Peer-Led, School-Based Nutrition Education for Young Adolescents: Feasibility and Process Evaluation of the TEENS Study.

Peer education has become a popular strategy for health promotion interventions with adolescents. but it has not been used widely in school-based nutrition educntion This paper describes and reports on the feasibility of the peer leader component of a school-based nutrition intervention for young adolescents designed to increase fruit and vegetable intakes and lower fat foods. Abour 1,ooO seventh-grade students in eight schools received the nutrition intervention. Ofthese, 272 were trained as peer leaders 10 assist the teacher in implementing the activities. Resultsfrom a multicomponent process evaluation based on peer leader and classroom student feedback, direct classroom observation, and teacher ratings and interviews are presented Results show that peer-led nutrition education approaches in schools are feasible and have high acceptability among peer leoders, classroom students, and teachers. (J Sch Health. 2002;72(3):121-127) espite the importance of healthy eating during adoles- D cence on both immediate and long-term health, studies consistently show that adolescents as a group have poor dietary habits that do not meet current dietary recommenda- tions.I4 Nutrition-related concerns include low intake of fruits, vegetables, fiber and calcium-rich foods; high intake of foods high in fat and sugar; unhealthful dieting; and erratic eating behaviors, such as meal skipping.ub Recent national data show that only 1% of adolescent males and females met national recommendations for all the Food Pyramid groups, and 18% of females and 7% of the males did not meet any of the recommendations.' Evidence also suggests that dietary quality declines from childhood to adolescence. Lytle et al' followed a cohort of students from third grade to eighth grade and found that intake of fruits, vegetables, milk, and fruit juices decreased and soft drink consumption increased during this time. The shift in eating patterns as children move into adolescence likely occurs due to lifestyle, and to developmental, social and, environ- mental changes. Growing independence and eating away from home, concern with appearance and weight, need for peer acceptance, and full schedules, all affect on eating patterns and food ch0ices.8-~ Nutrition education can help young people attain the knowledge and skills they need to make healthful food choices and develop lifelong healthy eating patterns. Schools are ideal settings for nutrition education because they reach most youth, and nutrition fits into several subject areas including health, science, and consumer science. Schools also provide opportunities to practice healthy eating since more than one-half of youth in the United States eats one of their three major meals in school. Since eating is a socially learned behavior influenced by social pressures, school-based programs also can harness the power of peer influences to support and reinforce healthy eating.' Given the research documenting the poor dietary quality of adolescents' diets and the importance of nutrition educa- tion, sqrisingly few nutrition education studies have been