Evaluation of the Effectiveness of the Drexel University Eat.Right.Now.
High School Curriculum in Pennsylvania Supplemental Nutrition Assistance Program Education (SNAP-Ed)
Jaclyn Conley, Viktoryia Kuzmitskaya, Allison Smith
Advisors: Judy Ensslin, MS, RDN, LDN and Ann Marsteller, MBA, MS, RDN, LDN
Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, 2015
Demographics
Abstract
Male
Female
Hispanic
Non-­‐Hispanic
African American
Asian
Caucasian NaIve Hawaiian/Pacific Islander
Grade 9
Grade 10
Grade 11
Background
The need for nutrition education has created an opportunity for nutrition educators to expand their work to increase
the knowledge and health of the high school population in this country. Nutrition education has been utilized to help
different populations increase their understanding of nutrition and improve healthy behaviors in individuals. Due to
the growing pandemic of obesity, there is a great need for nutrition education, especially targeting the high school
population.
Objectives
The objective of this research was to evaluate the effectiveness of nutrition education to improve nutrition
knowledge, attitudes, and behaviors in high school students in the School District of Philadelphia (SDP) after
receiving a series of lessons from the Drexel University Eat.Right.Now. (DU ERN) High School Curriculum,
administered by DU ERN nutrition educators.
Results
Knowledge-related topics that showed significant improvement included:
•  Identification of soda as containing “empty calories”
•  Understanding the importance of a healthy diet and physical activity
Behavior-related topics that showed significant improvement included:
•  An increase in students drinking 100% fruit juice
•  An increase in consumption of vegetables
•  A decrease in computer use
Background
Grade 12
PRE (n=445) 31% 66% POST (n=411) 32% 65% 19% 76% 69% 7% 3% 19% 79% 72% 6.5% 2% 2% Student’s knowledge of nutrition and health-related topics (Table 1) were compared before (pre) and after
(post) the Eat.Right.Now. education intervention was administered in the schools.
% Correct
Post
What is Eat.Right.Now.?
Bridging the Gap
I can get vitamin D from: Fish
18
23
Eat.Right.Now. is the official Pennsylvania (PA)
Nutrition Education TRACKS Program of the
SDP. It is funded by the Pennsylvania (PA)
Department of Human Services (DHS) through
PA Nutrition Education Tracks, a part of USDA’s
Supplemental Nutrition Assistance Program
(SNAP). DU ERN is a partner to the SDP ERN
program, providing nutrition education to
students in approximately 70 schools in the
SDP, including over 40 high schools.
The literature shows a gap in the evaluation
of high school nutrition education programs.
Because of the increasing rates of obesity, it
is important that nutrition education
outcomes are evaluated in high school
students. By implementing high school
nutrition education lessons, researchers and
educators alike can help bridge the gap
between nutrition misinformation and the
facts that will lead to a long, healthy life.
Which of these nutrients provides calories: Protein
45
51
Identify the drink with the most “empty calories:” Soda
16
28
As part of healthy eating each day I try to: eat healthy and exercise
43
51
If I do not like to drink milk, to make sure I am getting enough calcium, I
would: Eat yogurt
60
63
Definition of a serving size on a nutrition facts panel
26
29
How many cups of dairy does MyPlate recommend each day: 3
14
16
When physically active < 60 minutes I would drink: water
64
69
Eating too much fast food can result in: high blood pressure
86
87
•  Eight schools were randomly selected to participate in the 2014-2015 high school evaluation.
During the course of the evaluation two of the eight schools were eliminated.
•  A minimum of fifty students in at least three, but no more than five classrooms were selected
from each selected school.
•  The Nutrition and Physical Activity Survey was administered to 445 students pre-intervention
•  Five structured lesson plans were conducted by DU ERN nutrition educators.
•  The same survey was administered again at the completion of the lessons.
•  Pre and post intervention data was analyzed for behavior, knowledge, and attitudes regarding
the following categories:
o  Fruit/Vegetables
o  Dairy
o  Physical Activity
•  Survey data was compiled by the Pennsylvania State University Survey Research Center
•  Survey data was analyzed by Drexel University Department of Biostatistics to determine the
frequency of answers within the following categories:
o  Gender
o  Grade
o  Race
Table 3. Dairy and Soda
Survey Question
Consumption of soda ≤ 1x/day in the past 7 days
Consumption of milk > 1x/day in the past 7 days
Choosing non-whole milk varieties
Consumption of yogurt ≥ 4x in the past 7 days
Consumption of >8 oz milk at one time
Consumption of ice cream < 3x/wk
Cheese serving ≤ 1 slice/ stick
89
90
88
80
86
86
83
81
50
46
46
53
46
45
41
42
18
16
27
53
21
20
28
47
21
21
31
55
18
22
34
44
12
15
22
35
13
28
37
46
16
13
25
48
20
21
31
52
Black
Hispanic
Female
Male
% Desired % Desired % Desired % Desired
Pre Post Pre Post Pre Post Pre Post
55
66
58
60
62
63
41
52
68
77
74
70
70
75
52
58
If I went to the shopping mall, I would take the: Stairs
Behavior
31
31
40
49
20
28
11
12
Physical activity in the past 7 days for more than 60 minutes
70
71
66
63
64
65
82
75
TV watching during an average school day (1 hr/day or less)
Video/Computer games played during a school day (1 hr/day or
less)
34
39
31
45
37
42
34
42
35
48
33
41
34
45
37
43
Pre Post
Pre Post Pre Post Pre Post
18
33
18
22
18
33
12
21
77
76
70
74
70
72
67
70
16
21
11
11
13
18
16
Behavior
Consumption of milk in the past 7 days
27
27
30
33
22
26
39
14
36
Consumption of yogurt in the past 7 days
14
12
17
13
12
12
19
16
Consumption of cheese in the past 7 days
77
75
75
76
74
72
75
74
Type of milk consumed on a daily basis
54
69
58
54
68
71
48
51
Identify the drink with “empty calories”: Soda
Calcium and vitamin D are required for: Strong bones, teeth and
muscle contractions
Recommended servings of daily dairy by MyPlate
Conclusions
Limitations:
•  The post-test sample size was not the same as pre-test (-34 students).
•  Student identifiers were not used, so pre- and post-intervention surveys could not be matched.
•  Cold weather may have prevented students from going outside to engage in activity, or
consume a greater variety of fruits and vegetables.
•  The wording of the questions in the survey may have lead to confusion/ incorrect answers.
•  Results relied on student self-reporting/ student behaviors were not monitored.
•  No equal gender or race representations were present.
•  This intervention utilized a five-lesson subset of the DU ERN High School Curriculum.
Further evaluation of the effectiveness of a larger subset of lessons should be considered.
% Desired
Pre
Post
29
33
18
19
16
22
48
59
52
50
Table 4. Physical Activity and
Screen Time
% Desired
Pre Post
73
72
Survey Question
25
29
55
58
Physical Activity > 3 days/wk
14
14
68
72 TV watching ≤ 1 hr/day
75
78
Gaming/internet ≤ 1 hrs/day
69
72
Knowledge
Table 2. Fruit and Vegetable Consumption
Consumption of fruit > 1x/day in the past 7 days
Consumption of 1-2 servings of 100% fruit juice/day in the past 7 days
Consumption of green salad >4x/week in the past 7 days
Consumption of potatoes in the past 7 days (not fried or chips)
Consumption of ‘other vegetables’ ≥ 4-6x in the past 7 days
Table 7. Physical Activity and Screen
Time
Table 8. Dairy and Soda
Student’s fruit and vegetable consumption (Table 2), dairy and soda consumption (Table 3), and
reported physical activity and screen time (Table 4) were compared before (pre) and after (post)
the Eat.Right.Now. education intervention was administered in the schools.
Methods
Knowledge
Daily intake of healthy foods: Increased intake of fruit and
vegetables
Black
Hispanic Female
Male
% Desired % Desired % Desired % Desired
Behavior Results Overall
Survey Question
Pre Post Pre Post Pre Post Pre Post
Knowledge
Physical activity is important for: strong bones, healthy weight and
sleeping well
When I am physically active for less than 60 minutes, I should
drink: water
Table 1. Nutrition and Health-Related Topics
Pre
Table 6. Fruit and Vegetable
Behavior
Consumption of 100% fruit juice
Consumption of green salad
Consumption of carrots
Consumption of other green vegetables (Not potatoes or carrots)
Knowledge Results Overall
Survey Question
Black
Hispanic
Female
Male
% Desired % Desired % Desired % Desired
What is a good source of calcium: Dark leafy green vegetables
2% 34% 24% 19% 23% 33% 29% 14% 23% Results by Race & Gender
% Desired
Pre
Post
70
69
36
42
35
45
Conclusions:
•  Positive changes were seen in nutrition knowledge and behaviors, which supports the theory
that nutrition education in the school system can lead to positive changes in the minds of high
school students.
•  There should be more programs like the one implemented by EAT.RIGHT.NOW, which was
successful in its ability to increase nutrition knowledge and behaviors of high school aged
students living in the Philadelphia school district.