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Nutrition Games for School-Age Students: An Effective Tool to Increase Nutritional Awareness and Understanding?

A. Elliott, BS; A. Oceguera; C. Banta, MS, RD, LD

ARAMARK Distance Learning Dietetic Internship Program, Houston, TX
The onset of obesity among adolescents is of growing concern. Children generally learn dietary habits from their parents or caregivers, since nutrition is not emphasized in school curriculum. Poor dietary habits lead to lower test scores and trouble focusing in the classroom. This quantitative study examined the effectiveness of interactive nutrition games to teach basic nutrition principles. Over the course of one week, second grade students participated in three days of nutrition games, each covering a different topic. Subjects (p=55) were selected from a single elementary school based on grade level, understanding of the English language, and willingness to participate in the required pre- and post-tests. The games covered the five food groups, correct portion sizes and servings, and daily meal planning. Data was collected before and after completion of the intervention. Analysis of results revealed a successful intervention, with average test scores rising from 42.4 to 78.5 percent. The use of games as a nutrition education tool is an emerging trend within dietetics that should be further examined.

Quantitative study with an evaluation analysis of student data. Students were chosen using a convenience sample. Inclusion Criteria: Students enrolled in second grade classes A & B Attend the chosen elementary school in Houston, TX Understand basic English Willing to participate in pre- and post-test evaluations Exclusion Criteria: Students enrolled in second grade classes C & D Students attending all other elementary schools in Houston, TX First, Third, Fourth, & Fifth grade students Mean age of participants was 8 years old. Participant data was collected to obtain mean increase of nutritional knowledge. Participants naturally divided into two subgroups: Class A: Monday, Wednesday, Thursday Class B: Monday, Tuesday, Friday Approval from Houston Independent School Districts Research Department was obtained for this study.

Research findings support the use of games to enhance application and understanding of nutrition among school-age students. The addition of nutrition to school curriculum should be required. Nutrition games have the potential to impact students health as they grow into adults. The hypothesis that nutrition games are more effective than standard teaching methods was confirmed during this intervention. Limitations: o Small sample size (55 students), lack of a control group o Inability to take attendance daily o Some participants learned English as a second language o Limited time of intervention (less than 3 hours total)

Study proves the exciting impact that RDNs could have in proactively helping to create healthy habits. Many individuals only receive nutrition education in a hospital setting, at which point a decline in health may already exist. Future Research: Further research is needed to examine the impact of nutrition games as part of an entire school years curriculum. Longer studies would be able to examine changes in dietary habits at school and at home, as well as changes in body mass index. RDNs can use the results from this study and supporting research to encourage the presence of nutrition experts within school districts nationwide.

Nutrition education is not heavily emphasized in school systems. As a result, most children form lifelong eating habits based on what is observed from parents and guardians. Empowering a child to create healthy habits can lead to better self-esteem and ability to focus in the classroom. Childhood obesity has grown from 7 percent to 18 percent within the last 30 years1. Children that are overweight or obese are prone to develop health complications at a younger age, compared to those who experience the weight gain as an adult. It is in the best interest of a child to receive nutrition education in a relaxed environment, without the added pressure of needing to lose weight. The rise in childhood obesity could easily be resolved if proper nutritional education were provided within school curriculums. Children tend to learn best in a fun and interactive environment, where they may not even realize they are learning2. Many previous studies have examined the use of online games, which may not be feasible in low income school districts.

Baseline characteristics of the participants: 30 boys, 25 females (p=55) Comparable demographics: age, grade level, and ethnicity Primary Results: 42.4% increase in average overall test score. No significant differences between gender or classes. Secondary Results: Individual components of the test were analyzed to reveal a significant increase (46.3%) in understanding of the appropriate number of servings per day for each food group.

1. Adolescent and School Health: Childhood Obesity Facts. Centers for Disease Control Website. Accessed November 20, 2013. 2. Yang JC, Chen CH, Jeng MC. Integrating video-capture virtual reality technology into a physically interactive learning environment for English learning. Computers and Education. 2010;55(3):1346-1356.

Table 1. Itemized Pre-Test Results % Correct 100% 80% 60% 40% 20% Food Groups 22 2 8 8 7 8 60% # Svgs/Day 1 0 7 12 14 21 23.3%

Table 2. Itemized Post-Test Results % Correct 100% 80% 60% 40% 20% 0% Avg Score: Food Groups 33 4 10 4 1 0 84.6% # Svgs/Day 26 0 10 9 3 4 69.6%

For questions or additional information, please contact: Allison Elliott Aramark Dietetic Intern

Determine whether interactive games are effective in helping students to retain information about basic nutrition.

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