The purposes of this study were to (1) identify the evaluation categories, areas, attributes, and criteria of the school food service program using both a qualitative and a quantitative analyses, (2) define the relative importance of the evaluation categories, areas, attributes, and criteria of the school food service program using analytic hierarchy process, (3) organize the evaluation system to improve quality of the school food service in Korea. A survey was conducted from August to October 2004 to collect data from 172 dietitians, 15 school food service officials at the educational board, 10 professionals of school food service. Statistical analyses were performed on the data utilizing the SPSS 12.0 for Windows and Excel, such as Descriptive statistics and analytic hierarchy process was performed. The result of the analytic hierarchy process indicated that relative importance of evaluation category was 0.4319 (food service manage ment), 0.2369 (nutrition education), 0.1455 (satisfaction) and 0.0912 (parent involvement program). 'Sanitation, safety and facility (0.1739)' was the most important area among the subcategories of food service management, followed by nutrition management (0.1581), procurement (0.1375), production (0.1345), organization and personnel management (0.0662), planning (0.0644), food service evaluation (0.0585), financial accountability (0.0555), and information management (0.0554). There existed a relative importance on the three areas of the nutrition program and satisfaction evaluation category: students (0.5281, 0.6221), parents (0.1812, 0.1491), and teachers (0.1838, 0.1618). In the parent involvement program evaluation category, relative importance of committee and monitoring management was 0.4658 and information communication was 0.3724. The quality of food and service to school children can be improved by the appropriate application of the developed evaluation tool for the school food service program.
This study was carried out to evaluate the effects on elementary school children of Internet-based nutrition education programs. The subjects consisted of 80 boys and girls (book-loaming group : 42, Internet-based teaming group : 38) in the 5th grade of elementary school. The results were as follows : The evaluation of Internet-based education programs by Internet-teaming group showed above average in all domains. As the favorite and wholesome menu chose‘nutrition kingdom’(52.6%) made of animation. The educational effect of this program was evaluated by comparing the methods of the Internet-learning group with those of the book-learning group. For effect-evaluation were measured the degree of nutrition knowledge and diversity score of dietary intake from before and after education. Before undertaking the program, there was no significant difference between the two groups in terms of their nutrition knowledge. However, the nutrition knowledge of the Internet-based teaming group after the program had increased significantly (p < 0.01) compared to the book-learning group. There was no significant difference between the two groups in terms of the diversity of dietary intake before the start of the program, but upon its completion, the Internet-based learning group showed a significant increase compared to the book-loaming group (p < 0.05). This suggests that Internet-based educational programs could be effective in drawing the interest and boosting the concentration levels of schoolchildren. In conclusion, Internet-based nutrition education shows the potential to be an effective alternative education method. (Korean J Nutrition 36(5): 500∼507, 2003)
Hypertension is the major risk factor for cardiovascular disease which is considered the leading cause of death in Korea. Since nonpharmarologic dietary intervention is recommended as the first step in the management of hypertension, evaluation of intervention programs is needed to formulate strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) at a public health center, by assessing changes in nutrition knowledge, food attitude, self-efficacy, dietary behavior, and nutrient intake after program completion. An HNEP was conducted in Suwon city for 5 months in 1999 by a public health center. The program provided 3 sessions of group education with individual nutrition counseling. Thirty-five patients participated fully in the program out of 62 enrollees. Data about nutrition knowledge, food attitude, self-efficacy, dietary behavior, and intake (24-hour recall) were collected before (baseline) and after the program. Post program results indicate the following : 1) nutrition knowledge and perception of importance of nutrition significantly increased, 2) food attitudes also improved, 3) the self-efficacy for maintaining a low salt diet was increased significantly, whereas self-efficacy for maintaining a low fat diet or dietary guidelines was not improved, 4) frequency of intake of processed food, animal fat, and sweets as well as frequency of dining out were significantly reduced, 5) nutrient intake was not improved after the program, 6) the most serious barrier for participating in the program and practicing diet therapy was lack of time and willingness. In conclusion, it appears that HNEP might improve food attitudes, individual perceptions and self-efficacy for desirable eating behavior, but it might not improve dietary intake. It follows then, that a long term intervention program may need to increase effectiveness of patient dietary adherence.
The purpose of this study was to evaluate the effects of Web-based nutrition education program for junior and senior high school students. Three materials, which were printed materials on Group I, WBI (Web-Based Instruction) leaflet on Group II and the web-based nutrition education program developed in the antecedent research, were applied for 564 students in 3 junior high school and 4 senior high school in Seoul during 4 weeks. Pre-test was done from October 21 to October 26, 2002 and post-test was done from November 25 to December 13, 2002. The statistical data analysis was completed using SPSS WIN (ver. 11.0) for descriptive analysis, t-test and ANOVA. According to the evaluation of effectiveness for web-based nutrition education program, nutrition knowledge, food attitude, food habit and nutrient intake were not significantly improved but positively. And on the evaluation of effectiveness for nutrition education program by materials, WBI was more effective educational materials than WBI leaflet and printed materials. Consequently nutrition knowledge, food attitude, food habit and nutrient intake were improved positively but not significantly using WBI, which was due to the instructional period of the only 4 weeks. Therefore long-term instruction should be required for effective nutrition program, as well as more WBI nutrition education program for high school students would need to be developed in the near future in that WBI was effective material on nutrition education.
Impact and process evaluations were performed in order to verify the effectiveness of a public health nutrition program developed for child-bearing aged women in Korea. Participants included 58 high school girls who were divided into two groups. Each group received four 50 - 60 minute nutrition education lectures regarding healthy eating, osteoporosis, constipation and nutrition labeling in every two weeks. Each session took 50- 60 minutes. Regarding nutrition knowledge, there was a significant increase of degree of perception (p = 0.0004) , but no change in degree of accuracy after implementation (p = 0.9522) . Nutrition education was also effective in attitude change, showing more participants were ready to change their eating behaviors in terms of meal regularity (p = 0.0455) and less processed food intake (p =0.0143) . After implementing nutrition education, effective behavioral changes were observed in milk consumption (p =0.0037) and meal regularity (p = 0.0882) as well as daily activity such as stair use (p = 0.0701) . However, nutrition education had no effect on body mass index and perceived health status. In process evaluation conducted by a 9 item questionnaire, grand mean score was $4.17 \pm$0.72 out of 5. Proportion of items with scores higher than 4 ranged $68-91\%$. These results suggest that the nutrition education program used in this study was effective and useful. For a wider use of this program, more research was recommend for a strategy development of program diffuse. (Korean J Nutrition 38(10): 873$\sim$879,2005)
This paper presents the status of nutrition education for older adults in Korea, and examines considerations in developing effective nutrition education programs for the elderly based on literature reviews. Finally, strategies of nutrition education for older adults in Korea are examined. Status of nutrition education were examined by surveying 90 senior centers, and 46 public health centers providing nutrition services. Most senior centers(96%) provided health education programs, however, nutrition was only a part of health programs. Among the 41 public health centers which responded to the survey, 73.1% provided nutrition education for older adults. The frequently covered topics were prevention & management of hypertension/stroke, diabetes, nutritional management during later adulthood, and osteoporosis. Common barriers in planning and implementing elderly education were; lack of educational materials for older adults, reliance on lectures, difficulty in following-up. To develop effective nutrition education, four stages consisting of needs assessment, planning and implementation of programs, and evaluation should be carefully done. Needs assessment might be done using quantitative or qualitative assessment. Factors influencing nutrition behavior of older adults can be systematically examined using a theoretical approach such as the PRECEDE-PROCEED framework. Qualitative methods, such as focus group interviews, also provide insightful information regarding the needs of older adults. In planning nutrition education programs, physical and pshychological changes associated with aging should be considered. Literature regarding elderly education suggest that active participation or participatory learning is also effective for older adults. Educational materials are developed following the principle of KISS and pre-tested. Program evaluation has been rarely done in practice, although it provides valuable feedback to the program. Strategies for developing nutrition education for Korean elderly include; performing needs assessment, developing a standard program by topics in a logical and systematic way, developing programs for subgroups of elderly, applying diverse education methods developing educational materials for the elderly, evaluating programs using simple tools, and delivering a nutrition program as a part of health promotion program. Finally, the interaction and communication between researchers and practitioners is strongly recommended to ensure better nutrition education and services to the elderly.
Objectives: This study aimed to develop evaluation criteria for the elementary-school-based health promotion program using the RE-AIM framework and to examine their feasibility. Methods: Previous evaluation studies on health interventions for elementary-school students using the RE-AIM framework were reviewed systematically to identify appropriate evaluation criteria. A diet and physical activity intervention based on the transtheoretical model was implemented in a pilot study using the "Happy Me" application. The feasibility of using the RE-AIM framework to evaluate it was examined. Results: The review yielded the following evaluation criteria: "reach," the ratio of participants out of the total target population; "efficacy/effectiveness," the difference in outcomes between the intervention and control groups, or between a pre- and post-test; "adoption," the rate of use of the program and participation in the next stage of the program; "implementation," the progress on the program components; "maintenance," the participants' and teachers' intention to continue using the program. The pilot study reached 76.6% of the targeted population. The intake of sugar-sweetened beverages decreased (P < 0.0001), and the duration of walking increased (P < 0.0001). Other indicators could not be evaluated; therefore, potential indicators were suggested. Conclusions: This study produced feasible evaluation criteria for elementary-school-based health promotion using the RE-AIM framework. Nevertheless, the feasibility needs to be validated with a broader range of studies and long-term interventions.
The purpose of the study was to implement and evaluate a nutrition capacity training program for dietitians and other professionals working at customized home visiting health services (CHVHS). This program focused on nutrition services for hypertension or diabetes mellitus patients including topics regarding CHVHS, and composed of 10 sessions with lectures, discussion and practice. Dietitians (n = 54) and other professionals (n = 20) participated in the program and completed the questionnaire to assess their understanding of nutritional management, nutrition services and CHVHS before and after the program, and to examine program satisfaction and education needs. Subjects were mostly women (98.6%) and college or university graduates (93.2%). Total score (p < 0.001), as well as all items (p < 0.001 or p < 0.01) of understanding regarding nutritional management, nutrition services and CHVHS, were significantly increased after the program both in dietitians and in other professionals. Subjects were generally satisfied with the program, showing more satisfaction with items regarding subject's participation, acquiring new knowledge, usefulness of the program for CHVHS, and education materials. In future nutrition capacity training programs, subjects wanted to have classes regarding nutrition services for specific chronic diseases, development of education materials, methods for dietary life education, modifying eating habits and so on. Other professionals compared to dietitians, showed higher education needs in meal management (p < 0.01) and nutrition counseling skills (p < 0.05). This study showed the effectiveness of a nutrition capacity training program for home-visiting dietitians and other professionals, and suggests the need and direction for future nutrition capacity training programs.
The purpose of this study was to investigate the effect of the web-based nutrition counseling on the dietary behavior and food intake of hyperlipidemic patients and to evaluate the web-based nutrition counseling program. Forty hyperlipidemic patients, twenty of them were hypercholesterolemia and the other twenty were hypertriglyceridemia, participated in the web-based nutrition counseling program. At the first nutrition counseling, the patients were interviewed and then follow-up nutrition counselings were accomplished four times during eight weeks through a web-based internet program. The web-based nutrition counseling program was consisted of diet management, nutrition education and nutritional assessment and the follow-up counseling program. The dietary behavior score increased significantly in both groups after the nutrition counseling program(p<0.01). The diet therapy knowledge score also increased significantly (p<0.01). For food frequency, vegetable (p<0.01), fruit (p<0.05) and seaweed (p<0.01) consumption increased significantly, while meat (p<0.01), egg (p<0.01), snack (p<0.01) and instant food (p<0.01) intake decreased significantly in both groups after the nutrition counseling program. The evaluation of the web-based nutrition counseling program by the patients showed above average in all domains, specially the evaluation scores of younger aged patients habituated to practice computer were better than those of older aged patients. Therefore, this study shows that the web-based nutrition counseling program is effective for improving dietary behavior and food consumption the patients. In addition, these results indicate that internet presents us with potential as a new medium for nutrition counseling in informationized society.
This study was conducted to develop and apply a computer-based multimedia nutrition education program for preschoolers based on the Dick and Carey model of instructional design. The Dick and Carey model included 4 phases: analysis, design, development, and evaluation. The program's instructional goals, objectives, assessment instruments, content, examples, and practice questions with feedback were written in the design phase. To be familiar with the 5 food groups, 'Nutrition exploration' were programmed using Hyperstudio. 'Nutrition exploration' was designed as a five-session, interactive multimedia game, with each session taking about 5 minutes to complete. Nineteen preschoolers, aged 6, volunteered to participate formative evaluation. The effectiveness of the program was examined using a pre-post test design. Participants were recruited by personal contact at the individual preschool education center. The application was carried out during 4 weeks. The results showed that intervention participants significantly increased knowledge between pre-test and post-test. The results support using IMM (interactive multimedia) to disseminate nutrition education to the target population. This research provides the basis for continuing development of computer-based nutrition education materials.
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