Changing Adolescents' Food-Related Behavior Via Nutrition Education

A nutrition education behavior change strategy for secondary health classes was developed, implemented, and evaluated with 159 adolescents in 6 schools. The experimental design was pretest/posttest, treatment/control group with two treatment groups--one receiving only the behavior change strategy (BC) and one receiving the strategy plus a traditional knowledge-oriented component (BC+). Fundamental concepts of the behavior change strategy included personalization, goal setting, self-management, self-implementation, structured feedback, and structured self-evaluation. Based on a personal nutrient analysis, each adolescent in a treatment group selected improvement of one nutrient as a goal. Effectiveness of the strategy was tested by changes made in nutrient intake related to goal set. Pre- /post-assessments included three-day food records and written questionnaires of food practices and nutrition attitudes and knowledge. A rating instrument was administered to adolescents in treatment groups to assess their perceptions of activities facilitating change.

Setting a goal for specific nutrient improvement had the strongest effect on change. No difference between treatment groups was found. Adolescents who set a goal related to calcium, vitamin A, and vitamin C increased intake and those with a sodium-related goal decreased sodium. No positive changes in nutrient intake occurred for the control group. Gender was related to positive change for calcium, vitamin A, folacin, and vitamin C, with males making significant improvements. Nutrition attitudes and knowledge generally were not related to change. Food practice scores, as assessed by the written questionnaire, increased for the BC+ group only. Knowledge scores increased in both treatment groups but not in the control group. No differences in attitudes were seen, either within or among groups.

Activities perceived as most helpful in facilitating change included keeping food records, assessing personal nutrient intake, implementing a plan for nutrient improvement, and participating in follow-up classes.