Need Analysis Approach

Allison Rossett’s (1995)  5-Step Process

According to Allison Rossett's 5-step process, we first enter the analysis stage. In this phase, we focused on lower-level primary school students (the target group) and the relevant information about existing nutrition education programs. By delving deep into understanding the students' needs and backgrounds and the current state of educational programs, we aim to gain a comprehensive understanding of the underlying issues. Our objective is to identify the barriers preventing students from attaining healthy dietary habits and to lay a solid foundation for designing future solutions.

In the secondary research, our focus was on the current state of nutrition education in schools and identifying areas for improvement. The sources provided insights into the scope of current nutrition education, existing systems, and their effectiveness. Key sources include Nutrition Education in Public Elementary and Secondary Schools (National Center for Education Statistics), FY 2022 USDA Nutrition, Education Coordination (Food and Nutrition Service), Why nutrition education is inadequate in the medical curriculum: a qualitative study of students’ perspectives on barriers and strategies (National Library of Medicine), Childhood Obesity Facts (Centers for Disease Control and Prevention).

Learner Analysis Approach 

Smaldino, Lowther, and Rossell's (2012) Process

We used Smaldino, Lowther, and Russell's (2012) process to thoroughly examine secondary resources to understand elementary school students' interests, knowledge, and dietary habits. Through a comprehensive literature review on nutrition education and an in-depth analysis of child health and nutrition data, we will learn about the student body's diverse age groups, ethnicities, and socioeconomic statuses. Phases of this investigation included Analysis, Design, Development, Implementation, and Evaluation. The initial Analysis phase assesses students' nutritional knowledge and eating habits and tailors educational initiatives to address these gaps, improving entry competencies needed to promote healthy dietary habits. 

For our secondary research, we will use Ansorge, R., Gatta, F., & Gopal, A.'s (2024, February 16) research on Piaget's stages of development, Bower's (2013), Chouinard's (2007), Copple & Bredekamp's (2009), EL Education Inc. (2022, 2014), Erikson (1959), Gonya and Howard (2006), and other scholars and These sources reveal elementary school students' needs, interests, and cognitive and social-emotional challenges. We will focus on elementary school students' intrinsic and extrinsic motivations and how they interact with nutritional health education. We will also explore developmentally appropriate play, exploration, and community building activities to support student learning and development.

Task Analysis Approach

Smith/Ragan's (1999) 5-Step Process, Smaldino et al. (2012) ABCD Process

When thinking about task and context analysis, we decided to use Smith and Ragan's 5-Step Process (1995). The research approach for nutrition education in primary schools involves: Analysis, Design, Development, Implementation, and Evaluation. Initially, the analysis step assesses students' nutritional knowledge, dietary habits, and the school's resources, in order to know the need for comprehensive education on healthy eating, etiquette, and food culture. In the design phase, we decided to establish the learning objectives and select relevant content such as dietary guidelines and portion control. In the development stage, materials like lesson plans, games, and digital resources are created to fulfill the needs and make the program enjoyable. Implementation involves training teachers, integrating the program into the curriculum, and involving parents and caregivers, requiring collaboration among various stakeholders. Finally, the evaluation step assesses the program's effectiveness in terms of knowledge gains, dietary changes, and overall satisfaction, providing insights for future improvements.

In our secondary research, we focused on identifying effective strategies for teaching nutrition education to primary school students and understanding the challenges faced in this context. The sources offered insights into the importance of interactive and engaging learning experiences, the need for clear and age-appropriate content, and the role of parents and caregivers in reinforcing healthy eating habits. Key references included the Dietary Guidelines for Americans (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2020), CDC's School Nutrition Education Resource List (Centers for Disease Control and Prevention, n.d.), and research on nutrition communication (Gavaravarapu, 2019).

Context Analysis

Smith/Ragan's (1999) 5-Step Process

Using Smith and Ragan's 5-Step Process (1995), specifically for context analysis we realize that nutrition education effectiveness in lower-level elementary schools in the United States is a complex issue that requires a comprehensive and multi-context approach. To address this, we will conduct several analyses:

1. Curriculum analysis: we will examine the existing nutrition education curriculum to identify its strengths and weaknesses and determine what could be improved. We will also assess its suitability and relevance in the context of current cultural and societal needs. We aim to use the result of this analysis to develop and incorporate nutrition education more practically.

2. Policy analysis: we will examine the existing policies related to nutrition education to help us identify policy barriers or opportunities to improve nutrition education. By learning about policy, we aim to understand how it impacts the implementation of nutrition education.

3. Environmental scan: we will assess social, cultural, and economic factors that influence nutrition education. We will look at the availability and affordability of healthy food options in students’ environments.

4. Stakeholder analysis: we will identify key stakeholders involved in nutrition education and examine their perspectives, interests, and influence on nutrition education.

By focusing on these contexts, we aim to design a learning experience that effectively addresses the current issues in nutrition education and promotes healthy eating habits among lower-level elementary school students. We think that using an all-encompassing and multifaceted approach will give us a better understanding of the situation and help us create more potent nutrition education programs.

CONTEXT AND SETTING

Cultural Context

Food is one of the main products of culture, our research found that culture significantly influences student’s attitude towards nutrition and their food choices. According to research by Kumanyika and Morssink (1997) and Nguyen and Murimi (2017), students from different cultural backgrounds, norms, and beliefs have different eating habits and food choices. Nutrition education must be culturally responsive and inclusive as cultural backgrounds impact students’ receptiveness to nutrition education. Our goal is to maximize the role of community and social environment to develop healthy habits and the ability to choose nutritious meal options for children. We realized the main challenge of this initiative is the knowledge, access, and diverse socioeconomic background (Perera, et. al., 2015), so we aim to provide as much positive reinforcement for children in their community (CDC, 2019).

Curriculum Context

Aside from cultural context, we also found that the existing curricula lack practical implementation and real-world examples, so it is hard for students to apply the knowledge in their daily lives (Beckwith et.al, 2016; Follong et.al, 2022). Another study from the Linus Pauling Institute at Oregon State University also reveals that current approaches for teaching nutrition and dietary behavior are largely ineffective in changing elementary school students’ eating habits due to competing academic expectations, lack of available time, and suitable curricula (Perera et. al, 2015). These findings suggest a need for a more comprehensive and practical nutrition education curriculum that not only highlights knowledge but also equips students with skills to actively contribute to their food choices. We aim to design a learning experience that transcends traditional classroom settings. So, the physical setting is a simultaneous combination of home, school, and community, and the design should be adaptable and flexible to various settings. The design should be able to be incorporated into learners' daily lives, specifically when they are faced with meal options, we aim to facilitate learners in choosing the healthiest and most balanced options they can get. We believe the success of our project depends on the sustainable collaboration of the stakeholders, the parents, teachers, school, and meal providers.

Teacher Attitude, Knowledge, and Skills

Another valuable insight is the attitudes, knowledge, and skills of teachers are the key determinants of nutrition education effectiveness. Teachers who have a positive attitude toward nutrition education are more likely to deliver effective lessons (Institute of Medicine, 2007; Peralta et.al, 2020). Unfortunately, many teachers expressed concerns about the lack of time, resources, and engaging methods to deliver nutrition education (Institute of Medicine, 2007; Peralta et.al, 2020; Follong et.al, 2022). We are also aware of the possible barriers and distractions, for example, the easily accessible fast food and their creative and interesting advertisement (Perera, et. al., 2015). Also, learners’ characteristics like motivations and attitudes towards nutrition and health in general. We would also maximize the role of multimedia for this campaign and make sure that information access is not a problem for our learners. We also identify some possible constraints and affordances, specifically possible populations we excluded:

• Learners with special needs

• Learners with a specific allergy

• Learners with dietary restrictions (religious/cultural)

• Learners with lower socioeconomic backgrounds

GAPS

Knowledge Gap

Despite the critical role of nutrition education in shaping healthy eating behaviors among children, schools in the United States face challenges in providing adequate nutrition education. Students receive far less than the recommended 40-50 hours of nutrition education per year, with high school students averaging only 7 hours, middle school students 5.6 hours, and elementary students 4.6 hours (Centers for Disease Control and Prevention, 2019). Moreover, the comprehensiveness and quality of school wellness policies, which include nutrition education, vary significantly from school to school, often taking a backseat to other priorities (Beckwith et al., 2016). Consequently, this causes an inadequate knowledge gap and awareness for children on nutrition and healthy diet lifestyles (Rosenkranz, Warner, Yarrow, & Rosenkranz, 2021). The limited enforcement of wellness policies, lack of training for teachers and staff, and constrained curriculum flexibility further hinder the effectiveness of nutrition education in schools (Beckwith et al., 2016). Despite these challenges, nutrition education is a vital component of a comprehensive health education program, empowering children with the knowledge and skills to make healthy eating choices (Centers for Disease Control and Prevention, 2019).

Habit Gap

According to research by Michael et al. (2021) during 2019 - 2021 47.1% of students had eaten fruit or drunk 100% fruit juices less than once a day, 45.3% had eaten vegetables less than once a day, and 75.0% had not eaten breakfast daily. Moreover, 30% to 40% of daily energy consumed by children and adults is energy-dense and nutrient-poor foods and drinks (Council on School Health, 2015). They are not eating even half of the recommended servings of total vegetables, beans, greens, or whole grains. In addition, this population is consuming excess sodium, refined grains, and empty calories, which are food components that provide little to no nutritional value (Banfield et al., 2016). These unhealthy habits could lead to a higher risk of chronic diseases such as obesity and diabetes (Rosenkranz et al, 2021).

Motivation Gap

Children can influence each other's eating habits (Hursti, 1999), as their own dietary habits may be influenced by the social environment in which they are situated, and peers' dietary decisions can also affect children's own dietary choices. Additionally, attitudes towards nutrition are one of the factors influencing their healthy eating habits. According to Gutkowska et al. (2023), although many children read food labels, they are unsure about the sources of nutritional components and their effects on their bodies. The health of children is closely linked to parental caregiving behaviors; when parents prioritize dietary education, children themselves become attentive to their health. Furthermore, children's own dietary preferences also have a certain influence on dietary health; picky eating behaviors, resistance to trying new things, and preferences for unhealthy foods are also important reasons why children resist healthy eating (Arthur et al., 2023).

NEEDS ANALYSIS

OPTIMAL PERFORMANCE

Following the first step of Allison Rossett's 5-step process, a thorough analysis of the needs of lower-level primary school students and existing nutrition education programs is conducted. Based on the information collected, custom solutions are designed to ensure that students receive comprehensive and effective nutrition education. Success in this issue would be ensuring that students receive adequate nutrition before and after school, cultivating healthy dietary habits, and maintaining a normal healthy body weight. 

FINDINGS (BASED ON RESEARCH QUESTIONS)

*Citations will be included in the INSIGHTS & CLAIMS section*

1. “What fundamental knowledge and practical skills are crucial for lower-level primary school students to acquire regarding nutrition and healthy eating habits?”

According to our research results, students need to acquire the following Dietary Knowledge:

• Identifying nutritional categories

• Recognizing the five major food groups

• Understanding the benefits of healthy eating and the risks of unhealthy eating

• Identifying food product labels

• Familiarity with various cooking techniques

• Awareness of food processing techniques

• Knowing how to seek resources for assistance

Additionally, students should master practical skills such as:

• Identifying unhealthy components in daily foods

• Recognizing unhealthy foods in everyday scenarios

• Learning to limit unhealthy components for oneself

• Finding healthier alternatives

• Understanding the influence of culture and tradition on shaping dietary habits

• Having the ability to select healthy foods in various situations

• Cultivating personalized healthy eating habits based on one's culture and preferences.

2. “What gaps or deficiencies exist in the current nutrition education curriculum for lower-level primary school students, hindering their understanding and application of healthy eating habits?”

Based on the findings, we have identified the following factors hindering elementary students from adopting healthy eating habits:

• The complexity of Curriculum Content: Considering the learners' age, the inherent complexity of nutrition itself may be challenging for them to grasp.

• Personal Factors: Individual food preferences significantly influence dietary habits.

• Cultural Background: Dietary habits are deeply influenced by personal cultural backgrounds.

• Family Income: Income levels affect accessibility to healthy foods to some extent.

• Lifestyle Habits: Lifestyle habits also influence dietary health. In one study, some elementary school students were found to enjoy watching TV while eating, a behavior that can disrupt control over food intake.

• Advertising and Marketing: Marketing of unhealthy foods also plays a role in influencing individuals' choices towards healthier options.

• Nutrition Education Lacks Coverage in Schools: According to the National Center for Education Statistics, approximately 50% of schools provide nutrition education, but we believe this is far from sufficient.

• Lack of Systematic Teaching Materials/Methods: Teaching plans for children such as MyPlate are scattered in content and lack systematic/structured instruction.

3. "What factors influence the attitudes and feelings of lower-level primary school students towards nutrition education, and how do these factors impact their engagement and receptiveness to learning?"

Based on our research results, parental influence, individual taste preferences, and reluctance to instruction are factors affecting elementary students' attitudes towards nutrition education:

• Parents' Influence: Parents play a crucial role in their children's nutrition education. If parents show a high level of interest in nutrition-related knowledge, children typically adhere to dietary rules and maintain healthy eating habits at home. Conversely, if parents lack interest in nutrition-related knowledge, children may not pay much attention to their diet. This can often lead to issues such as overweight or obesity.

• Taste Preferences: Some students are reluctant to try unfamiliar foods, which affects their overall healthy eating habits.

• Reluctance to Instruction: Some students are unwilling to be instructed on dietary habits. For example, some children prefer eating at home because they feel schools dictate their meal times.

INSIGHTS & CLAIMS

Importance of Knowledge: Our research underscores the critical importance of providing lower-level primary school students with fundamental knowledge regarding nutrition and healthy eating habits. This includes identifying nutritional categories, understanding food groups, and recognizing the benefits of balanced eating (Dietary Guidelines Advisory Committee, 2015).

Practical Skills Acquisition: In addition to theoretical knowledge, practical skills acquisition is essential. Learners need to be equipped with the ability to identify unhealthy components in foods, seek healthier alternatives, and understand the influence of culture on dietary habits (Nebraska Department of Education, n.d.).

Challenges: The complexity of nutrition education curriculum content poses a significant challenge for elementary students (Silva, Araújo, Lopes, & Ray, 2023). Additionally, personal factors, cultural backgrounds, and lifestyle habits further hinder students' understanding and application of healthy eating habits (Gavaravarapu, 2019).

Role of Parents: Parents' influence on children's attitudes and behaviors towards nutrition education cannot be overstated. A high level of parental interest in nutrition-related knowledge positively impacts children's adherence to dietary rules and maintenance of healthy eating habits (Gutkowska et al., 2023). Therefore, it is important to get the parents involved in shaping students’ eating habits (Hursti, 1999).

Learners’ Preference: Some students exhibit reluctance to instruct on dietary habits, often preferring to adhere to familiar foods or routines (Arthur et al., 2023). Recognizing and addressing this reluctance is crucial for fostering engagement and receptiveness to learning about nutrition.

Advantages

• Simplicity: The simple design of the logo allows individuals to grasp the principles of the five food groups more quickly.

• Dietary guidance: Assists individuals in selecting their own healthy diet based on the five food groups according to their personal circumstances (U.S. Department of Agriculture, n.d.).

Disadvantages:

• Lack of systematic teaching: The absence of systematic teaching may make it difficult for individuals to understand the content and assess learning outcomes effectively. 

• Neglect of nutritional information: MyPlate lacks sufficient explanation on Fat, a nutrient. This oversight may lead individuals to blindly choose low-fat diets, increasing the risk of diseases (Harvard T.H. Chan School of Public Health, 2023)

Task and Procedures 

This project should include the development of engaging educational content, interactive tasks, and clear procedures for effective learning. Getting nutrition education right is paramount, as it equips students with:

Diet knowledge: Eat a diverse range of foods within each food group, limit intake of foods and beverages high in added sugars, solid fats, and sodium, select whole grain products, and adhere to an eating pattern that underpins healthy growth and development (Institute of Medicine, 2007, p. 23). 

Dining Etiquette (manners): Dining etiquette for young children is about more than just manners; it's about preparing them for the world, respecting cultural differences, developing their motor and social skills, fostering healthy eating habits, and enhancing family and social interactions (Nebraska Department of Education, n.d.).

Interaction with others: The process of communication also understands that ‘people’ are individuals in communities, and they do not operate in a vacuum and that an individual's food habits are influenced by his/her social, cultural and economic milieu. An individual cannot be viewed outside the context of family, peers, social structure, community, culture and physical environment (Gavaravarapu, 2019).

Procedures and Knowledge that Learners Need to Know:

1. Identify food groups and nutrients: 

   • Recognize the components of a balanced diet, including fruits, vegetables, grains, protein foods, and dairy (Dietary Guidelines Advisory Committee, 2015).

   • Understand the nutritional classifications, such as carbohydrates, proteins, fats, vitamins, minerals, dietary fiber, and water (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2020).

2. Read and interpret nutrition labels:

   • Learn how to read nutrition facts on food labels to make healthier choices (Institute of Medicine, 2007).

   • Analyze food labels to determine the nutritional content of packaged foods and make comparisons between similar products (Institute of Medicine, 2007).

3. Plan and prepare balanced meals:

   • Use dietary guidelines to plan and prepare meals that include all food groups (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2020).

   • Incorporate essential nutrients found in the 5 food groups into meals and explain their importance for health (Dietary Guidelines Advisory Committee, 2015).

4. Practice portion control:

   • Recognize appropriate serving sizes for different foods to maintain a healthy weight (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2018).

   • Understand the concept of energy balance and its role in weight management  (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2018).

5. Make healthy snack choices:

   • Identify healthy snack options that are low in added sugars, solid fats, and sodium (Dietary Guidelines Advisory Committee, 2015).

   • Explore creative and nutritious snack ideas that align with dietary recommendations (Dietary Guidelines Advisory Committee, 2015).

6. Understand the importance of hydration:

   • Learn about the role of water in the body and the importance of staying hydrated (Institute of Medicine, 2007).

   • Identify signs of dehydration and strategies to increase water intake (Institute of Medicine, 2007).

7. Use cooking techniques that enhance nutritional value:

   • Apply cooking methods such as steaming, roasting, and grilling to preserve nutrients in foods (Kumanyika & Morssink, 1997).

   • Experiment with different cooking techniques to create flavorful and nutritious dishes (Kumanyika & Morssink, 1997).

8. Seek professional guidance:

   • Recognize when to seek support and guidance from health professionals, such as dietitians or nutritionists (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2018).

   • Understand the role of nutrition experts in providing personalized dietary advice (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2018).

9. Limit unhealthy food choices:

   • Restrict foods and drinks high in calories from added sugars, saturated fat, and sodium (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2018).

   • Develop personalized strategies to reduce the consumption of unhealthy foods and drinks in the diet (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2018).

10. Identify healthier alternatives:

    • List common foods and drinks high in calories from added sugars, saturated fat, and sodium (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2020).

    • Find healthier substitutes for these items that align with nutritional goals (U.S. Department of Agriculture & U.S. Department of Health and Human Services, 2020).

11. Recognize health risks:

    • Describe the health risks associated with consuming excess calories, added sugars, saturated fat, and sodium, such as obesity, type 2 diabetes, heart disease, and high blood pressure (Dietary Guidelines Advisory Committee, 2015).

    • Share knowledge about these health risks with others to promote awareness and prevention (Dietary Guidelines Advisory Committee, 2015).

12. Customize and savor nutrient-rich options:

    • Adapt food selection to incorporate personal preferences, cultural traditions, and financial circumstances while maintaining nutrient-rich choices (Dietary Guidelines Advisory Committee, 2015).

    • Celebrate cultural diversity through food by sharing and appreciating dishes from different cultures (Dietary Guidelines Advisory Committee, 2015).

References:

Dietary Guidelines Advisory Committee. (2015). Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary Health and Human Services and the Secretary of Agriculture. Washington, DC: US Department of Health and Human Services.

Institute of Medicine. (2007). Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth. Washington, DC: The National Academies Press.

Kumanyika, S. K., & Morssink, C. B. (1997). Cultural appropriateness of weight management programs. In S. Dalton, Overweight and weight management: The health professional’s guide to understanding and practice (pp. 69–106). Aspen Publishers.

U.S. Department of Agriculture. (n.d.). What is MyPlate? MyPlate. Retrieved March 8, 2024, from https://www.myplate.gov/eat-healthy/what-is-myplate 

U.S. Department of Agriculture & U.S. Department of Health and Human Services. (2018). Dietary Guidelines for Americans: Infographic. MyPlate. Retrieved from https://myplate-prod.azureedge.us/sites/default/files/2020-12/DGA%20Infographic%282018%29.pdf

U.S. Department of Agriculture & U.S. Department of Health and Human Services. (2020). Dietary Guidelines for Americans, 2020-2025. https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf

What makes nutrition education hard to learn for students? 

1. Complexity of the Subject Matter

Nutrition is a complex subject with many variables, and there is an abundance of information available, not all of which is reliable or consistent. This can lead to confusion as individuals try to discern which advice to follow (Silva, Araújo, Lopes, & Ray, 2023). 

2. Understanding Nutrition and Diet Guidelines

Nutrition and diet guidelines can be complex and may be difficult for children to understand. Concepts such as portion control, nutrient density, and balanced meals may be abstract or confusing, and young learners may need more concrete examples and hands-on experiences to grasp these concepts (Silva, Araújo, Lopes, & Ray, 2023).

3. Personal Food Preferences

Individuals have unique tastes and preferences that can influence their willingness to try new foods or adhere to certain dietary recommendations (Liem & Russell, 2019). Personal dislikes or food aversions can make it challenging to incorporate a variety of nutrient-rich foods into the diet, and emotional eating and cravings for comfort foods can interfere with making healthy food choices (Liem & Russell, 2019).

4. Cultural Influences & Socioeconomic Factors

Cultural background and socioeconomic factors can significantly influence dietary habits and food choices. Traditional cuisines, family customs, income, access to fresh produce, and the availability of healthy food options can all impact the ability to maintain a nutritious diet (Ziso, Chun, & Puglisi, 2022). Social norms and peer pressure, particularly among children and adolescents, can also affect eating habits (Centers for Disease Control and Prevention, n.d., p1).

5. Marketing of Unhealthy Food Options

The prevalence of marketing for unhealthy food options, especially targeting children, can influence dietary choices and make it challenging to prioritize nutritious foods. Advertising campaigns often emphasize the taste and convenience of processed foods, overshadowing the importance of nutritional value, and the availability of high-calorie, low-nutrient foods in schools, vending machines, and fast-food restaurants contributes to the difficulty of making healthy choices (Smith, Kelly, Yeatman, & Boyland, 2019).

Learner Analysis

PERSONA

CHALLENGES

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•  Retrieved from https://www.apa.org/topics/obesity/food-advertising-children

• Ansorge, R., Gatta, F., & Gopal, A. (2024, February 16). Piaget Stages of Development. WebMD. https://www.webmd.com/children/piaget-stages-of-development

• Arthur, S., Mitchell, A. E., & Morawska, A. (2023). Parent-reported barriers to establishing a healthy diet with young children in Australia. Child: Care, Health and Development, 49(4), 669-678. 

https://doi.org/10.1111/cch.13081

• Banfield, E. C., Liu, Y., Davis, J. S., Chang, S., & Frazier-Wood, A. C. (2016). Poor Adherence to US Dietary Guidelines for children and adolescents in the National Health and Nutrition Examination Survey population. Journal of the Academy of Nutrition and Dietetics, 116(1), 21–27. https://doi.org/10.1016/j.jand.2015.08.010

• Barr, E. (2020). Extrinsic & Intrinsic Motivation Examples - What’s the Difference? SpriggHR. https://sprigghr.com/blog/hr-professionals/extrinsic-intrinsic-motivation-examples-whats-the-difference/

• Beckwith, S., Cooper, M., Goesch, H., & MacKinnon, G. (2016). Nutrition education in America’s schools: A policy brief. An act to improve the health of America’s youth through nutrition education in schools (H.R. 3800). Retrieved from https://www.nutritioneducation.org/policy-brief.pdf

• Better Health Channel. (n.d.). Food processing and nutrition. Retrieved from https://www.betterhealth.vic.gov.au/health/healthyliving/food-processing-and-nutrition

• Bower, N. M. (2013). Adventure, play, peace: Insights and activities for social-emotional learning and community building with young children. Wood N Barnes Publishing.

• Centers for Disease Control and Prevention. (n.d.). School nutrition education resource list for busy teachers, principals, and school staff. Retrieved February 21, 2024, from https://www.cdc.gov/healthyschools/nutrition/pdf/308155-A_FS_SchoolNutritionEd-508.pdf

• Centre for Health Protection, Department of Health, Hong Kong SAR Government. (n.d.). Frequently asked questions on infection control related to COVID-19. Retrieved from https://www.chp.gov.hk/en/static/100022.html

• Chouinard, M. M. (2007). Children's questions: A mechanism for cognitive development. Monographs of the Society for Research in Child Development, 72(1), vii-ix, 1-112; discussion 113-26.

• Copple, C., & Bredekamp, S. (Eds.). (2009). Developmentally appropriate practice in early childhood programs serving birth through 8. NAEYC.

• Council on School Health, Committee on Nutrition. (2015). Snacks, Sweetened Beverages, Added Sugars, and Schools. Pediatrics, 135(3), 575–583.

• Dietary Guidelines Advisory Committee. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary Health and Human Services and the Secretary of Agriculture. Washington, DC: US Department of Health and Human Services; 2015.

• Dirksen, J. (2016). Who are your learners? In Design for How People Learn (2nd ed., pp. 27–58). New Riders.

• EL Education Inc. (2014). Characteristics of primary learners. Retrieved from https://eleducation.org/resources/characteristics-of-primary-learners

• EL Education Inc. (2022). Characteristics of elementary learners. Retrieved from https://eleducation.org/resources/characteristics-of-elementary-learners

• Erikson, E. H. (1959). Identity and the life cycle. International Universities Press.

• Follong BM, Verdonschot A, Prieto-Rodriguez E, Miller A, Collins CE, Bucher T. Nutrition across the curriculum: a scoping review exploring the integration of nutrition education within primary schools. Nutrition Research Reviews. 2022;35(2):181-196. doi:10.1017/S0954422421000111

• Gavaravarapu S. M. (2019). Nutrition communication - Rhetoric & reality. The Indian journal of medical research, 149(3), 333–344. https://doi.org/10.4103/ijmr.IJMR_1772_18

• Gonya, J. Early childhood building blocks: Turning curiosity into scientific inquiry. Resources for early childhood, an online resource for Ohio educators. Retrieved from http://rec.ohiorc.org/orc_documents/orc/recv2/briefs/pdf/0008.pdf

• Gutkowska, K., Hamułka, J., & Czarniecka-Skubina, E. (2023, November 9). The attitudes of 7–9 year old primary school students towards Food and Nutrition: Insights from qualitative FGI research-the junior-edu-żywienie (JEŻ) project. MDPI. https://www.mdpi.com/2072-6643/15/22/4732

• Harvard T.H. Chan School of Public Health. (2023, February 6). Healthy Eating Plate vs. USDA’s Myplate. Healthy Eating Plate vs. USDA’s MyPlate. https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate-vs-usda-myplate/#:~:text=MyPlate%20is%20silent%20on%20fat,and%20worsens%20blood%20cholesterol%20profiles.

• Howard, S. (2006). What is Waldorf Early Childhood Education? Gateways, Fall/Winter. Waldorf Early Childhood Education Association.

• Hursti, U.-K. K. (1999). Factors influencing children’s Food Choice. Annals of medicine. https://pubmed.ncbi.nlm.nih.gov/28850280/

• Inclusive Design Principles. (n.d.). Inclusive Design Principles. Retrieved from https://inclusivedesignprinciples.org/

• Institute of Medicine. (2007). Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier Youth. Washington, DC: The National Academies Press

• Kumanyika, S. K., & Morssink, C. B. (1997). Cultural appropriateness of weight management programs. In S. Dalton, Overweight and weight management: The health professional’s guide to understanding and practice (pp. 69–106). Aspen Publishers. 

• Liem, D. G., & Russell, C. G. (2019). The Influence of Taste Liking on the Consumption of Nutrient Rich and Nutrient Poor Foods. Frontiers in nutrition, 6, 174. https://doi.org/10.3389/fnut.2019.00174

• Michael SL, Jones SE, Merlo CL, et al. Dietary and Physical Activity Behaviors in 2021 and Changes from 2019 to 2021 Among High School Students — Youth Risk Behavior Survey, United States, 2021. MMWR Suppl 2023;72(Suppl-1):75–83. DOI: http://dx.doi.org/10.15585/mmwr.su7201a9

• Mulders, M. (2020, November 25). A Guide to Positive Reinforcement in UX Design. Design & UX. SitePoint. https://www.sitepoint.com/a-guide-to-positive-reinforcement-in-ux-design/

• Nguyen, B., & Murimi, M. W. (2017). An after-school cultural and age-sensitive nutrition education intervention for elementary schoolchildren. Journal of Nutrition Education and Behavior, 49(10), 877–8802.

• Peralta, L. R., Werkhoven, T., Cotton, W. G., & Dudley, D. A. (2020). Professional development for elementary school teachers in nutrition education: A content synthesis of 23 initiatives. Health Behavior and Policy Review, 7(5), 374-396. https://doi.org/10.14485/HBPR.7.5.1

• Perera, T., Frei, S., Frei, B., Wong, S. S., & Bobe, G. (2015). Improving nutrition education in U.S. elementary schools: Challenges and opportunities. Journal of Education and Practice, 6(30), 41-50.

• Rosenkranz, R., Warner, N., Yarrow, L., & Rosenkranz, S. (2021). Use of Food Rewards in Education: Time to De-implement this Practice? Journal of Child Nutrition and Management, Fall 2021(2). https://schoolnutrition.org/wp-content/uploads/2022/06/Use-of-Food-Rewards-in-Education-Time-to-De-Implement-this-Practice-Fall2021.pdf

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