From a workshop at "Farms & Food: Teaching the Hudson Valley from the Ground Up," July 2014, Hyde Park, NY, for more information, www.TeachingtheHudsonValley.org "Empowered Eaters: Making Connections through Food & Nutrition Education." Let’s think broadly about food and nutrition education for the next generation. Explore ways to inspire youth to care about how choices influence their health, that of the planet, and the lives of everyone working with food from farm to plate. We’ll also review how to empower students to create practical action plans to successfully make real changes in their day-to-day food choices. Pam Koch, professor of nutrition education and executive director, Laurie M. Tisch Center for Food, Education & Policy, Teachers College, Columbia University

1. Nutrition Education
DESIGN Procedure
Pamela Koch, EdD, RD
Program in Nutrition
Teachers College Columbia University
With
Isobel Contento, PhD, Emily Abrams PhD, & Ana Islas EdD

2. Social /Environmental
Determinants:
Social/ cultural
environment:
•Social relations
•Cultural practices
•Social structures
•Public policy
Informational
environment
Economic
environment
•Resources
•Price
•Time
• Food availability
• Built environment
•Advertising
•Media
Biologically
determined
behavioral
predispositions:
•Taste/pleasure
•Sweet, sour, salt, bitter
•Hunger/satiety mechanisms
•Sensory specific satiety
Experience with Food:
Associative conditioning
Physiological
conditioning:
•Familiarity:
learned safety
•Conditioned food
preferences
•Conditioned satiety
Social conditioning:
Person-Related
Determinants
•Motivations &
values
•Personal
meanings
•Knowledge &
skills
FOOD CHOICE AND
DIET-RELATED
BEHAVIORS
•Social norms
•Cultural
norms•Social affective
context
•Parenting practices
•Perceptions
•Attitudes
•Beliefs
Inter-person
factors
Family & social
networks
Intra-person
factors
Physical/ built
environment
.

3. Social /Environmental
Determinants:
Social/ cultural
environment:
•Social relations
•Cultural practices
•Social structures
•Public policy
Informational
environment
Economic
environment
•Resources
•Price
•Time
• Food availability
• Built environment
•Advertising
•Media
Biologically
determined
behavioral
predispositions:
•Taste/pleasure
•Sweet, sour, salt, bitter
•Hunger/satiety mechanisms
•Sensory specific satiety
Experience with Food:
Associative conditioning
Physiological
conditioning:
•Familiarity:
learned safety
•Conditioned food
preferences
•Conditioned satiety
Social conditioning:
Person-Related
Determinants
•Motivations &
values
•Personal
meanings
•Knowledge &
skills
FOOD CHOICE AND
DIET-RELATED
BEHAVIORS
•Social norms
•Cultural
norms•Social affective
context
•Parenting practices
•Perceptions
•Attitudes
•Beliefs
Inter-person
factors
Family & social
networks
Intra-person
factors
Physical/ built
environment
Nutrition Education
.

4. Social /Environmental
Determinants:
Social/ cultural
environment:
•Social relations
•Cultural practices
•Social structures
•Public policy
Informational
environment
Economic
environment
•Resources
•Price
•Time
• Food availability
• Built environment
•Advertising
•Media
Biologically
determined
behavioral
predispositions:
•Taste/pleasure
•Sweet, sour, salt, bitter
•Hunger/satiety mechanisms
•Sensory specific satiety
Experience with Food:
Associative conditioning
Physiological
conditioning:
•Familiarity:
learned safety
•Conditioned food
preferences
•Conditioned satiety
Social conditioning:
Person-Related
Determinants
•Motivations &
values
•Personal
meanings
•Knowledge
& skills
FOOD CHOICE AND
DIET-RELATED
BEHAVIORS
•Social norms
•Cultural
norms•Social affective
context
•Parenting practices
•Perceptions
•Attitudes
•Beliefs
Inter-person
factors
Family & social
networks
Intra-person
factors
Physical/ built
environment
Nutrition Education
.

5. DEFINING NUTRITION EDUCATION
Is “Nutrition Education” The
Wrong Term?

6. DEFINING NUTRITION EDUCATION
Nutrition education is any combination of
educational strategies, accompanied by
environmental supports, designed to facilitate
voluntary adoption of food choices and other
food and nutrition-related behaviors conducive to
health and well-being (of individuals, community,
planet)

7. DEFINING NUTRITION EDUCATION
Promoting environmental supports for action
When and where to take action
Enhancing motivation
to act
Why-to take action
Facilitating ability
to act
How-to take action
Selecting the behavior change or action
* Alternative names: Behavior Change Communication (BCC);
Food and Nutrition Communication and Education (FNCE);
Nutrition Education and Promotion (NEP).

8. DESIGN Procedure Overview
The DESIGN Procedure
creates behavioral, theory-
based nutrition education
lessons tailored to the target
audience.

9. DESIGN Procedure Overview
Decide behavior change goals of the
program based on:
• analyzing issues of concern for audience
• identifying and prioritizing behaviors
contributing to issues of concern

10. DESIGN Procedure Overview
Explore determinants of behavior change
or action based on a variety of data sources

11. DESIGN Procedure Overview
Select theory/ create appropriate model
based on determinants
• Clarify educational philosophy
• Articulate perspectives on content

12. DESIGN Procedure Overview
Identify general objectives for key
determinants of behavior change or action

13. DESIGN Procedure Overview
Generate educational / program plans
based on:
• strategies to address determinants of
change
• sequencing for implementation

14. DESIGN Procedure Overview
Nail down evaluation plan:
• specify outcomes
• create indicator(s) and tool(s) to measure
outcome
Plan process evaluation
• create tool(s) to measure how
implementation went

15. DESIGN Procedure Overview
Nail down evaluation plan:
Outcomes
/objectives
Indicators for
outcomes
Tools for indicators
Mediators
Behaviors
Environmental
factors
Health

16. Food, Health & Choices
An innovative intervention for 5th grade
students that involved classroom
nutrition curriculum and wellness
activities

17. Food, Health & Choices
Step 1: Decide issue & behavior
• Decide health issue:
- Childhood obesity
• Decide audience:
- Beginning independence
• Decide on goal behaviors:
- Choose more and choose less behaviors
(Based on literature & survey)

18. Food, Health & Choices
Step 1: Decide behavior
Choose more: Choose less:
• Fruits & vegetables • Sweetened drinks
• Physical activity • Processed packaged snacks
• Fast food
• Recreational screentime

19. Food, Health & Choices
Step 1: Decide behavior
Choose more: Choose less:
• Fruits & vegetables • Sweetened drinks
• Physical activity • Processed packaged snacks
• Fast food
• Recreational screentime

20. Food, Health & Choices
Step 2: Explore audience motivators
Student comment Mediator
• Good at sport • Outcome expectations: physical
• See friends eat • Outcome expectations: social
• Feeling good about self
choosing healthy
• Outcome expectations: self-
evaluative
• Not confident knowing
healthier snacks
• Self-efficacy

21. Food, Health & Choices
Step 2: Explore audience knowledge & skills
Student comment Mediator
• Did not know sugar in drinks • Factual knowledge
• Do not use food labels • Food skills
• Do not select salad bar • Behavioral skills
• Never set action goals for healthier
eating or PA
• Self-regulation skills

22. Food, Health & Choices
Step 3: Select theory, philosophy &
components
• Select theory:
- Social cognitive and self-determination theories
• Select philosophy:
- System-blame, not person-blame approach
• Select program components:
- Classroom curriculum & wellness
- Family support

23. Food, Health & Choices
Step 3: Select theory, philosophy &
Components

24. Food, Health & Choices
Step 4: Indicate general objectives
Mediators Objectives
• Outcome expectations • Explain why energy balance is important
• Outcome expectations • Describe health benefits of F&V /PA/
healthy snacks
• Social norms • Explain how food ads influence us
• Perceived/ actual
barriers
• Describe how environment makes it
hard to do FHC behaviors

25. Food, Health & Choices
Step 4: Indicate general objectives
Mediators Objectives
• Factual knowledge • State how much F, V, sugar, fat is
recommended
• Skills • Identify ‘right size’ for foods
• Action goal-setting skills • Create a personal action plan
• Self-regulation skills • Monitor progress towards goals
• Autonomous motivation • State personal desire/ policy to eat
healthier and be more active

26. Food, Health & Choices
Step 5: Generate educational plans
• Teacher lesson plans
• Student worksheets
• Supplemental pages for teachers
• Case study skit that students would read in class
• Goal setting and self-monitoring sheets

27. Food, Health & Choices
Overview Curriculum Units
Unit 1: Success through science: energy balance
Unit 2: ‘Choose more’ behaviors
Unit 3: ‘Choose less’ behaviors
Unit 4: Summarizing & sharing: ‘Just right’ eating/
PA
Unit 5: Sustaining ‘just right’ balance
Unit 6: Change agents

28. Food, Health & Choices
Step 5: Generate educational plans
Teacher Educational Plans
• Create activities to address determinants
of change
• Sequence activities for implementation

29. Food, Health & Choices
Step 5: Generate educational plans

30. Food, Health & Choices
Step 6: Nail down evaluation plan
Outcomes /
objectives
Indicators for outcomes Tools for indicators
Determinants/
mediators
Mediators for each of
the 6 behaviors
87-item survey
Behaviors Frequency & portion
size, duration intensity
of PA
49-item survey
Health BMI Height, weight

31. Food, Health & Choices
Step 6: Nail down evaluation plan

32. Food, Health & Choices
Step 6: Nail down evaluation plan

33. Food, Health & Choices
Step 6: Nail down evaluation plan
Heights &
Weights

34. Nutrition Education DESIGN Procedure

35. Nutrition Education DESIGN Procedure

36. Nutrition Education DESIGN Procedure
Conclusions
• Provides a systematic way to design nutrition
education sessions and environmental supports
• Behavior focused, based on strong assessment
• Uses theory as a tool or framework for designing
the intervention
• Can be brief or comprehensive depending on
need

37. Nutrition Education DESIGN Procedure
Conclusions
• Provides a systematic way to design nutrition
education sessions and environmental supports
• Behavior focused; strong needs assessment
• Uses theory as a tool for designing the intervention
• Can be brief or comprehensive depending on need