A Piaget-Based Nutrition Education Intervention in Preschool Children (PNEP)

The Effect of Piaget-Based Nutrition Education on Food Consumption, Nutrition, and Eating Behaviors in Preschool Children: A Mixed Methods Study

This study examined whether a nutrition education program based on Piaget's theory of cognitive development could improve preschool children's eating habits and food choices. Children attending preschools connected to the Provincial Directorate of National Education, along with their mothers, took part in the study. Some children received six sessions of nutrition education designed according to how young children think and learn (Piaget's theory), while other children did not receive this education and served as a comparison group. Before and after the program, researchers measured children's food consumption, nutrition-related behaviors, and eating behaviors using questionnaires completed by mothers. After the program ended, researchers also talked with a smaller group of mothers in more detail to better understand their experiences and observations. The results showed that children who received the nutrition education improved their food consumption and nutrition-related behaviors. However, the program did not appear to change children's general eating behaviors, such as picky eating or appetite. Mothers' descriptions of their children's experiences helped explain these findings in more depth. These results suggest that nutrition education based on how young children think and learn can help improve what children eat, but changing broader eating behaviors may require additional strategies that also address psychological, cultural, and social factors.

Study Overview

• Status: Completed
• Conditions: Feeding Behaviors; Eating Behaviors; Child Nutrition; Nutrition Education
• Intervention / Treatment: Behavioral: Piaget-Based Nutrition Education Program

• Study Type: Interventional
• Enrollment (Actual): 238
• 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: Non-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 and mothers in this group received six sessions of nutrition education based on Piaget's theory of cognitive development.	Behavioral: Piaget-Based Nutrition Education Program; A nutrition education program consisting of six weekly sessions, each lasting 30 minutes, delivered to preschool children by the researcher. The program was developed based on Piaget's theory of cognitive development and designed to match the cognitive developmental stage of preschool-aged children (approximately 3-6 years). Sessions aimed to improve children's food consumption, nutrition knowledge, and eating behaviors through age-appropriate, interactive educational activities.
No Intervention: No Intervention; Children and mothers in this group did not receive the nutrition education program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Food Consumption	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.	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 and Erdoğan (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. in 2001, the CEBQ (Children's Eating Behavior Questionnaire) is a Likert-type questionnaire answered by parents, consisting of 8 subscales, that evaluates children's eating behavior across 35 items on a 5-point scale (1=never, 5=always). In the original study where the scale was developed, an eight-dimensional factor structure emerged during the development of the questionnaire, and it was shown that the total variance explained by these eight subscales ranged between 50% and 80%. The Cronbach's alpha coefficients of the eight sub-dimensions ranged between 0.74 and 0.91. The validity and reliability of the scale in Turkey were conducted by Yılmaz and colleagues (2011). This 35-item questionnaire consists of 8 subscales that evaluate the behaviors of enjoying food, food craving, drinking passion, satiety craving, emotional overeating, emotional undereating, slow eating, and food neophobia. The Cronbach's alpha coefficients obtained from ÇYDA's study were 0.69	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): July 15, 2026
• Last Update Submitted That Met QC Criteria: July 13, 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