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Nutrition Education Intervention Improves Vegetable-Related Attitude, Self-Efficacy, Preference, and Knowledge of Fourth-Grade Students


  • The authors would like to acknowledge Eric Loken, PhD, for assistance with data analysis, local workgroup members and state nutrition staff who participated in intervention development and refinement, local partner staff who recruited schools and administered surveys, and participating school staff for classroom access and support of Pennsylvania SNAP-Ed. Curriculum information is available by contacting

Denise E. Wall, Pennsylvania Nutrition Education Tracks Evaluation Coordinator, (, Pennsylvania State University, 135 E. Nittany Ave., Suite 405, State College, PA 16801.


BACKGROUND: Impact of a classroom-based, standardized intervention to address limited vegetable consumption of fourth graders was assessed.

METHODS: A 4-lesson, vegetable-focused intervention, revised from extant materials was repurposed for Pennsylvania fourth graders with lessons aligned with state academic standards. A reliability-tested survey was modified, then examined for face and content validity and test-retest reliability. Lessons and evaluation materials were modified through an iterative testing process with educator feedback. A nonequivalent control group design was stratified by local Supplemental Nutrition Assistance Program Education (SNAP-Ed) partnering organizations with random assignment of participating elementary schools as control (N = 68) or intervention (N = 72) treatments. Independent t-tests compared control and intervention group changes. A mixed effects model was created to account for classroom effects from the nested sampling method of selecting classrooms within SNAP-Ed partnering organizations. General linear model univariate analyses of variance were conducted to assess intervention effects considering gender, and food preparation/cooking experience.

RESULTS: During a 3- to 5-week time frame, 57 intervention classrooms (N = 1047 students) and 51 control classrooms (N = 890) completed pre- and post-testing. Intervention students improved in vegetable-related attitude, self-efficacy, preference, and knowledge scores (p < .001). For example, intervention vegetable preference increased 1.56 ± 5.80 points; control group mean increase was only 0.08 ± 4.82 points. Group differences in score changes were not affected by gender or interactions between gender and food preparation/cooking experience with family.

CONCLUSIONS: A defined intervention delivered in a SNAP-Ed setting can positively impact mediators associated with vegetable intake for fourth-grade students.