Effectiveness of the Apprenti en Action School-based Culinary Program on 9-10-year-old Children's Food Literacy

Effectiveness of the Apprenti en Action School-based Culinary Program on 9-10-year-old Children's Food Literacy and Vegetable and Fruit Consumption

In New Brunswick, Canada, only 53% of Kindergarten to Grade 5 students reported eating five or more vegetables and fruits per day in 2016-2017. Low intakes of vegetables and fruits are a marker for poor nutrition, which may impair the growth and cognitive development of children and adolescents and may put them at risk of developing certain non-communicable diseases earlier in life. It has been suggested that increasing children's food literacy may be an effective way of promoting healthier diets, including increasing vegetable and fruit intake among students. Since children spend most of their waking hours at school, this may be a key setting for promoting food literacy and healthy eating behaviors. Previous studies have found that culinary interventions that include taste testing and nutrition education may improve students' food literacy and vegetable and fruit consumption. Therefore, this quasi-experimental study aimed to assess the effectiveness of a school-based culinary program titled "Apprenti en Action" on primary school children's food literacy, breakfast, and vegetable and fruit consumption. Specifically, data were collected among Grade 5 students from ten francophone elementary schools, five of which received the "Apprenti en Action" program and five who did not. The "Apprenti en Action" program consisted of six, one-hour culinary workshops given once a week, at school, during school hours. Data on students' food literacy, breakfast, vegetable, and fruit consumption were collected via online questionnaires before and after the program. In addition to collecting quantitative data, qualitative data were collected from program participants and their parents to assess their perceptions of "Apprenti en Action".

Study Overview

• Status: Completed
• Conditions: Eating Behavior; Fruit and Vegetable Intake
• Intervention / Treatment: Behavioral: "Apprenti en Action" program

Detailed Description

This study used a quasi-experimental design. Quantitative data from Grade 5 students from five francophone elementary schools in the province of New Brunswick, Canada, who participated in the "Apprenti en Action" culinary program were compared to those of Grade 5 students from five other elementary schools who did not receive the program. "Apprenti en Action" consists of six, one-hour culinary workshops offered once a week during school hours. The program aims to teach students how to read and follow recipes, prepare and cook various foods using various culinary techniques, and apply food safety practices. Students are also taught the basics of healthy food, nutrition, and cooking.

A questionnaire was developed based on previously-validated questionnaires and it measured vegetable and fruit consumption, breakfast consumption, concepts of food literacy including food and cooking skills as well as nutrition knowledge. All students will complete this self-administered online questionnaire before and after the program. Multilevel regressions will be used to assess the effectiveness of the culinary class on students' food literacy, breakfast, vegetable, and fruit consumption. Additionally, focus groups with children who participated in the "Apprenti en Action" program and their parents will be invited to share their perceptions of the program and how/if it has impacted the children's food literacy and eating behaviors.

• Study Type: Observational
• Enrollment (Actual): 150

Contacts and Locations

Study Locations

• Canada
  • New Brunswick
    • Moncton, New Brunswick, Canada, E1A 3E9
      • Universite de Moncton

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 8 years to 11 years (Child)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Participants are Grade 5 students enrolled in one of the 10 recruited francophone elementary schools in the province of New Brunswick, Canada.

Description

Inclusion Criteria:

• Be enrolled in a Grade 5 or mixed Grade 4 and 5 class

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Apprenti en Action (intervention group); "Apprenti en Action" consists of six, one-hour culinary workshops offered once a week during school hours.	Behavioral: "Apprenti en Action" program; The "Apprenti en Action" program aims to teach students how to read and follow recipes, prepare and cook various foods using various culinary techniques, and apply food safety practices. Students are also taught the basics of healthy food, nutrition, and cooking.
Control group; Students in the control group do not receive the "Apprenti en Action" program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in vegetable and fruit consumption at the end of the program	Students' consumption of vegetables and fruits was measured using two questions from the provincial New Brunswick Student Wellness Survey (New Brunswick Student Wellness Survey, 2016). These questions asked how many vegetables and fruits they had eaten the day before the survey. This was measured using a scale from 0 (None), to 7 (7 or more).	Baseline and Endpoint (Week 6)
Change from baseline in breakfast consumption at the end of the program	Students' breakfast consumption was assessed based on one question from the provincial New Brunswick Student Wellness Survey (New Brunswick Student Wellness Survey, 2016). Students were asked to report how often they ate breakfast during the last school week. This question was scored from 0 (none) to 7 (7 days of the week).	Baseline and Endpoint (Week 6)
Change from baseline in cooking skills at the end of the program	Cooking skills include all skills needed to prepare and cook foods, including cooking methods and food preparation techniques, and were measured using 18 questions. Among the questions, one was assessed with a five-point, downwards Likert-type scale (e.g. "Rate your ability to make the different breakfast foods"), and 17 questions were multiple-choice questions (e.g. "How long does it take to cook hard- and soft-boiled eggs?"). All cooking skills included in the questionnaire were skills that children were expected to have practiced during the program. The questionnaire was based on three previously-validated tools (Skeaff et al. 2020, Dean et al. 2021, Lavelle et al. 2017). Specifically, these questions measured children's ability to prepare breakfast, to use various cooking methods, to use kitchen equipment, to apply food safety practices, and to use various food preparation techniques. In total, a score ranging from 0 to 83 points was possible for this outcome variable.	Baseline and Endpoint (Week 6)
Change from baseline in nutrition knowledge at the end of the program	Nine multiple-choice questions were used to assess children's nutrition knowledge, including their understanding of a balanced plate and food safety. These questions were inspired by those used in Skeaff et al.'s (2020) validated questionnaire. In total, a score of 0 to 9 points was possible for this outcome variable.	Baseline and Endpoint (Week 6)
Change from baseline in food skills at the end of the program	Food skills represent the knowledge and skills required to choose and prepare food according to available resources and to cook balanced meals. They include meal planning, following a recipe, using leftovers, making and following a grocery list, reading nutrition labels, etc. Of the three questions used to measure food skills, two questions were multiple-choice questions (e.g. "The above picture is of French toast. What are three ingredients you need for French toast?") and one was a five-point downwards Likert-type scale ("From this list, indicate how good you are at performing these actions."). These questions were based on previously-validated questionnaires (Skeaff et al. 2020, Lavelle et al. 2017). In total, a score of 0 to 53 points was possible for this outcome variable.	Baseline and Endpoint (Week 6)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Student perception of the program	Students' perception of the program will be measured via virtual semi-structured focus groups. Two 40-45 minute sessions with 8-10 students per group are anticipated. Students will be asked to share their perception of the program's impact on their knowledge, skills, appreciation for healthy foods, and self-efficacy, as well as the strengths, weaknesses, and perceived relevancy of the program.	One week after the end of the program (Week 7)
Parent perception of the program	Students' parents' perception of the program will be measured via virtual semi-structured focus groups. Two 40-45 minute sessions with 8-10 parents per group are anticipated. Parents will be asked to share their perception of the program's impact on their children's knowledge, skills, appreciation for healthy foods, and self-efficacy, as well as the strengths, weaknesses, and perceived relevancy of the program.	One week after the end of the program (Week 7)

Collaborators and Investigators

• Sponsor: Universite de Moncton
• Collaborators: New Brunswick Innovation Foundation
• Investigators: Principal Investigator: Stephanie A Ward, PhD, RD, Universite de Moncton

Publications and helpful links

General Publications

• Lavelle F, McGowan L, Hollywood L, Surgenor D, McCloat A, Mooney E, Caraher M, Raats M, Dean M. The development and validation of measures to assess cooking skills and food skills. Int J Behav Nutr Phys Act. 2017 Sep 2;14(1):118. doi: 10.1186/s12966-017-0575-y.
• Dean M, Issartel J, Benson T, McCloat A, Mooney E, McKernan C, Dunne L, Brennan SF, Moore SE, McCarthy D, Woodside JV, Lavelle F. CooC11 and CooC7: the development and validation of age appropriate children's perceived cooking competence measures. Int J Behav Nutr Phys Act. 2021 Jan 30;18(1):20. doi: 10.1186/s12966-021-01089-9.
• Miller LM, Cassady DL. The effects of nutrition knowledge on food label use. A review of the literature. Appetite. 2015 Sep;92:207-16. doi: 10.1016/j.appet.2015.05.029. Epub 2015 May 27.
• Brown, J. (2019). Nutrition through the life cycle (7e ed.). Cengage Learning.
• Conseil de la santé du Nouveau-Brunswick. (2017). Sondage sur le mieux-être des élèves du Nouveau-Brunswick au niveau primaire de la maternelle à la 5e année (2016-2017) (p. 19). https://csnb.ca/sites/default/files/publications-attachments/sondage-mieux-etre-des-eleves-au-primaire-2016-2017-fr.pdf
• Dudley DA, Cotton WG, Peralta LR. Teaching approaches and strategies that promote healthy eating in primary school children: a systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2015 Feb 25;12:28. doi: 10.1186/s12966-015-0182-8.
• Evans CE, Christian MS, Cleghorn CL, Greenwood DC, Cade JE. Systematic review and meta-analysis of school-based interventions to improve daily fruit and vegetable intake in children aged 5 to 12 y. Am J Clin Nutr. 2012 Oct;96(4):889-901. doi: 10.3945/ajcn.111.030270. Epub 2012 Sep 5.
• Skeaff, S., Govan, A., & Skeaff, M. (2020). A Practical Kitchen-Based Validation of the Food Skills Section of a Food Literacy Questionnaire for 9-10 Year Old Children.
• Maynard M, Gunnell D, Ness AR, Abraham L, Bates CJ, Blane D. What influences diet in early old age? Prospective and cross-sectional analyses of the Boyd Orr cohort. Eur J Public Health. 2006 Jun;16(3):316-24. doi: 10.1093/eurpub/cki167. Epub 2005 Sep 1.
• Nathan N, Wolfenden L, Butler M, Bell AC, Wyse R, Campbell E, Milat AJ, Wiggers J. Vegetable and fruit breaks in Australian primary schools: prevalence, attitudes, barriers and implementation strategies. Health Educ Res. 2011 Aug;26(4):722-31. doi: 10.1093/her/cyr033. Epub 2011 May 13.
• Neumark-Sztainer D, Wall M, Larson NI, Eisenberg ME, Loth K. Dieting and disordered eating behaviors from adolescence to young adulthood: findings from a 10-year longitudinal study. J Am Diet Assoc. 2011 Jul;111(7):1004-11. doi: 10.1016/j.jada.2011.04.012.
• Wang Y, Bentley ME, Zhai F, Popkin BM. Tracking of dietary intake patterns of Chinese from childhood to adolescence over a six-year follow-up period. J Nutr. 2002 Mar;132(3):430-8. doi: 10.1093/jn/132.3.430.
• Krebs-Smith SM, Heimendinger J, Patterson BH, Subar AF, Kessler R, Pivonka E. Psychosocial factors associated with fruit and vegetable consumption. Am J Health Promot. 1995 Nov-Dec;10(2):98-104. doi: 10.4278/0890-1171-10.2.98.
• Karpouzis F, Lindberg R, Walsh A, Shah S, Abbott G, Lai J, Berner A, Ball K. Evaluating OzHarvest's primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: protocol for a pragmatic cluster non-randomized controlled trial. BMC Public Health. 2021 May 22;21(1):967. doi: 10.1186/s12889-021-10302-0.
• Harris G, Mason S. Are There Sensitive Periods for Food Acceptance in Infancy? Curr Nutr Rep. 2017;6(2):190-196. doi: 10.1007/s13668-017-0203-0. Epub 2017 Apr 29.
• Baranowski T, Baranowski J, Cullen KW, Marsh T, Islam N, Zakeri I, Honess-Morreale L, deMoor C. Squire's Quest! Dietary outcome evaluation of a multimedia game. Am J Prev Med. 2003 Jan;24(1):52-61. doi: 10.1016/s0749-3797(02)00570-6.

Study record dates

Study Major Dates

• Study Start (Actual): March 15, 2022
• Primary Completion (Actual): June 30, 2022
• Study Completion (Actual): June 30, 2022

Study Registration Dates

• First Submitted: March 3, 2022
• First Submitted That Met QC Criteria: March 3, 2022
• First Posted (Actual): March 14, 2022

Study Record Updates

• Last Update Posted (Actual): October 17, 2022
• Last Update Submitted That Met QC Criteria: October 14, 2022
• Last Verified: October 1, 2022

More Information

Terms related to this study

• Keywords: School; Food literacy; Nutrition knowledge; Cooking skills; Food skills; Culinary program; Cooking program
• Other Study ID Numbers: 2122-006

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: Data will be made available to researchers upon reasonable request made to the principal investigator.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No