UC Davis

Obesity in adolescence is increasingly prevalent and likely perpetuated by the overall poor diet quality observed in this age group. Advancement in food literacy has been indicated for improving eating patterns and subsequently reducing obesity prevalence, thus diminishing risk for chronic disease in adulthood. Food literacy includes knowledge and skills required to adopt and maintain healthy eating practices. Despite the postulated benefit to health, there is a dearth in food literacy programming for adolescents. Consequently, the objective of this dissertation was to understand the most effective approach and to develop a food literacy program for high school-aged adolescents. This was achieved through three specific aims: validation of an age-appropriate nutrition knowledge assessment; establishment of an effective pedagogical approach; and development of an innovative curriculum.The first aim of this dissertation was accomplished through testing an existing nutrition knowledge questionnaire for validity and reliability with high school-aged adolescents. Sections of the original questionnaire pertaining to nutrition advice and nutrients in food were administered to groups of students at four high schools. Participants were stratified by whether they had known previous nutrition education (n = 174) or not (n = 136). Upon eliminating one question, for demonstrating poor item difficulty, the questionnaire was determined to have good internal consistency reliability (Cronbach α = 0.83). Additionally, results of an independent samples t-test suggested that the questionnaire displayed construct validity with the nutrition education group scoring significantly higher than the no nutrition education group (P < 0.0001). The second aim involved testing the effectiveness of implementing experiential garden-enhanced nutrition curricula with adolescents as cross-age teachers for younger youth. Adolescents were initially trained during a 2-day workshop and completed weekly reflections following teaching sessions. During these reflections, adolescents provided commentary on practices that worked well while facilitating the curricula and aspects that needed improvement in subsequent sessions. Fidelity to the curricula was collected through detailed observations. While the goal for adequate fidelity is 80%, adolescents were only able to achieve 45% overall fidelity. Lesson components that were the most insufficiently delivered included those requiring increased content knowledge and additional pedagogical training. Findings from the cross-age teaching study provided impetus for the final aim of this dissertation, which involved developing a food literacy curriculum specifically for high school-aged adolescents. In addition to filling the need for more food literacy curricula for this age group, the resulting curriculum could be utilized in training adolescents to be component cross-age teachers. The curriculum was developed utilizing Backward Design and includes Social Cognitive Theory and Constructivism as theoretical frameworks. Learning concepts were drawn from food literacy components and attributes as defined in the literature and encompass three overarching topics of agriculture, nutrition, and cooking. After expert committee review, the curriculum was pilot tested in two rounds in low-income communities. Results from the pilot tests led to modification of lesson procedures to increase efficacy for achieving learning objectives. The final curriculum, Teens CAN: Comprehensive Food Literacy in Cooking, Agriculture, and Nutrition, includes 12 modules featuring learner-centered lessons and application activities. The work presented in this dissertation provides two novel materials, a nutrition knowledge questionnaire and food literacy curriculum for high school-aged adolescents, and additional considerations into application of cross-age teaching. Taken together, these results lend to a succinct food literacy program with the potential to improve knowledge and skills that contribute to healthy lifestyle behaviors. Testing of the program utilizing a two-tiered cross-age teaching approach, with college interns educating adolescents and then mentoring them to teach younger youth, began in the 2019-2020 school year. However, due to the COVID-19 pandemic, the implementation had to be suspended. Preliminary data indicated that college interns were delivering Teen CAN with high fidelity. Data assessing improvement in adolescent measures could not collected and education of younger youth was yet to be conducted. The college internship was adapted for the 2020-2021 school year to involve creation of online enhancements to accompany Teens CAN modules. Future directions include testing the newly developed virtual components and, when safe, restarting implementation of the two-tiered cross-age teaching model.