Impact of a nutrition education programme on the nutrition knowledge of grade R learners in Durban

AIM: The aim of the study was to identify the need, develop, implement and determine the effect of a Grade R Nutrition Education Programme (NEP) in order to make recommendations to the South African Department of Basic Education (DBE) to include an effective NEP in the pre-primary school education curriculum. OBJECTIVES: The objectives for this study is in two phases, The objective of the baseline study was to assess the need for nutrition education (NE) in Grade R in suburban areas of Durban and identify the most suitable nutrition education tools (NETs) for this age group. For the intervention study the objectives were 1) to develop a nutrition knowledge questionnaire (NKQ) to determine the existing nutrition knowledge of Grade R learners in suburban government and private schools in Durban, 2) to develop a nutrition education programme (NEP) for Grade R based on the South African Food-Based Dietary Guidelines (FBDGs) and the food groups, 3) to implement the NEP in Grade R in a government and private school, 4) to determine the effect of the NEP on the retention of FBDGs (Section one) and food group (Section two) knowledge, and 5) to compare the results between the control group (CG) and the government (EGG) and private (EPG) experimental school groups, and between genders. METHODS: A self-administered nutrition education needs questionnaire was completed by 20 Grade R teachers in Durban suburban schools. Nutrition education material was identified based on the results from the pilot study and a Nutrition education programme developed. The classroom-based intervention study involved 120 Grade R learners in three schools, two experimental schools: government (n=37) and private (n=40), with a control school (n=43), with 35 percent (n= 42) male and 65 percent (n=78) female participants, ranging in age from five to seven years. A validated questionnaire assessed baseline nutrition knowledge of these children. A qualified foundation phase teacher was trained to implement the NEP. The experimental school groups received eight one hour nutrition education (NE) lessons over an eight week period; the control group did not receive any NE. During the lesson firstly theory was covered then the children worked on the related fun activities in the Healthy Eating Activity Book (HEAB) and lastly involved in the nutrition educational games. These included a food group plate puzzles, a NEP board game, a card game and ‘My little story books’. A post-test determined the impact of the intervention. RESULTS: The baseline study confirmed the need for NE in Grade R and identified suitable NETs that were used in the intervention. At pre-test, the nutrition knowledge of Grade R children in the two experimental groups (EG) and one CG was very similar with knowledge of FBDGs greater than knowledge relating to the food groups. Both Grade R EGs showed a significant increase in knowledge for the whole test immediately after the intervention with the CG, achieving similar post-to pre-test results. The intervention had a significant impact on nutrition knowledge of Grade R children in both experimental schools (EGG p=0.004 and EPG p=0.001). The EPG were most knowledgeable regarding FBDGs with no significant difference in knowledge of the EGG. Food group knowledge in all schools was poor at baseline and the NEP resulted in the EGG obtaining the highest post-test results. Post-intervention for the whole test the EGG were marginally (0.80 percent) more knowledgeable than the EPG. The knowledge of boys and girls were very similar in pre-and post-test results. However, the boys were fractionally more knowledgeable than the girls in relation to the whole post-test. In Section two, relating to food group knowledge, girls were slightly more knowledgeable than boys although both genders lacked knowledge in relation to which foods belonged to a particular food group. CONCLUSION: The primary aim of formal NE was met as the statistical significance between the CG and experimental group post-test results was evident in the majority of Section one questions and in all questions in Section two. The NEP resulted in similar increase in knowledge of Grade R learners in the government and private experimental school groups in Durban. In addition, the boys and girls showed a minimal difference in nutrition knowledge.