Piaget-Based Nutrition Education in Preschools (PNEP)

Piaget-Based Nutrition Education in Preschools: An Explanatory Sequential Mixed-Methods Evaluation

This explanatory sequential mixed-methods study evaluated a six-week Piaget-based nutrition education programme for preschool children. Seven public preschools were randomized at the school level to an intervention condition (three preschools) or a usual-curriculum control condition (four preschools). The intervention consisted of six weekly, approximately 30-minute, developmentally tailored sessions delivered to groups of children in their usual classrooms. Mothers completed measures of children's food consumption frequency, nutrition behavior, and eating behavior before and immediately after the programme. Following the quantitative phase, three focus groups with 18 mothers from intervention preschools explored perceived changes and helped interpret the quantitative patterns. Because preschool identifiers were not retained in the final analytical dataset, the reported child-level analyses did not adjust for clustering and are interpreted as exploratory.

Study Overview

• Status: Completed
• Conditions: Eating Behaviour; Child Nutrition; Nutrition Education; Food Consumption
• Intervention / Treatment: Behavioral: Piaget-Based Nutrition Education Program

• Study Type: Interventional
• Enrollment (Actual): 268
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Uşak, Turkey (Türkiye), 64200
    • Preschools affiliated with the Provincial Directorate of National Education, Uşak

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

The sample of the study consists of preschool children and their mothers.

Inclusion criteria for the sample:

• Mothers of children aged 3-6 attending kindergartens affiliated with the Provincial Directorate of National Education
• Mothers whose children do not have any health problems affecting their nutritional status
• Mothers aged 18 and above
• Mothers who are at least literate.

The exclusion criteria for the study are as follows:

• Children with hearing and speech problems,
• Children who do not understand or speak Turkish,
• Children with any illness or learning difficulties,
• Those who participate for a maximum of 2 weeks during the six-week nutrition training.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Piaget-Based Nutrition Education; Children attending the three intervention preschools received the six-week Piaget-based nutrition education programme in their usual classrooms. A total of 138 mother-child dyads were allocated to intervention preschools; 130 children received at least part of the programme, and 127 dyads were included in the reported per-protocol analysis.	Behavioral: Piaget-Based Nutrition Education Program; The researcher delivered six weekly sessions, each lasting approximately 30 minutes, to groups of 8-15 preschool children in their usual classrooms. The programme was tailored to the preoperational stage of cognitive development and used simple language, concrete classification, play, pictures, coloring, cartoons, songs, sensory exploration, and fruit-yogurt preparation. Sessions addressed food groups; fruits; vegetables; energy- and growth-supporting foods; milk and dental health; and foods to be consumed every day or occasionally.
No Intervention: Usual Preschool Curriculum; Children attending the four control preschools continued their usual preschool curriculum and did not receive the Piaget-based nutrition education programme during the study period. A total of 130 mother-child dyads were allocated to control preschools, and 111 dyads were included in the reported analysis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in food consumption frequency	In the Food Consumption Frequency Questionnaire, there are foods that include 7 food groups (dairy group, meat group, vegetable group, fruit group, grain group, oil/margarine group, and sweet group) aimed at determining the child's food consumption status (Güneş et al., 2016). Food consumption frequency is recorded in nine different categories (>6/day, 4-5/day, 2-3/day, 1/day, 5-6/week, 2-4/week, 1/week, 1-3/month, 1-none/month). The Food Consumption Frequency Questionnaire specific to Turkish children was developed by Güneş and colleagues in 2016. The form includes not only food items but also commonly used ingredients in Turkish cuisine. During the development phase of the form, a food atlas containing the most frequently consumed foods, beverages, and some Turkish dishes was used. Results are reported by food item or food group; the questionnaire does not yield a single total score.	Baseline and immediately after completion of the six-week intervention
Change in Nutrition Behavior Scale (NBS) Score	In determining eating behaviors, the Nutrition Behavior Scale developed by Edmundson et al. (1996) and adapted for Turkish children by Öztürk (2010) was used. The scale consists of fourteen different items, each containing two different food items-low-fat, high-fat, salty, and unsalted-depicted in pictures and presented as choices, to determine children's food consumption. Students are asked to indicate which of the two comparable food items in each question item they eat more. The scale items receive a value of -1 for unhealthy food and +1 for healthy food. The total score ranges from -14 to +14. A high total score on the scale indicates a healthy eating habit. The reliability of the scale has been reported as r=0.76 (Öztürk, 2010).	Baseline and immediately after completion of the six-week intervention
Change in Children's Eating Behavior Questionnaire (CEBQ) Subscale Scores	Developed by Wardle et al. (2001), the Children's Eating Behaviour Questionnaire (CEBQ) is a 35-item parent-reported instrument that assesses children's eating behaviours on a five-point Likert scale ranging from 1 (never) to 5 (always). It comprises eight subscales: Food Responsiveness, Emotional Overeating, Enjoyment of Food, Desire to Drink, Satiety Responsiveness, Slowness in Eating, Emotional Undereating, and Food Fussiness. Each subscale is scored separately, with higher scores indicating a greater level of the behaviour represented by that subscale. The original instrument demonstrated an eight-factor structure, with Cronbach's alpha coefficients ranging from 0.74 to 0.91. The Turkish validity and reliability study was conducted by Yılmaz et al. (2011).	Baseline and immediately after completion of the six-week intervention

Collaborators and Investigators

• Sponsor: Uşak University

Study record dates

Study Major Dates

• Study Start (Actual): September 30, 2022
• Primary Completion (Actual): February 20, 2023
• Study Completion (Actual): June 30, 2023

Study Registration Dates

• First Submitted: July 7, 2026
• First Submitted That Met QC Criteria: July 7, 2026
• First Posted (Actual): July 13, 2026

Study Record Updates

• Last Update Posted (Actual): August 25, 2026
• Last Update Submitted That Met QC Criteria: August 23, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavior; Behavior, Animal; Feeding Behavior
• Other Study ID Numbers: PAU-BESEG-2026-01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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