Impact and process evaluation of a primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia : pragmatic cluster non-randomized controlled trial

Journal article


Karpouzis, Fay, Lindberg, Rebecca, Walsh, Adam, Shah, Smita, Abbott, Gavin and Ball, Kylie. (2024). Impact and process evaluation of a primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia : pragmatic cluster non-randomized controlled trial. BMC Public Health. 24(1), pp. 1-17. https://doi.org/10.1186/s12889-024-18079-8
AuthorsKarpouzis, Fay, Lindberg, Rebecca, Walsh, Adam, Shah, Smita, Abbott, Gavin and Ball, Kylie
Abstract

Background: Environmentally sustainable food initiatives accompanying nutrition education, such as the Food Education and Sustainability Training (FEAST) program, have gained traction in school settings. The aim of this trial was to conduct an impact and process evaluation of FEAST, to evaluate its effect on children’s fruit and vegetable (F&V) intakes, and secondary outcomes: F&V variety consumed, nutrition knowledge, food preparation/cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours, and food production knowledge.

Methods: FEAST was a 10-week curriculum-aligned program, designed to educate children about healthy eating, food waste, and sustainability, while teaching cooking skills. It was implemented by classroom teachers, face-to-face and online, during COVID-19 school closures, in Australia in 2021. A custom designed survey was used to collect baseline and post-intervention data from students. Generalised linear mixed models (GLMM) estimated group differences in pre-post changes for primary and secondary outcomes. Surveys were also administered to students and teachers to evaluate intervention implementation.

Results: Twenty schools participated and self-selected to be either intervention schools (n = 10) or wait-list control (WLC) schools (n = 10). A total of 977, 5th and 6th grade children participated in the trial with a mean age of 11.1 years (SD ± 0.7). The FEAST intervention, compared to WLC, did not result in significant increases in primary outcomes nor secondary outcomes. The process evaluation revealed FEAST was well-received by students and teachers, but COVID-19 school closures hindered implementation fidelity with a less intense program delivered under the constraints of pandemic lockdowns.

Conclusions: This is the first cluster non-randomized controlled trial designed to independently evaluate FEAST in the primary-school setting. No evidence was found for improved F&V intakes in children, nor secondary outcomes. However, the positive process evaluation results suggest that further trials of the program are warranted. If implemented as originally designed (pre-pandemic), with increased duration and complemented by supporting school policies, such programs have the potential to improve children’s daily F&V intakes, cooking skills and food waste behaviours. This would support the Australian curriculum and contribute to: health promotion within schools and sustainable schools initiatives, the national agenda to reduce food waste and sustainable development goals.

KeywordsSchool; Children; Food; Nutrition,; Education; Sustainability; Fruit,; Vegetable; Cluster non-randomized controlled trial; Impact evaluation; Process evaluation
Year01 Jan 2024
JournalBMC Public Health
Journal citation24 (1), pp. 1-17
PublisherBioMed Central Ltd.
ISSN1471-2458
Digital Object Identifier (DOI)https://doi.org/10.1186/s12889-024-18079-8
Web address (URL)https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18079-8
Open accessOpen access
Research or scholarlyResearch
Page range1-17
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online01 Mar 2024
Publication process dates
Accepted12 Feb 2024
Deposited05 Sep 2024
Additional information

© The Author(s) 2024.

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

For electronic supplementary material: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-02...

Place of publicationUnited Kingdom
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