A core focus of our work is developing and examining the effectiveness of nutrition education curricula and interventions that are based on the intersection of food, personal health, and the environment. We examine how these interventions can change targeted behaviors and related mediators (psychosocial influences). Alongside creating our own curricula, we strengthen organizations that teach children food-system based nutrition education by conducting program evaluations. We seek to create an evidence base for why and how to teach good food and nutrition education.
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In 2015, the Tisch Food Center launched a partnership with Wellness in the Schols (WITS) to evaluate two WITS programs, Cook for Kids and Coach for Kids. Wellness in the Schools inspires healthy eating, environmental awareness and fitness as a way of life for approximately 30,000 kids in 60 public schools in New York, Kentucky and Florida. NYC schools receiving WITS programming will be compared to control, non-WITS schools with similar risk for unhealthy eating, physical activity habits and obesity. The effectiveness of these programs will be assessed over two academic years comparing students at WITS and control schools on school lunch consumption, activity at recess, classroom attention, and academic achievement. This evaluation is funded through a grant from the Newman’s Own Foundation.
As the rates of childhood obesity and related health consequences increase, researchers have been interested in how nutrition education curricula and wellness policy implementation change students’ eating and physical activity behaviors. Yet, there has been little research to compare curriculum and wellness policy individually versus when both are implemented together. This was the study design for the Food, Health & Choices trial.
The Food Health & Choices intervention uses social cognitive theory and self-determination theory as its foundation. It has two components:
- Wellness Policy: includes guidelines for healthy foods to be provided in classrooms for snacks and celebrations as well as “Dance Breaks," an activity where students dance to videos during the school day
- Classroom Curriculum: students receive 23 lessons that teach nutrition concepts through inquiry-based science explorations. Lessons encourage students to choose more fruits and vegetables and choose less sweetened beverages, fast foods, and processed packaged snacks such as candy and chips. Students are also encouraged to choose more physical activity and choose less television and video games.
Twenty schools participated in the outcome evaluation conducted during the 2012-13 school year. Schools were placed in one of four groups: a) Wellness Policy only; b) Classroom Curriculum only, c) Both Wellness Policy and Classroom Curriculum, and d) delayed control (received standard science curriculum the intervention year, but received the “Both” condition the year after the intervention). Pre- and post- intervention, we assessed students’ heights, weights, percent body fat, eating and physical activity-related behaviors, and theory-based mediators of behavior change.
Food, Health & Choices will be published as the 4th book of the LiFE Curriculum Series. Funded by a United States Department of Agriculture (USDA), Agriculture Food Research Initiative (AFRI) Grant.
Koch P, Lee H, Contento IR, Graziose M, Burgermaster M, Di Noia J. Food, Health & Choices (FHC): A retrospective evaluation of changes in energy balance related behaviors (EBRBs). Journal of Nutrition Education and Behavior. 2014;46(4 Suppl). Retrospective Evaluation Poster
Abrams E, Koch P, Contento IR, Mull L, Lee H, Di Noia J, et al. Food, Health & Choices: Using the DESIGN stepwise procedure to develop a childhood obesity prevention program. Journal of Nutrition Education and Behavior. 2013;45(4 Suppl):S13-S4.
Lee H, Mull L, Abrams E, Contento IR, Koch P, Di Noia J, Gallagher D. Food, Health & Choices: Understanding body fatness in urban elementary school youth. Journal of Nutrition Education and Behavior. 2013;45(4 Suppl):S59-60.
Lee H, Mull L, Contento IR, Abrams E, Koch P, Di Noia J. Food Health & Choices: Understanding relationships among food and activity behaviors and theory-based mediators. Journal of Nutrition Education and Behavior. 2013;45(4 Suppl):S60.
Mull L, Koch P, Abrams E, Contento IR, Lee H. Food, Health & Choices: Development and implementation a classroom wellness intervention “Positively Healthful Classrooms”. Journal of Nutrition Education and Behavior. 2013;45(4 Suppl):S60-61.
- Lee H, Koch P, Contento IR, Di Noia J, Mull L, Abrams E. Food, Health & Choices: Validation of an Audience Response System (ARS)-delivered food and activity questionnaire for youth. Journal of Nutrition Education and Behavior. 2013;45(4 Suppl):S59.
As our culture becomes more accustomed to the use of visual and interactive tools, the use of media in education is also becoming more popular. Documentaries are increasingly being used as pedagogical tools because they can provide perspectives that are not always addressed in mainstream media or found in textbooks. In addition, they can hold students’ attention, draw them into the themes being presented, and encourage passionate engagement in the topic. We are exploring food documentaries in the context of a growing social food movement and in conjunction with the evidence-based theory-driven and behavior-focused curricula development process that has been shown to influence food-related behavior choices. Using this framework, we are developing a middle school curriculum to accompany the In the Defense of Food documentary, which will be available in 2015 on PBS. Development of the curriculum funded by a National Science Foundation grant to Kikim Media and by PBS.
Since 2012, we have been working with Edible Schoolyard NYC to conduct a longitudinal program evaluation. Edible Schoolyard NYC partners with public schools to build gardens and kitchen classrooms where children can engage in hands-on learning. Their goal is to provide students with the knowledge, skills, and supportive environment required to make healthier choices and change the way students eat… for life. At the Manhattan flagship school PS/MS 7, we are assessing students’ food consumption at school lunch and outside of school, as well as psychosocial determinants (i.e. influences like attitudes) related to food intake. Baseline data (pre-program) was collected in spring 2013. It included digital photographs of three days of school lunch as well as survey data on behaviors and psychosocial determinants. The first round of post-test data was collected in spring 2014, after students received about eight kitchen classroom lessons. Analysis of these data is currently being conducted. We collected post in 2014, 2015 and 2016. See report below. The evaluation is funded by Edible Schoolyard NYC.
Participation in the National School Lunch Program (NSLP) dramatically declines as children get older, especially for middle and high school students. Eating school lunch has the potential to improve students’ health, academic achievement, and social equity. Cafeterias could be designed to promote healthy eating, but there is rarely an opportunity to evaluate the impact of school cafeteria renovations on the potential to improve students’ eating behaviors. It is known that the physical environment can influence healthy eating. What is not known is whether or not creating a dramatically more enjoyable dining experience can lead to increased school lunch consumption, participation rate, and more positive healthy-eating attitudes. The proposed case study will evaluate the effects a renovation of one NYC high school cafeteria, part of a larger effort by NYC Department of Education to renovate 20 middle and high school cafeterias. The cafeteria renovations will include open, choice based serving lines, a variety of inviting, colorful, and comfortable seating options, and nutrition education messaging that promotes healthy food choices.
Specific study aims are:
(1) To measure the effects the renovation on students’ school lunch consumption measured at baseline, one-month and three-months post renovations.
(2) To measure the effects of renovations on potential mediators (school lunch participation rates, seated times, and healthy eating attitudes of students) of students’ school lunch consumption at baseline, one-month and three-months post renovations,
(3) To measure the effects of fidelity to the Healthy Eating Design Guidelines on consumption and mediators of consumption.
This study will provide needed evidence to school design guidelines and enhance efforts to create best practices for school cafeterias during renovations, new school development, and school additions. At the completion of the study we will better understand how shifting from a traditional one-size-fits-all school cafeteria design to a more appealing cafeteria design may entice students to participate in the NSLP and eat their lunch.
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In 2015, the Tisch Food Center launched a partnership with FoodCorps, an AmeriCorps partner, to lead their evaluation study. FoodCorps connects kids to healthy food by placing service members in over 400 schools across the nation to foster the creation of holistically healthy school food environments.
The goals of this evaluation were to:
Revise FoodCorps’ Healthy School Progress Report to better reflect FoodCorps’ programming and evidence from the research literature on creating a healthy school environment to promote fruits and vegetables.
Better understand how the presence of a FoodCorps service member in a school changes the school food environment.
- Explore which aspects of a healthy school food environment are related to higher consumption of fruits and vegetables at school lunch.
Below is a summary of the work and findings—including that students in high-implementation FoodCorps schools eat triple the fruits and vegetables compared to children in low-implementation schools.
Poster and oral presentations from the Society for Nutrition Education and Behavior Conference 2017:
- FoodCorps Healthy School Progress Report [Poster ] [Abstract]
- FoodCorps Cross-Sectional Study of Associations Between Fruit and Vegetable at School Lunch and Food-Based Programming [Poster ] [Abstract]
- FoodCorps Development and Validation of a Questionnaire to Assess Fruit and Vegetable Consumption at School Lunch [Presentation ] [Abstract]
- FoodCorps Study to Assess Whether School Lunch Cafeteria Noise is Associated with Fruit and Vegetable Consumption Among Elementary Students [Presentation ] [Abstract]
As the levels of childhood obesity increased through the 1990s and 2000s, researchers began to develop and evaluate school-based interventions aimed at changing behaviors that would decrease obesity rates. The Choice, Control & Change trial was developed to determine if a standards-based curriculum could be effective at changing students’ “energy balance related behaviors” (i.e. food and physical activity behaviors) to ultimately decrease obesity risk. The curriculum served as a replacement for a required 7th grade science unit on “dynamic equilibrium."
C3 is a 20-lesson theory-based curriculum that utilizes both social cognitive theory and self-determination theory. The inquiry-based science lessons explore key questions such as, “How can we use scientific evidence to help us maintain energy balance?” Students participate in activities such as measuring out teaspoons of sugar in common sweetened beverages and then assessing how sugar can build up in our blood causing type two diabetes if we take in too many total calories and do not engage in enough physical activity. Students also set personal goals and monitor their progress attaining their goals, discussing triumphs and challenges and working together to increase confidence and success.
The C3 trial took place during the 2006-2007 school year and involved 10 New York City middle schools, matched in pairs that were similar in terms of ethnicity/race of students, percent of students who qualified for free or reduced price lunch, and academic achievement levels of students. One school in each pair was randomly assigned to receive C3 and the other to receive the standard science curriculum on dynamic equilibrium. The students who received C3 got around 30 total sessions (many lessons took multiple sessions to complete) over 3 months. Students who received C3 reported drinking fewer sweetened beverages, eating fewer snacks such as chips, candy, and packaged baked goods, and eating healthier options at fast food restaurants. They also increased walking for exercise and decreased recreational screen-time.
During the dissemination phase in 2007-09 the curriculum was taught in several sites in Michigan, in Hayward, CA, and in Philadelphia, PA, and an implementation trial in Michigan showed similar results to the NYC trial.
Choice, Control & Change: Using Science to Make Food and Activity Decisions is the third book of the LiFE curriculum series. The development, evaluation, and dissemination of Choice, Control & Change was funded by a National Institutes of Health Science Education Partnership Award and extra online resources were funded by a stimulus grant.
- Koch, P. Choice, Control & Change: A Formative, Outcome, Process and Qualitative Evaluation of a Middle School Obesity Prevention Curriculum. Presented at the New York City Nutrition Education Network, October, 2013.
Lee H, Contento IR, Koch P. Using a systematic conceptual model for a process evaluation of a middle school obesity risk-reduction nutrition curriculum intervention: Choice, Control & Change. Journal of Nutrition Education and Behavior. 2013 Mar;45 (2):126-36.
Mallya A, Mensah FM, Contento I, Koch PA, Calabrese Barton A. (2012). Extending science beyond the classroom door: Learning from students’ experiences with the Choice, Control & Change (C3) curriculum. Journal of Research in Science Teaching; 49:24-269, 2012
Contento IR, Koch PA, Lee, H, Calabrese-Barton A. Adolescents demonstrate improvement in obesity risk behaviors after completion of Choice, Control & Change (C3), a curriculum addressing personal agency and autonomous motivation. Journal of the American Dietetic Association, 110:1830-1839, 2010.
Sauberli W, Lee H, Contento IR, Koch PA. Enhancing personal agency and competence in eating and moving: An outcome evaluation of Choice, Control, and Change (C3), an inquiry-based middle school science curriculum to reduce obesity risk. Journal of Nutrition Education and Behavior. 40(4S): S36, 2008.
Contento, I., Koch, P. A., Lee, H. W., Calabrese-Barton, A., & Sauberli, W. (submitted). Outcome evaluation of Choice, Control, and Change (C3), a middle school curriculum to reduce obesity risk focusing on enhancing personal agency and autonomous motivation. Journal of the American Dietetic Association.
Contento IR, Koch PA, Lee H, Sauberli W, Calabrese Barton A. Enhancing personal agency and competence in eating and moving: Formative evaluation of a middle school curriculum, Choice, Control, and Change. Journal of Nutrition Education and Behavior, 39(S2): S179-S186, 2007
Koch P, Calabrese Barton A, Whitaker R, Contento I.. Choice, Control, & Change. Science Science Scope. Vol 31(3) 16-20, 2007
Lee H, Contento IR, Sauberli W, Koch PA, Calabrese Barton, A. Using Science Education to Move Middle Schoolers toward More Healthful Food and Activity Choices: An Outcome Evaluation of Choice, Control, & Change (C3). Journal of Nutrition and Education Behavior 39(4S), S96, 2007.
Today’s youth spend a lot of time playing video and online games. Increasingly, games are being developed to address health and social issues. The objective of this study was to develop, implement, and evaluate the effectiveness of an educational computer game, Creature 101, based on the Choice, Control, & Change curriculum. In the game, designed for children aged 9-12, students care for the health of creatures and along the way learn why healthful dietary and activity choices are important. Students also learn how to incorporate healthful choices into their lives, while setting and tracking personal food and physical activity behavior change goals. The behavioral and potential influences are the same as for the C3 curriculum. The Creature 101 game was evaluated in middle schools in Manhattan and Brooklyn and was shown to be effective at significantly reducing frequency and quantity of sweetened beverage intake and frequency (and some size) of processed packaged snack intake. Students had significantly higher knowledge scores compared to the control group which did not initially play the game. This study was funded by a NIH Small Business Innovation Research (SBIR) grant and was completed in partnership with Stottler Henke Inc.
Majumdar D, Koch PA, Lee H, Contento IR, de Lourdes Islas-Ramos A, Fu D. ‘‘Creature-101’’: A Serious Game to Promote Energy Balance-Related Behaviors Among Middle School Adolescents. Games for Health, 2013 Nov:5(2):280-290.
Majumdar, D., Koch, P., Lee, H., Contento, I., Islas, A., & Fu, D. (2013). Creature 101: A virtual reality online game to promote energy balance related behaviors among middle- schoolers. Journal of Nutrition Education and Behavior, 45(4), S9.
Majumdar, D., Koch, P., Lee, H., Contento, I., Islas, A., & Fu, D. (2012). “Creature-101”: Using a virtual reality, serious game to promote healthy eating and physical activity behaviors among middle school students. Journal of Nutrition Education and Behavior, 44(4, Supplement), S38.
Koch, P. A., Islas, A., Lee, H., Majumdar, D., Contento, I., Farl, C., . . . Hoffman, E. (2010). Development of LiFESim: A social networking game to teach middle school students why and how to make healthful food and activity choices. Journal of Nutrition Education and Behavior, 42(4), S83.
Majumdar, D., Koch, P., Lee, H., Contento, I. Validation of an online instrument for assessing eating and physical activity behaviors in young adolescents, Annual Conference of The Society for Behavioral Nutrition and Physical Activity, May-2014, P-082
Majumdar, D., Palmer-Keenan, D. Identifying barriers to PA among low-income tweens, Annual Conference of The Society for Behavioral Nutrition and Physical Activity, May-2014, P-410
Majumdar, D., Koch, P., Lee, H., Contento, I., Islas, A., & Fu, D. Evaluation of “Creature- 101”- A Theory based Virtual Reality serious game for Nutrition Education, Annual Conference of The Society for Behavioral Nutrition and Physical Activity, May-2012, LB-200
The National School Lunch Program launched in 1946, but the current focus on improving school meals gained momentum in the 1990s. In 1996, we worked on the initial development and evaluation of the Cookshop Program. The evaluation took place in two NYC public schools. It was the first known study to investigate if nutrition education that involved cooking and eating the same recipes as were served in the cafeteria was more effective at changing school lunch consumption of vegetables and whole grains than nutrition education without these direct food experiences. In the lunchroom, all students in the study were offered at least one of 13 new vegetable and whole grain recipes every day over the intervention period of five months. The results showed that children who had the Cookshop Program were more likely to try the target foods in school lunch than children who received no nutrition education, but also compared to children who received standard nutrition education without the cooking component. These results demonstrate that only changing what is offered in the lunchroom, without being accompanied by direct experiences with the new recipes, is not enough for students to try and accept new, more healthful foods.
Liquori, T, Koch, PD, Contento, IR, and Castle, J. The Cookshop Program: outcome evaluation of a nutrition education program linking lunchroom food experiences with classroom cooking experiences. Journal for Nutrition Education, 30:302-313, 1998
More about Cookshop (Now housed in Food Bank for New York City)
Cancer survivors can decrease their risk of cancer recurrence and also decrease their risk of chronic diseases by eating plenty of fruits and vegetables and decreasing intake of saturated fat. From 2009-2011, we collaborated with the Columbia School of Public Health on the Cook for Your Life program, to develop a behavioral nutrition intervention for Hispanic women who are breast cancer survivors. Through this intervention, these Hispanic women learned cooking skills that allowed them to increase their intake of fruits and vegetables and decrease their intake of dietary fat (through smaller portions of meat, reduced amounts of fat from meats, smaller portions of dairy, and smaller amounts of fat used in cooking). Funded by the National Institutes of Health.