what can I do Presentation & Discussion p#o # #~ # #mk r# kp # q #mk #o #e ˆ #mk er# np# #e ˆ p#re mp #ed # p k e# v#k # rp # /# e v#k /# e p#m # p#re m 1# # v p #k p# #kl #e} #e # r # # l#e }pv # o # m 1# p #Žo p +Srzhu Srlqw/#SSW,#q # l# # # #d p # # d # #p # m /#edp# p#vl#tl v# r # # # p# np#p # k #t ep# l # o p #ee m 1# o# # d r mp /# #p l# p l # # m 1# o# # #q # # # ov qp#sl #r p# l# p# # r# m l# #l l#r n m 1 n fa j mk op# # # o # s p# p # op# r/# l# s #ee # # p # # m 1# v # l +Sdun# # 5333># Vklq# 5337>#Zrr# #5339>#K xq#)#nlp#533:,l# l qp#p /#mkve/#ed /#e}pv # m q p#žk #o # # #e s # m 1#q # v #6 # p# p # # r e s m#p # #p #~ # # ov qp#slp# ˆp # l# v# p# p m#nl # r/# m l# n m 1# p p#k p# /#l /# rëq /#l p#v q#o /# r# p#e t q/# pp#~ l# #pep vr# vl# # m /# #l#ee #e~ # # p#eq/#~tp#s # l#~v v +Erg #Pdvv#Lqgh{/#EPL,m# # m 1 # #EPL # tp # # k# #~ #e~ o t +Nruhd# Fhqwhu# iru# Glvhdvh# Frqwuro# dqg Suhyhqwlrq+NFGF,#)#Wkh#Nruhdq#Shgldwulf#Vrflhw +NSV,#533:,p# Ël #EPL# o m# l m 1#r~tp#EPL# o #8(# /#r ~tp 8( ;8(# /# ~tp#;8( <8(# /# p#<8( p p # m 1# # p #s # vk m#mk # #tevoq#q # l# d # rp# rr# #v # n m 1# mkvep#mk #e l# # vep#tr #mk p# o #l /#l p# /#e # # e/#e ˆ #mk e/#k e/#m # e l# #46 v p#re m 1# # l# #r p#4r/#m p#3r p# l l#46r# rp # l# m 1# k p#ed # #eˆ #Žk #o #e p# /#k e #l # #e # /# el # # el /#n e# # e# #eˆ/#e #ˆ # p# #43 p # m 1# # l# #6r#} + @ 6r/# p
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«wáw Á½x Á187 Table 2. General characteristics of the subjects Variable Gender Age (yrs) Perceived body type Male Female 7 8 9 Thinness Normal Fatness Educated (n = 28) 15 (53.6) 1) 13 (46.4) 1 (53.6) 19 (67.9) 8 (28.5) 8 (28.6) 14 (50.0) 6 (21.4) Control (n = 26) 13 (50.0) 13 (50.0) 1 (53.8) 19 (73.1) 6 (23.1) 4 (15.4) 21 (80.8) 1 (53.8) Total (N = 54) 28 (51.9) 26 (48.1) 2 (53.7) 38 (70.4) 14 (25.9) 12 (22.2) 35 (64.8) 7 (13.0) Statistical value 5 0.069 5 0.212 5 6.239* Height (cm) 129.1 6.4 2) 129.8 6.5 129.4 6.4 5 0.37 Weight (kg) 31.2 6.7 29.3 6.1 30.3 6.4 5 1.08 BMI (kg/m 2 ) 18.6 2.9 17.2 2.3 17.9 2.7 5 1.85 Obesity status 3) Mother's working status Person who prepare meals Beneficiary of school meal support program Underachieved student Underweight Normal Overweight Obese Yes No Without mom Mother Father Grandparents Others Yes No Yes No 2 (57.1) 15 (53.6) 4 (14.3) 7 (25.0) 12 (42.9) 14 (50.0) 2 (57.1) 17 (60.7) 2 (57.2) 7 (25.0) 2 (57.1) 4 (14.3) 24 (85.7) 4 (14.3) 24 (85.7) 2 (57.7) 20 (76.9) 3 (11.5) 1 (53.9) 17 (65.4) 9 (34.6) 0 (50.0) 25 (96.2) 1 (53.8) 0 (50.0) 0 (50.0) 8 (30.8) 18 (69.2) 4 (15.4) 22 (84.6) 4 (57.4) 35 (64.8) 7 (13.0) 8 (14.8) 29 (53.7) 23 (42.6) 2 (53.7) 42 (77.8) 3 (55.5) 7 (13.0) 2 (53.7) 12 (22.2) 42 (77.8) 8 (14.8) 46 (85.2) 5 5.217 5 3.880 10.798* 5 2.119 5 0.013 *: p < 0.05 1) N (%) 2) Mean SD 3) Obesity status by BMI percentiles for age: Underweight: < 5th percentiles, normal: 5th~85th percentiles, overweight: 85th~ 95th percentiles, obese:= 95th percentile Table 3. Comparison of nutrition-related knowledge before and after receiving nutrition education Questions Educated (28) Control (26) Pre Post t-value Pre Post t-value Major nutrients in vegetables 0.54 0.51 1) 0.79 0.42 1.888 0.38 0.50 0.69 0.47 2.857** Major nutrient in rice 0.14 0.36 0.43 0.50 2.521* 0.19 0.40 0.15 0.37 0.570 Major functions of milk 0.71 0.46 0.86 0.36 1.279 0.85 0.37 0.85 0.37 0.000 Role of protein 0.36 0.49 0.64 0.49 2.295* 0.35 0.49 0.46 0.51 1.364 Multiple choices on fast food 0.61 0.50 0.55 0.51 0.902 0.55 0.51 0.38 0.50 1.140 Health problems related to sugar intake 0.32 0.48 0.39 0.50 0.570 0.27 0.45 0.19 0.40 0.700 Multiple choices on eating habits to prevent obesity 0.71 0.46 0.68 0.48 0.328 0.62 0.50 0.62 0.50 0.000 Definition of balanced diet 0.71 0.46 0.54 0.51 3.286** 0.62 0.50 0.46 0.51 0.811 Matching foods to suitable floor of the food tower 0.25 0.44 0.71 0.46 4.264*** 0.27 0.45 0.31 0.47 0.440 Multiple choices on breakfast 0.68 0.48 0.71 0.46 0.372 0.69 0.47 0.69 0.47 0.000 Definition of unbalanced eating 0.75 0.44 0.82 0.39 1.000 0.73 0.45 0.85 0.67 1.140 Information from nutrition labeling 0.39 0.50 0.68 0.48 2.521* 0.46 0.51 0.42 0.50 0.570 Multiple choices on proper way of snacking 0.29 0.46 0.71 0.46 3.959*** 0.31 0.47 0.42 0.50 1.364 Total score 2) 6.05 2.67 8.46 3.56 5.478*** 6.05 3.66 6.5 3.73 1.325 *: p < 0.05, **: p < 0.01, ***: p < 0.001 by paired t-test : p < 0.05, : p < 0.01 by t-test (group difference) 1) Mean SD 2) Possible total score ranged from 0 13 points, each item was scored (1=correct or 0=incorrect)
188Á w z o# #mk p# oe +s?3138,/# vp# +s? 3138,/#mk el #l #r +s?3138,/# #p #e +s?31334,/#e ˆ+s?31334,/#m # e +s?31334,p##9 # l #op #mkve#r # p# ˆ /# # # #r #e ˆ# l#l m# ep#r #tn#mk # l # s l# #oprp # k 1# s p# p# k# } #r #tn#mk # p#mkve#r #opr p # d l +s?3134,1 m mk op# #e # #kk #o # #v p r# v # #ee # # o#r# #v p#ed r p# # # #v p#e #r l #opr p# p #ll# r# v p# # p # ˆ 1# o # s # #ed #rp#oprp# # ˆ v#kk +Wdeoh#7,1# # o l #mk o# # e # l# #r #op # p # ˆ l# #4 #p # e# k p#v l +s?3138,/# p# k# s p#k e p#e #r # d m #r e #r # m +s?3138,1# h Ð m mk o#ee#r# #v p#e # # / } #n#:sp#e # s p# # p# p#pl /# # #s l# # p# s p#o p # # k +s?3138/#wdeoh#8,1# #m k r #ppˆ# #p #ov# # /#ˆ p /#Žd /# e /# #k# Že p# # s p# kp # rp #op # p # ˆ v#kk 1# o p#mk o# #k p# #e p# p# s p# #op # d l +s?3138,1# #n l# # #s /#o # # /#no# #or /# / #k# Že # #8sp#e p# # #r o# # kv # p# m 1# s p# n # p# # k#} m# e p# #op #v l +s?3138,1# n³q m mk op# #epq # #kk #o # v p# r# v # #ee # /# o p# #q #r #6;1<3r/# s p# r #69156rp # o p# # kv # rp #op # p #ll +Wdeoh#9,1# o p#mk o# # e # # k#š rp# #}p#p # p# v#kp#qep#p p# p#rn #q p# # p#r m##r d # p# m 1# # e v#k # p# # p# #p p# l #op #qe p# dp# ˆ 1# /# p# # k# s p#q p#opr p# #ll 1 Table 4. Comparison of eating habits before and after receiving nutrition education Questions Educated (28) Control (26) Pre Post t-value Pre Post t-value 51. Do you eat meals regularly? 51.39 0.63 1) 1.57 0.74 1.095 1.73 0.67 1.81 0.75 0.464 52. Do you have breakfast every morning? 51.25 0.44 1.32 0.55 0.701 1.27 0.45 1.54 0.65 2.273* 53. Do you eat meals faster than others? 51.61 0.69 1.79 0.74 1.307 1.96 0.77 1.62 0.57 2.087* 54. Do you eat meals until you are full? 51.50 0.70 1.68 0.82 1.307 1.62 0.80 1.69 0.80 0.464 55. Do you only eat side dishes you like? 51.71 0.66 1.79 0.83 0.570 1.88 0.77 1.69 0.74 1.224 56. Do you eat snack more than once a day? 51.61 0.74 2.07 0.86 2.100* 1.88 0.82 1.85 0.88 0.182 57. Do you skip meals after eating snacks? 51.46 0.79 1.50 0.75 0.205 1.62 0.80 1.88 0.91 1.428 58. Are you eating out more than once a week? 52.43 0.69 2.29 0.76 0.812 2.08 0.63 2.19 0.75 0.647 59. Do you have midnight snack? 51.50 0.75 1.64 0.73 1.162 1.46 0.71 1.46 0.65 0.000 10. Are you watching TV or reading a book while eating? 51.57 0.69 1.39 0.69 1.544 1.50 0.71 1.54 0.71 0.205 Total score 2) 18.54 3.47 18.68 2.21 0.255 18.50 3.17 19.08 3.73 0.790 *: p < 0.05, **: p < 0.01, ***: p < 0.001 by paired t-test : p < 0.05, : p < 0.01 by t-test (group difference) 1) Mean SD 2) Possible total score ranged from 10 30 points. Each item was scored (3 = yes, 2 = often, 1 = no) and item 3, 4,5, 7, 8, 9, 10 were scored reversely
«wáw Á½x Á189 Table 5. Food consumption frequency before and after receiving nutrition education Food Educated (28) Control (26) Pre Post t-value Pre Post t-value Vegetables 2.77 2.13 1) 3.25 2.32 1.277 2.71 2.35 3.77 2.60 2.148* Fish and shellfish 2.11 1.88 2.64 1.73 1.371 3.39 2.38 3.81 2.50 0.701 Meat and poultry 2.36 2.30 2.38 1.78 0.037 2.90 2.30 2.52 1.88 0.833 Beans and Tofu 2.59 2.02 2.23 2.19 1.033 3.13 2.52 2.83 2.55 0.559 Fruits 4.41 2.31 4.25 2.40 0.336 4.65 2.15 4.27 2.43 0.708 Milk and dairy products 3.86 2.72 4.63 2.10 1.431 4.62 1.97 4.14 2.75 0.785 Sea weeds 2.38 2.09 3.38 2.42 2.121* 2.89 2.66 3.33 2.45 0.828 Kimchi 4.09 2.47 4.48 2.67 0.644 4.90 5.33 5.17 2.29 0.529 Sweets 1.68 1.94 2.57 2.19 1.729 1.89 1.72 2.13 2.39 0.556 Soft drinks 1.25 1.75 1.30 1.64 0.161 1.65 1.41 1.24 1.54 1.651 Fast food 1.07 1.80 1.09 1.69 0.044 1.21 1.64 1.14 1.47 0.217 Flour based food 1.39 1.62 1.79 2.22 1.093 2.38 2.09 1.62 1.72 2.255* Street stall foods near school 0.96 1.73 0.95 1.56 0.044 1.04 1.78 0.98 1.87 0.127 *: p < 0.05 by paired t-test : p < 0.05 by t-test (group difference) 1) Mean SD, Each food item was scored by 5 scales (7 = every day, 5.5 = 5~6 times a week, 3.5 = 3~4 times a week, 1.5 = 1~2 times a week, 0 = rarely) Table 6. Comparison of self-efficacy before and after nutrition education Questions Education (28) Control (26) Pre Post t-value Pre Post t-value I can have meals regularly 53.68 0.91 53.79 1.03 0.486 53.65 0.98 53.54 1.27 0.570 I can eat meals at moderate pace 53.75 1.35 53.75 1.18 0.000 53.38 1.02 53.69 1.23 0.927 I can eat adequate amount of meals 54.04 0.92 54.29 0.90 1.126 53.69 1.05 54.04 1.34 1.140 I can have breakfast every morning 53.86 1.38 53.86 1.11 0.000 53.54 1.24 53.62 1.30 0.440 I can eat meals with variety of side dishes 53.00 1.22 53.57 1.43 2.161* 53.35 1.16 53.46 1.50 0.398 I can snack fresh fruits instead of candy or cookies 54.43 0.88 54.68 0.86 1.045 54.42 0.76 54.23 1.42 0.817 I can choose juice or milk instead of soft drinks 54.43 0.79 54.50 0.92 0.386 54.12 0.82 53.92 1.38 0.655 I can drink more than two cups of milk a day 53.57 1.48 53.86 1.51 1.395 53.73 1.22 53.88 1.31 0.570 I can exercise to sweat more than three times a week 53.89 1.23 53.93 1.44 0.118 53.31 1.09 53.23 1.37 0.296 I can have meals without watching TV or reading a book54.25 1.14 53.82 1.63 1.511 53.04 1.18 53.19 1.65 0.440 Total score 2) 38.89 6.01 40.04 7.57 1.202 36.23 5.04 36.81 7.91 0.415 *: p < 0.05 by paired t-test 1) Mean SD 2) Possible total score ranged from 10 50 points. Each item was scored by 5-point scales ranging from 'strongly agree' (5) to 'strongly disagree' (1) j m mk op# e#q l# # #kk #o # o#rë # #k p# #pel# #q #dž ƒp# #w0whvw # m +Wdeoh#:,1# o#rl # s # o p# p #llp #mk o# # p# l # o p#q #džƒp# # l# # l#op rp# p # ˆ 1# # o# # +s?31334,/# +s? 31334,/# +s?3134,l # # # l#op # p ˆ pp# lt 1# # p#er#q l# #m p# #o # p# v# p# #pp#q p # r l# m 1# o#r# o # s p#pp#q p# p# #31;: Ë 319: nj/#31;5 Ë 318: njp # p #ll 1 mk o# # #43p p# p#e p #q p# r # o p# #q p#3157 njp #oprp # m +s?3134,1#
190Á w z Table 7. Comparison of school lunch leftover between control and educated groups Leftover stickers (piece) Pre Post Educated Control t-value Educated Control t-value Rice 60.80 1.14 1) 61.50 1.27 1.300 0.10 0.32 61.90 1.29 4.296*** Soup 17.60 7.11 19.40 5.21 0.646 6.90 3.90 17.60 5.10 5.268*** Main dish 65.10 6.12 66.60 6.48 0.532 1.80 3.29 64.90 6.05 1.424 Side dish 69.70 5.64 11.80 5.90 0.814 2.60 2.37 67.50 4.53 3.033** Kimchi 67.30 2.41 67.00 1.89 0.310 4.10 2.23 63.80 2.49 0.284 Dessert 61.10 2.47 60.60 1.90 0.508 0.10 0.32 60.20 0.63 0.447 Amount of leftover (kg) *: p < 0.05, **: p < 0.01, ***: p < 0.001 1) Mean SD 60.87 0.67 60.82 0.57 0.778 0.24 0.19 60.62 0.58 2.864** 고 p#l l # #kke# q# # #6 p p # #43 e#8t p#mk op#mkve/#ed #e l# #m p#s #o #mk op#ee # o #mk op#ee v#kp# s p# m 1# s qp# #eq #~tp#533: # # k# ~ #e~ o# t +NFGF#)#NSV#533:,p#; < m# p# #eq #~t# # p# tpl 1# o # s # # p#eq #~t/# # # # #v p#oprp# p # ˆ v#kk 1# # pp#~ pv l # o p# s l# # # # # p #p # pp# k# o p# pp#~ l# # # p #ppp# lt +s?3138,1# #nl# /# rëq # /#l p#vl#o /#tevol /# vk# p# p# d l# #v p# vrp#v p # # #pl 1 k p#mkve#rp# o#r# #913+79r2433 r,p # l l # +Sdun# #5333>#\x# 533:>#Mhrqj#)#Nlp#533<,# p#mkve# t # # ˆ 1#p # l p# p#7 9 p # # #l p#6 #p# p # #l #4 5 l #mk op# p#p lvv#k # p # p 1# #l # o q #l # # r# l# ol p# l#6 p# p # p/# /# m p#pn # p# pm# l# o m 1# #7/#8/#9 #k p# p #8t #e op#ee # l # # +Ohh# #5338,/#mk vep# #7 p#8;1;rl #;614r/#8 p#8<13 찰 rl #::13r/#9 p#9618rl #;315rp #r # d p# # p#7 p # ˆ #p # rp# m 1#mkvep#rp# o#r# #913l #mk o# o p# p#;179+ #98r2433r,p #k#73(#r # d # rrp# # ˆ 1#p #mk o#e e # ee p# # # l +\rrq# #5333> Ohh#)#Ohh#5337>#\rq#)#K xq#533:,m#o l#k p#mk op#mkve# l# rpp#k# #p 1# #r # pl# # # #s # k p nop#l /# e# # ep#rp/# p#m #o e d # p# r # rp # p# /#mk p o+ˆ, #l + v,l# # ve #e n l# n #mk e# #m # e # l #vep# # s # ˆ 1#p # #8 p# p # #Dkq# +533<,p#l l #mk p# # oe l# #ver # k # m#zrr# +5339,p#l l # ep#rpl# #r pp# p# #mk el# #r pp# o# l # k #l m#o # # m 1#mk ol#p #k p#mkv e# # #mk p# oe /# vp# /#m k el #l #r /# #p #e /#e ˆ/#m e l# # #r~##r #oprp # d l# o# #mkvep# # ˆ pp#k# #p 1 # s l # } #r #tn#mk # +s?3134,l #op #r # dp# ˆ /#p # l l #v #mk o l#nl # l #~o/# # #ˆ# l #mkvel# # d p# eˆ #plp # # p # p 1# mk ol#p #mkvep# #eˆ /#e l #m p#p # # pv#k 1#e eˆ#
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«wáw Á½x Á193 q p#3157 njp #oprp # m +s?3134, p p#l # # #q #e p#pn l#e e # #6 #k # p#mk op#mk ve p# eˆ #epq /#eˆ # #e r rp #sp# p # # p# ˆ p # ep#q s m#q p# e # e rl#op m p#t# #ppp#e m 1# # v # # mk# # ep# #e v #ed # l p # #k p# prp#mk o# p #re # pp /# # o #l #~ rp #v rp# p# # n# rp# o # # #pp p # 1 k Ahn Y, Ko SY, Kim KW (2009): Evaluation of a nutrition education program for elementary school children. Korean J Community Nutr 14(3): 266-276 Bundy D (2005): School health and nutrition: policy and programs. Food Nutr Bull 26(2): S186-192 Heo ES (2002): Evaluation of problem and nutritional education status for children's nutrition, and the development of internet assisted nutritional education program for children's healthy dietary habit. Dissertation, Changwon National University Hwang SN (2008): Nutrition education for elementary school students step by step process. 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