Effects of school-based nutrition education on nutrition knowledge, self-efficacy and food choice intentions of learners from two primary schools in resource limited settings of Pretoria

Abstract

School-based nutrition education programs (NEP) may promote positive dietary practices in children. Thus, we assessed whether nutrition education would improve the nutrition knowledge and self-efficacy of Grade 2 and 3 learners and food choice intentions of Grade 1 learners in two resource-limited schools in Pretoria. Following a needs assessment, we planned a NEP to address the inappropriate dietary practices of learners. The NEP was guided by evidence from the literature and the South African food-based dietary guidelines and was embedded in Social Cognitive Theory (SCT). We tested the effects of the NEP using a quasi-experimental design. Conveniently selected learners (N=244) from two schools were taught nine lessons over a six-week period. A modified Pathways Knowledge, Attitudes and Behaviours questionnaire assessed the outcomes at baseline, six weeks and 12 months. Sixty-three percent (n=157) of participants completed the study. Compared to baseline, nutrition knowledge and food choice intentions were significantly improved at six weeks, while self-efficacy was slightly reduced. The two schools had significantly different food choice intentions scores. Overall, girls scored higher than boys for the measured outcomes, though non-significant. At 12 months, only nutrition knowledge was sustained. A tailored NEP can improve the nutrition knowledge and food choice intentions of Grades 1 to 3 learners in resource-limited settings. Specific interventions to improve nutrition self-efficacy ought to be developed and implemented for this age group. Further studies using randomisation as well as assessing actual dietary behaviours are needed.