Lessons Learned: Implementing the Shaping Healthy Choices Program With Teenagers as Teachers

Authors

DOI:

https://doi.org/10.5195/jyd.2020.761

Keywords:

cross-age teaching, teenagers as teachers, nutrition education, garden-based education

Abstract

One approach that has been successful at improving youth health outcomes is the Shaping Healthy Choices Program, which features garden- and cooking-demonstration-based nutrition education curricula. The objective of this study was to assess the feasibility of implementing Shaping Healthy Choices Program curricula in 4-H using a teenagers as cross-age teachers approach. A teenagers as cross-age teachers model was employed to educate younger youth using the evidence-based curricula in 2 projects, each lasting 6 months over a 2-year period. Teenage teachers completed an initial 2-day training and reflection-on-action discussions following each educational session. Fidelity observations were collected to assess how well the curricula were delivered by teenage teachers. With a goal of 80%, overall fidelity was low (45%) and teenage teachers were able to deliver only the procedure component of the lessons with adequate average fidelity (84.6%). Poor participant attendance hindered presentation of additional data. Findings from this study suggest a need for more extensive and specific training for teenage teachers to implement the Shaping Healthy Choices Program.

References

Ajala, O., Mold, F., Boughton, C., Cooke, D., & Whyte, M. (2017). Childhood predictors of cardiovascular disease in adulthood. A systematic review and meta-analysis. Obesity Reviews, 18(9), 1061-1070. https://doi.org/10.1111/obr.12561

Arnold, M. E., Flesch, J. M., Ashton, C., Black, L., Brody, B., Hosty, M., & Northway, S. (2016). YA4-H! Youth advocates for health: Impact of a 4-H teens-as-teachers program. Journal of Extension, 54(6), n6.

ASA24, the automated self-administered recall system. Retrieved from https://asa24.nci.nih.gov/

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

Banfield, E. C., Liu, Y., Davis, J. S., Chang, S., & Frazier-Wood, A. C. (2016). Poor adherence to US dietary guidelines for children and adolescents in the national health and nutrition examination survey population. Journal of the Academy of Nutrition and Dietetics, 116(1), 21-27. https://doi.org/10.1016/j.jand.2015.08.010

Bergman, J. J., Linnell, J. D., Scherr, R. E., Ginsburg, D. C., Brian, K. M., Carter, R., Donohue, S., Klisch, S., Lawry-Hall, S., Pressman, J., Soule, K., &Zidenberg-Cherr, S. (2018). Feasibility of implementing a school nutrition intervention that addresses policies, systems, and environment. Journal of Extension, 56(1).

Bolshakova, V. L. J., Gieng, J., & Sidhu, C. S. (2018). Teens-as-teachers nutrition program increases interest in science among schoolchildren and fosters self-efficacy in teens. California Agriculture, 72(2), 135-143. https://doi.org/10.3733/ca.2018a0016

Bolshakova, V. L. J., Gieng, J., Sidhu, C. S., Vollinger, M., Gimeno, L., & Guild, J. (2018). Teens as teachers in the garden: Cultivating a sustainable model for teaching healthy living. Journal of Youth Development, 13(3), 111-135. https://doi.org/10.5195/jyd.2018.621

Breitenstein, S. M., Gross, D., Garvey, C. A., Hill, C., Fogg, L., & Resnick, B. (2010). Implementation fidelity in community-based interventions. Research in Nursing & Health, 33(2), 164-173. https://doi.org/10.1002/nur.20373

Brian, K. M., Linnell, J. D., & Zidenberg-Cherr, S. (2015). Cooking Up Healthy Choices. Davis: University of California.

Century, J., Rudnick, M., & Freeman, C. (2010). A framework for measuring fidelity of implementation: A foundation for shared language and accumulation of knowledge. American Journal of Evaluation, 31(2), 199-218. https://doi.org/10.1177/1098214010366173

Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41(3-4), 327-350. https://doi.org/10.1007/s10464-008-9165-0

Edwards, H. C., Safrit, R. D., Gliem, J. A., & Rudd, C. (2006). Knowledge and attitudinal impacts upon teen volunteers teaching younger youth in a community-based obesity and overweight prevention education program. The International Journal of Volunteer Administration, 14, 41-52.

Faienza, M. F., Wang, D. Q., Fruhbeck, G., Garruti, G., & Portincasa, P. (2016). The dangerous link between childhood and adulthood predictors of obesity and metabolic syndrome. Internal Emergency Medicine, 11(2), 175-182. https://doi.org/10.1007/s11739-015-1382-6

Fetter, D. S., Scherr, R. E., Linnell, J. D., Dharmar, M., Schaefer, S. E., & Zidenberg-Cherr, S. (2018). Effect of the Shaping Healthy Choices Program, a multicomponent, school-based nutrition intervention, on physical activity intensity. Journal of the American College of Nutrition, 37(6), 472-478. https://doi.org/10.1080/07315724.2018.1436477

Flesch, J. M., Lile, J. R., & Arnold, M. E. (2015). YA4-H! Youth advocates for health: Teens as teachers. Journal of Youth Development, 10(2), 121-124. https://doi.org/10.5195/jyd.2015.414

Fosnot, C. T. (2013). Constructivism: Theory, perspectives, and practice (2nd ed.). Teachers College Press.

Fryar, C. D., Carroll, M. D., & Ogden, C. L. (2018). Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2-19 years: United States, 1963–1965 through 2015–2016. National Center for Health Statistics. https://www.cdc.gov/nchs/data/hestat/obesity_child_13_14/obesity_child_13_14.htm

Furco, A., Muller, P., & Ammon, M. (1998). The civic responsibility survey. Service-Learning Research Center, University of California, Berkley.

Gearing, R. E., El-Bassel, N., Ghesquiere, A., Baldwin, S., Gillies, J., & Ngeow, E. (2011). Major ingredients of fidelity: A review and scientific guide to improving quality of intervention research implementation. Clinical Psychology Review, 31(1), 79-88. https://doi.org/10.1016/j.cpr.2010.09.007

Harn, B., Parisi, D., & Stoolmiller, M. (2013). Balancing fidelity with flexibility and fit: What do we really know about fidelity of implementation in schools? Exceptional Children, 79(3), 181-193. https://doi.org/10.1177/001440291307900204

Hayes, D., Contento, I. R., & Weekly, C. (2018). Position of the Academy of Nutrition and Dietetics, Society for Nutrition Education and Behavior, and School Nutrition Association: Comprehensive nutrition programs and services in schools. Journal of the Academy of Nutrition and Dietetics, 118(5), 913-919. https://doi.org/10.1016/j.jand.2018.03.005

Jones, A. M., Lamp, C., Neelon, M., Nicholson, Y., Schneider, C., Wooten Swanson, P., & Zidenberg-Cherr, S. (2015). Reliability and validity of nutrition knowledge questionnaire for adults. Journal of Nutrition Education and Behavior, 47(1), 69-74. https://doi.org/10.1016/j.jneb.2014.08.003

Kim, J., Lee, I., & Lim, S. (2017). Overweight or obesity in children aged 0 to 6 and the risk of adult metabolic syndrome: A systematic review and meta-analysis. Journal of Clinical Nursing, 26(23-24), 3869-3880. https://doi.org/10.1111/jocn.13802

Kolb, D. A. (2015). Experiential learning: Experience as the source of learning and development (2nd ed.). Upper Saddle River, New Jersey: Pearson Education.

Lee, F. C. H., & Murdock, S. (2001). Teenagers as teachers programs: Ten essential elements. Journal of Extension, 39(1).

Linnell, J. D., Smith, M. H., Briggs, M., Brian, K. M., Scherr, R. E., Dharmar, M., & Zidenberg-Cherr, S. (2016). Evaluating the relationships among teacher characteristics, implementation factors, and student outcomes of children participating in an experiential school-based nutrition program. Pedagogy in Health Promotion, 2(4), 256-265. https://doi.org/10.1177/2373379916649603

Linnell, J. D., Smith, M. H., & Zidenberg-Cherr, S. (2015). Discovering Healthy Choices. Davis: University of California.

Morris, J. L., & Zidenberg-Cherr, S. (2002). Garden-enhanced nutrition curriculum improves fourth-grade school children's knowledge of nutrition and preferences for some vegetables. Journal of the American Dietetic Association, 102(1), 91-93. https://doi.org/10.1016/s0002-8223(02)90027-1

Mowbray, C. T., Holter, M. C., Teague, G. B., & Bybee, D. (2003). Fidelity criteria: Development, measurement, and validation. American Journal of Evaluation, 24(3), 315-340. https://doi.org/10.1177/109821400302400303

Murdock, S. W., Lee, F. C. H., & Paterson, C. A. (2003). The role of cross-age teaching in supporting adolescent development. 4-H Center for Youth Development, University of California. http://4h.ucanr.edu/files/1308.pdf

National 4-H Council. Retrieved from https://4-h.org/about/what-is-4-h/

Ruiz, L. D., Howe, L., Holland, D., Brian, K. M., & Scherr, R. E. (2019). Development of an innovative food literacy curriculum focused on agriculture, nutrition, and cooking for high school-aged adolescents. Current Developments in Nutrition, 3(S1). 1464.

Ruiz, L. D., Jones, A. M., & Scherr, R. E. (2017). Validity and reliability of a nutrition knowledge questionnaire for adolescents. The FASEB Journal, 31(S1), 957-953. https://doi.org/10.1096/fasebj.31.1_supplement.957.3

Scherr, R. E., Linnell, J. D., Dharmar, M., Beccarelli, L. M., Bergman, J. J., Briggs, M., Brian, K. M., Feenstra, G., Hillhouse, J. C., Keen, C. L., Ontai, L. L., Schaefer, S. E., Smith, M. H., Spezzano, T., Steinberg, F. M., Sutter, C., Young, H. M., & Zidenberg-Cherr, S. (2017). A multicomponent, school-based intervention, the shaping healthy choices program, improves nutrition-related outcomes. Journal of Nutrition Education and Behavior, 49(5), 368-379 e361. https://doi.org/10.1016/j.jneb.2016.12.007

Scherr, R. E., Linnell, J. D., Smith, M. H., Briggs, M., Bergman, J. J., Brian, K. M., Dharmar, M., Feenstra, G., Hillhouse, J. C., Keen, C. L., Nguyen, L., M., Nicholson, Y., Ontai, L. L., Schaefer, M. H., Spezzano, T., Steinberg, F. M., Sutter, C., Wright, J. E., Young, H. M., & Zidenberg-Cherr, S. (2014). The shaping healthy choices program: Design and implementation methodologies for a multicomponent, school-based nutrition education intervention. Journal of Nutrition Education and Behavior , 46(6), e13-21. https://doi.org/10.1016/j.jneb.2014.08.010

Shanahan, A. (2015). The Relationship between cross-age teaching and social & emotional learning. University of Minnesota Extension.

Singh, A. S., Mulder, C., Twisk, J. W., van Mechelen, W., & Chinapaw, M. J. (2008). Tracking of childhood overweight into adulthood: A systematic review of the literature. Obesity Reviews, 9(5), 474-488. https://doi.org/10.1111/j.1467-789X.2008.00475.x

Slattery, C. (2017). An exploration of leadership development through action inquiry and its impact on educator self-efficacy. National University.

Smetana, J. G., Campione-Barr, N., & Metzger, A. (2006). Adolescent development in interpersonal and societal contexts. Annual Review of Psychology, 57, 255-284. https://doi.org/10.1146/annurev.psych.57.102904.190124

Smith, L. H. (2011). Piloting the use of teen mentors to promote a healthy diet and physical activity among children in Appalachia. Journal for Specialists in Pediatric Nursing, 16(1), 16-26. https://doi.org/10.1111/j.1744-6155.2010.00264.x

Taylor, J. C., Zidenberg-Cherr, S., Linnell, J. D., Feenstra, G., & Scherr, R. E. (2017). Impact of a multicomponent, school-based nutrition intervention on students’ lunchtime fruit and vegetable availability and intake: A pilot study evaluating the shaping healthy choices program. Journal of Hunger & Environmental Nutrition, 13(3), 415-428. https://doi.org/10.1080/19320248.2017.1374899

Thomson, J. L., Tussing-Humphreys, L. M., Goodman, M. H., & Landry, A. S. (2019). Diet quality in a nationally representative sample of American children by sociodemographic characteristics. The American Journal of Clinical Nutrition, 109(1), 127-138.

Training Technologies for Experiential Learning Activities. (1998). (2nd ed., Vol. 21): Jossey-Bass/Pfeiffer.

Weybright, E. H., Hrncirik, L. M., White, A. J., Cummins, M. M., Deen, M. K., & Calodich, S. (2016). "I felt really respected and I know she felt respected too”: Using youth-adult partnerships to promote positive youth development in 4-H youth. Journal of Human Sciences and Extension, 4(3), 93-110.

Weybright, E. H., Martinez, A. D., Varrella, G., Deen, M. K., & Wright, K. (2018). Teens as teachers: Positive outcomes and recommendations for promoting healthy nutrition in adolescents. Journal of Youth Development, 13(3), 43-60. https://doi.org/10.5195/jyd.2018.595

Worker, S. M., Iaccopucci, A. M., Bird, M., & Horowitz, M. (2018). Promoting positive youth development through teenagers-as-teachers programs. Journal of Adolescent Research, 34(1), 30-54. https://doi.org/10.1177/0743558418764089

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Published

2020-09-22

Issue

Vol. 15 No. 5 (2020)

Section

Program & Practice Articles

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