National Nutrition Education Curriculum StandardsTeacher Training - Undergraduate

Esther C. Okeiyi, PhD, RD,LDN

GOAL

To develop a framework for nutrition education curriculum standards at the

undergraduate level that includes undergraduate level that includes teacher training, student training,

certification requirements, and career development.

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OBJECTIVES1. Demonstrate an understanding of nutrition

education in elementary, middle and high schoolsin Nor th Carolina.

2. Explain and discuss ways to better prepare2. Explain and discuss ways to better prepareundergraduates for teaching nutrition educationin all settings.

3. Make suggestions based on feedback fromstakeholders on teaching trainers.

4. Develop a framework for undergraduate teachertraining at the undergraduate level.

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SITUATION

Why is there a need for a standardized curriculum in Nutrition Education?

¨ Children in Pre-K to 12th grade are suffering from an epidemic ofvarious malnutrition problems which are preventable throughpromoting and providing nutrition education.

¨ Healthcare costs is on the rise from $258 billion in 1980 to 2.6

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¨ Healthcare costs is on the rise from $258 billion in 1980 to 2.6trillion in 2010 and exceeds $20,000 per family.

¨ There is a positive correlation between nutrition education and theservice and reduction in healthcare costs versus disease processesresulting from malnutrition.

¨ Nutrition education and standardization in early stages are critical ifeffective reform is to be achieved.

BACKGROUND6

Childhood Obesity is one of the biggest public health challenges ofthe 21st century. Devising effective policy and practices to combatchildhood obesity and resultant premature health conditions hasbecome a high priority1.

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Type 2 diabetes, associated with obesity, is one of the most commonforms of diabetes2,3,4. It is associated with a number of othercardiovascular risk factors which constitutes the metabolic syndrome.

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Statistics reveal that children are faced with variety of healthconditions with the basic cause of the problems rooted in nutritionalissues which may be preventable5.

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The growth in health care spending over the past twenty years islinked to modifiable population risk factors such as obesity and stress.Rising disease prevalence and new medical treatments account fornearly two-thirds of the rise in spending7.

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Statistics show that health care costs continue to increase according to the U.S.Bureau of Labor Statistics. CNN Money Fortune magazine reported that familyhealth care costs exceeds $20,000 per family in 2012. Health expenditures inthe United States neared $2.6 trillion in 2010; ten times the $256 billion spentin 19808,9,10.

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To be effective, reforms should focus on health promotion, healtheducation, public health interventions, and the cost-effective use ofmedical care11.

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Charged13

¨ Steps needed to provide training to educatestudents and methods to evaluate the training.students and methods to evaluate the training.

NCCU COURSES & PROGRAMS

Undergraduate Programs At NCCU15

¨ All Undergraduates must take a minimum of 124-128hours to graduate

¨ All undergraduate students at NCCU must take HealthEducation (HEDU 1531) and Physical Education (PEDUEducation (HEDU 1531) and Physical Education (PEDU1551); both 3 credit hour courses.

¨ Introduction to Human Nutrition Food 2200, a 3 credithour course is not taken by all students.

Undergraduate Programs At NCCU16

All undergraduates who are in health care relatedprograms and/or majors such as Nursing, Nutrition,Public Health, Physical Education and Sports andExercise Science may obtain additional nutritionknowledge from some of their core courses orknowledge from some of their core courses orelectives that incorporate nutrition topics.

NCCU Health Education Program

¨ Public Health Education additionally take personalhealth courses:n HEDU 2000: Introduction to Health Educationn HEDU 2200: Health Be. For Effective living

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n HEDU 2400: Methods and Application for GroupLeadership for Health Personnel.

These courses may incorporate nutrition.

¨ The science majors are not required to take the Food2200 course.

NCCU Health Education Program

¨ HEDU 1531: Health Educationn An introductory study of personal health promotion

and disease prevention with an emphasis on changingbehavior form those that threaten health to those that

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behavior form those that threaten health to those thatwill promote lifelong wellness.

NCCU Nutrition Program

¨ FOOD 2200: Introduction to Human Nutrition¤An introduction to the nutrients essential to human

life and well being. A study of dietary nature ofnutrients the function in the body and food sources.

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¨ FOOD 4670 (Food 2200 Pre-requisites)¤Designed for Nutrition majors, any student from any

discipline may elect to take the course if the pre-requisite is met.

¤ This course prepare nutrition majors to teachnutrition to the public of diverse culture in diversesettings.

Licensure Programs

¨ All teachers teaching at elementary, middle, and high school must belicensed according to NC State Board policy TCP-A-00.

¨ The licensure programs are offered:¤ At undergraduates level¤ As licensure certification programs only for 1st degree holders

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¨ Housed in the School of Education with varied areas of specialization.School of education handles admission and offers a majority of the coursesin professional education.

¨ Elementary, Middle, Secondary education with specialization in science,social studies, English, mathematics, family & consumer sciences, modernforeign language, music, physical education.

¨ Also produce majors in occupational and special areas of education incollaboration with 14 other departments.

¨ Students with B.S. B.A., M.S or M.A may elect to goback to school to take those courses required to meetthe licensure requirements.

Undergraduate Programs At NCCU(Licensure Only Certification)

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¨ All programs follow their accrediting and statestandards in designing the licensure courses.

NCCU Education Program Degrees

¨ Elementary Education, K-6 (B.A., M.Ed.)¨ Middle School Education, 6-9 (B.A., M.Ed.)¨ Educational Technology, (M.A.)

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¨ Educational Technology, (M.A.)¨ School Administration, (M.S.A.)¨ Special Education K-12, (M.Ed., M.A.T)¨ Communication Disorders (M.Ed.)¨ Counselor Education (M.A.)

What Steps Are Needed To Provide Training To Educate Students Pre K – 12th Grades?

Four major stakeholders were surveyed :1. NCCU program directors,2. NC state consultants assisting with state policy,3. NCCU teachers teaching nutrition education,

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3. NCCU teachers teaching nutrition education,4. and NCCU undergraduate students.

What steps are needed to provide training to educate students Pre-K – 12th grades?

Four major stakeholders were surveyed :1. Investigated what is currently being done in nutrition

education, from policy à implementation à trainingof students at public schools (Elementary, Middle, HighSchool).

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School).2. Additionally, assessed how well nutrition education is

provided currently from the standpoint of four majorstakeholders.

• The program directors• State Consultants a& State’s policy on NC Health Essential Course• Teachers teaching nutrition education• Undergraduate students at NCCU

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ASSESSMENT

STATE POLICY REVIEW

North Carolina Curriculum Standards

¨ The North Carolina State Board of Education and theDepartment of Public Instruction continue to recognize thevalue in comprehensive sequential Physical Education andHealth Education instruction at each grade level.

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¨ In fact, one High School semester of Health Educationcoursework and one High School semester of PhysicalEducation coursework, as per State Board of Educationpolicy GCS-N-004 is required in order to receive a NorthCarolina high school diploma.

North Carolina Curriculum Standards

¨ This instruction must be delivered by the appropriatelylicensed classroom teachers as per State Board ofEducation policy TCP-A-001.

The intent of the North Carolina Healthful Living Standard

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¨ The intent of the North Carolina Healthful Living StandardCourse of Study is to establish competency goals andobjectives for the teaching and learning of behaviors thatcontribute to a healthful lifestyle and improved quality oflife for all students. The NC Healthful Living StandardCourse of Study is a combination of two content areas:health education and physical education.

North Carolina Curriculum Standards

¨ Only a minimum of 1 credit of Healthful Living, whichreflects both Health Education and Physical Education,is required for graduation from a North Carolinapublic high school.

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North Carolina Curriculum Standards

¨ The State Department of Public Instructions overseesthe health and physical education taught as NCEssential Standards-Health Education in elementary,middle, and high schools. Nutrition is a part of NCEssential Standard-Health Education (Standard).

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Essential Standard-Health Education (Standard).

North Carolina Curriculum Standards

¨ The State government provided general objectives inNC Essential Standards - Health Education. Otherresources are provided to the teachers to help themteach Standards.

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¨ The Essential Standards are divided into gradelevels--(K-2; 3-5; 6-8, and High School)15.

¨ However, there is no monitoring as to whether thesestandards are covered and how they are coveredexcept for HS where every student must obtain 1credit hour of health and nutrition education tograduate.

NC Essential Standards Health Education (Nutrition Components Standards By Grade (K-2)

¨ Standard 1: Understand My plate as a tool forselecting nutritious foods.

¨ Standard 2: Understand the importance of consuming

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¨ Standard 2: Understand the importance of consuminga variety of nutrient dense foods and beverages inmoderation.

¨ Standard 3: This standard deals with alcohol, tobaccoand other drugs.

¨ Standard 1: Apply tools (MyPlate, food facts, Labels) to plan health nutrition and fitness.

NC Essential Standards Health Education (Nutrition Components Standards By Grade (3-5)

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¨ Standard 1: Analyze tools such as Dietary Guidelinesand Food Facts Labels as they relate to the planningof healthy nutrition and fitness.

Standard 2: Apply strategies to consume a variety of

NC Essential Standards Health Education (Nutrition Components Standards By Grade (6-8)

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¨ Standard 2: Apply strategies to consume a variety ofdense foods and beverages in moderation.

¨ Standard 3: Apply lifelong nutrition and health fitnessconcepts to enhance quality of life.

¨ Standard 1: Analyze strategies using tools (MyPlate, DietaryGuidelines, Food Labels), to plan healthy nutritious mealand fitness.

¨ Standard 2: Create strategies to consume a variety ofnutrient dense foods and beverages in moderation.

NC Essential Standards Health Education (Nutrition Components Standards By Grade (High School)

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nutrient dense foods and beverages in moderation.

¨ Standard 3: Analyze the relationship of nutrition, fitness, andhealthy weight management to the prevention of diseasessuch as diabetes, obesity, cardiovascular diseases, andeating disorders.

¨ Standard 4: Apply lifelong nutrition and health relatedfitness concepts to enhance quality of life.

¨ http://www.nchealthyschools.org/components/healtheducation

NC Health Education Resources 36

¨ http://www.nutritionnc.com/ResourcesForSchools/index.htm

¨North Carolina Nutrition EducationResources

SURVEY HIGHLIGHTS

STATE POLICY REVIEW

¨ Requires all schools to offer Essential Standard (PhysicalEducation and Health Education).

¨ Requires only those licensed to teach in public school.

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¨ Requires only those licensed to teach in public school.

¨ 1 credit hour of Healthful living is required in HS forgraduation.

¨ 56% and 53% of schools have school improvement plan forPhysical Education and Health Education respectively.

STATE POLICY REVIEW

¨ There was only 38% improvement plan for PE and 34%health education faculty and staff.

No minimum number of classroom hours for teaching nutrition

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¨ No minimum number of classroom hours for teaching nutritioneducation established.

¨ No monitoring as to whether Standards are being met.

PROGRAM DIRECTORS

q Students are well prepared (undergraduates andthrough licensure).

q Only very few majors teach after graduating fromPhysical Education, Public Health and HumanPhysical Education, Public Health and HumanSciences.

q Did not know if students are effectively teachingnutrition education in public schools.

q Had no idea how many hours of health or nutritioneducation is being taught in schools. 40

STATE CONSULTANTS

q Not sure if teachers teaching health education arewell qualified to teach.

q Not sure of how many hours are being taught inNorth Carolina Health Essential courses.North Carolina Health Essential courses.

q Not sure if students are learning because there isno End of Grade questions about nutrition on theexam.

q Could not attest to the quality and/or quantity ofHealth Essential courses being taught. 41

TEACHERS TEACHING NUTRITION

q Did not think they are adequately prepared to teachnutrition education.

q Suggested requirements to take more nutrition courses inundergraduate studies.undergraduate studies.

q Majority (92%) believed they were effective in changingdietary behavior of students.

q No assessment of quality and quantity education taught.

q All agreed that nutrition education is very important forstudents.

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UNDERGRADUATE STUDENTS

q Could not remember how many hours of nutritionwas taught to them in middle or high school.

q Education was not effective in changing dietarybehaviors.behaviors.

q Wished they have learned enough to enable themto make informed dietary decisions in college awayfrom home.

q Approximately 25% were likely to teach nutritioneducation as a career. 43

EXPERT ASSESSMENT & DEDUCTIONS

Expert Professional Assessment

¨ Students majoring in Physical Education, Public Health Education and other non-family and consumer science majors are not adequately prepared to teach nutrition education.

¨ There is no standardization in qualifying requirements to teach nutrition education.

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nutrition education.¨ There is no standardization as to the number of hours for

teaching nutrition education.

¨ There is no assessment of implement of nutrition education (quality and quantity) by teachers, State, and program directors.

Expert Professional Assessment

¨ Teachers taught nutrition education their way.¨ Students being trained to teach nutrition education may be

inadequately trained.¨ There was no agreement between state consultants, program

directors, teachers on how qualified teachers were in

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directors, teachers on how qualified teachers were in implementing nutrition education in public schools.

¨ Although policy and standards exist, not all schools and not all children receive nutrition education.

¨ Differences in implementation, if any, vary by schools and teachers.

RECOMMENDATIONS47

ANALYSISSLO’s Course Assessment

1. There should be a continuous evaluation of direct andindirect assessment of quality and quantity of nutritioninstruction on the knowledge and application ofnutrition education.1. DIRECT1. DIRECTq student work, papers, projects, test, observation

2. INDIRECTq self reported information such as surveys, interviews, course

grades

Testing should be designed to include questions on healthyliving or nutrition education components.

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TEACHING1. Nutrition education in elementary, middle and high schools

should be taught by “well qualified” trained teachers.

2. National, state, and accreditation standards should address the

minimum number of credit hours in undergraduate studyrequired to qualify teachers to teach nutrition education in

elementary, middle and high schools.

3. Educators and teachers must know what skills, knowledge, and

values students should have acquired when they have finished

the course.

4. Experiential learning, i.e. garden-based curriculum, cooking skills

for healthful meals, and the quality of the dining experience,

including time allowed for meals, should be included in teaching.

5. Determine assessment tools for students level of knowledge. 49

TEACHINGAdditionally there is a need to strengthen the existing curriculum

(Physical Education, Public Health Education, Family and Consumer

Science Licensure programs’) qualifying credit hours.

Suggested Nutrition Core Courses (Minimum Standards)Suggested Nutrition Core Courses (Minimum Standards)

• Introduction to Nutrition (3 credit hours)

• Intermediate nutrition course (3 credit hours)

• Food sanitation course (2-3 credit hours)

• Food Science and Prep Course (3-4 credit hours)

• Nutrition Education Course (3 credit hours)

TOTAL: 14-16 credit hours50

ACCOUNTABILITY1. Directors, professors and teachers should be held

accountable by SMART goals.q Specific (significant, simple)

q Measurable (manageable, meaningful)

q Attainable (appropriate, achievable, action-focused)

q Relevant (result-based, realistic)

q Timely (time-framed, time-limited, tangible)

q Evaluate (engaging, ethical)

q Revaluate (reassess, revisit )

q Satisfactory (satisfies strategic vision)

2. Develop student learning outcomes assessmentmethods.

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FUNDING1. Food and nutrition practitioners must work to ensure

mandatory, consistent funding for integrated and

comprehensive education and promotion programs.

2. Coordinated at the national level, administrated at the

state level, and implemented at the local level, a well-state level, and implemented at the local level, a well-

funded national nutrition education and promotion

program, focusing on comprehensive school nutrition

services, would provide needed infrastructure and help

leverage resources among other nutrition-related

federal programs11,12.

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CAMPAIGN1. Increasing the number of trained teachers to teach

nutrition education in elementary, middle, and highschools, is imperative if the standards in nutritioneducation are to be effectively met.

2. Let national, state and accreditation standards continueto drive nutrition education.

3. Keep the focus on learning and improvement.

4. Dieticians, nutritionists, professors, teachers,researchers, educators must lobby for healthcare reformwith nutrition education being an area of focus.

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CAREER DEVELOPMENT1. Increase jobs and opportunities associated with nutrition

education.

2. Educate undergraduate students about different careeroptions centered around nutrition education.

3. Create opportunities, internships and job placement forgraduating seniors interested in nutrition education.

4. Involve health care professionals in the importance ofnutrition education.

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POTENTIAL OUTCOMES

1. There will be an increase in studentknowledge of nutrition.

2. There will be enhanced skills in foodpurchase and healthy meal preparation.

3. There will be an application ofknowledge applied in dietary behaviorchanges, now and in the future.

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4. There will be standards which will leadto a standardized curriculum.

5. There will be a decrease in obesityamong children and families.

6. There will be a greater percentage ofchildren who will be educated innutrition.

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7. There will be improvement in nutritioneducation curriculum both at theuniversity and school age levels.

7. There will be consistency in nutritioneducation curriculums.education curriculums.

7. There will be a decrease in healthdisparities among socioeconomicdisadvantaged groups.

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10. The 2020 national and state nutritionhealth objectives will be met.

11. There will be a reduction in healthcarecosts in the government and withinfamilies.

12. There will be improvements in qualityof life as it relates to social issuesassociated with being overweight orobese.

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REFERENCES

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