Effectiveness of nutrition education in Dutch primary schools

<strong>“Nutrition education in Dutch primary schools”</strong> School-based nutrition education programmes have increasingly been used to teach children about nutrition and to provide them with the skills to make healthy food choices. As these programmes differ in content and delivery, it is hard to identify what intervention components and implementation conditions are most effective. Furthermore, as nutrition education is not mandatory in the Netherlands, it is not clear what effects can be achieved with nutrition education in Dutch primary schools. In this thesis therefore two versions of Taste Lessons were evaluated. Taste Lessons is a practice-driven school-based nutrition education programme on taste development, healthy nutrition, and food quality. The programme was evaluated on its aims to increase children’s interest in food, and their knowledge and skills regarding healthy and conscious eating behaviour. Furthermore, the influence of adding experiential learning activities and implementation factors on effectiveness are addressed. The first evaluation showed that partial implementation of the 10-12 lessons of Taste Lessons (first version) by the teachers during one school year resulted in small increases in psychosocial determinants of healthy eating behaviour. The highest increase was observed in children’s knowledge, which still persisted six months after the programme. A second evaluation was conducted with the aim to compare effectiveness of the revised and shorter version of Taste Lessons with and without additional experiential learning activities on change in (psychosocial determinants of) vegetable consumption and willingness to taste unfamiliar vegetables. Results from this second study showed that, with almost complete implementation of the five lessons of Taste Lessons by the teachers during a couple of weeks, similar results as the first effect evaluation. Again with knowledge as the strongest intervention effect. Additional experiential learning activities, such as an extended cooking lesson with a dietician and the parents, an excursion to a grower and a supermarket assignment with the parents, showed more and stronger increases in several psychosocial determinants of vegetable consumption than Taste Lessons without these additional activities. No significant intervention effects were found on children’s willingness to taste unfamiliar vegetables during a taste test, and also not on their daily vegetable consumption and food neophobia. Analyses on process indicators in both studies revealed that teachers and children highly liked Taste Lessons and that children most liked the experiential learning activities. Furthermore, children’s programme appreciation and interpersonal communication about the programme activities after the lessons were found to be positively associated with their change in psychosocial determinants. In conclusion, evaluation of Taste Lessons showed an increase in children’s knowledge and several other psychosocial determinants of eating behaviour. Implementation of (additional) experiential learning methods in school-based nutrition education is likely to enhance the intervention’s effectiveness, as children mostly liked these activities and children’s enthusiasm was the strongest predictor of effectiveness. No effects were found on children’s vegetable consumption. To achieve behavioural change, school-based nutrition education should be complemented with a consistent set of changes in children’s environment.