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

F Karpouzis, R Lindberg, A Walsh, S Shah, G Abbott, J Lai, A Berner, K Ball, F Karpouzis, R Lindberg, A Walsh, S Shah, G Abbott, J Lai, A Berner, K Ball

Abstract

Background: The promotion of healthy eating is a public health priority. Poor dietary behaviours, including low fruit and vegetable (F&V) consumption are of particular concern among children. Novel nutrition promotion strategies are needed to improve F&V consumption. Sustainability education could be used to support nutrition education within the school context. The purpose of this paper is to report the protocol for impact and process evaluation of the school-based Food Education and Sustainability Training (FEAST) program, designed to educate children about sustainability, food waste and nutrition, using hands-on cooking activities.

Methods: A pragmatic, parallel, cluster non-randomized controlled trial with pre- and post-measures, will be implemented among 20 primary schools (10 intervention vs 10 wait-list-control) within NSW, Australia, involving children in Grades 5-6. FEAST is a curriculum-aligned program, delivered as a 1.5-h lesson/week, for a 10-week unit of inquiry, incorporating theory and cooking. FEAST was developed using theoretical frameworks which included Social Cognitive Theory and the Precede-Proceed Planning model. Primary outcomes include children's self-reported F&V intakes (serves/day). Food literacy constructs such as: nutrition knowledge, food preparation and cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours and food production knowledge, will be assessed as secondary outcomes. Process evaluation will assess program reach, adoption, implementation, maintenance, satisfaction and perceived benefits by teachers and students. An online survey (including quantitative and qualitative questions) was developed for administration at baseline (impact evaluation) and immediately post-intervention (impact and process evaluation). Intervention effects on quantitative study outcomes will be estimated with ​generalised linear mixed models, including random effects and will follow the intention-to-treat principles. Open-ended questions embedded within the surveys will be analysed qualitatively using content and thematic analyses.

Discussion: Results from this trial will provide valuable information on the value of adding environmental sustainability strategies to nutrition education in schools. Results will inform the design of future research and programs focused on primary-school children's nutrition, sustainability-related behaviours and experiential school-based interventions.

Trial registration: Trial registered 14th December 2020 with the Australian and New Zealand Clinical Trials Registry ( ACTRN12620001347954 ).

Keywords: Children; Cluster non-randomized controlled trial; Cooking; Food waste; Fruit; Nutrition; Primary school; Process evaluation; Sustainability; Vegetable.

Conflict of interest statement

Authors FK, RL, AW, SS, GA, JL, and KB, declare that they have no competing interests. AB is a paid employee at OzHarvest (the organization that developed and is implementing the FEAST program).

Figures

Fig. 1
Fig. 1
Proposed logic model to guide evaluation of the FEAST program. Legend: F&V fruits and vegetables
Fig. 2
Fig. 2
Logic model for hypothesised pathways of effects of FEAST program for student outcomes. Legend: F&V fruit and vegetables; Blue outline denotes short-term outcomes measured in this trial; * Long-term outcomes not measured in this study
Fig. 3
Fig. 3
Timeline of school enrolments, intervention delivery and data collection. Legend: PI Primary Investigator (FK); Int Intervention group; WLC Wait-list control group; T1 Timepoint 1; T2 Timepoint 2; T3 Timepoint 3

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