Designing Effective Nutrition Interventions for Adolescents

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Abstract

By altering dietary behaviors, nutrition interventions during adolescence have the potential of affecting children at that time and later in life. The majority of interventions implemented in the teen years have occurred in schools, but other intervention sites have included after-school programs, summer camps, community centers, libraries, and grocery stores. Programs with successful outcomes have tended to be behaviorally based, using theories for the developmental framework; included an environmental component; delivered an adequate number of lessons; and emphasized developmentally appropriate strategies. One planning method that can be used in the development of nutrition interventions is Intervention Mapping. The steps of Intervention Mapping include conducting a needs assessment, developing proximal program objectives, mapping appropriate strategies and methods to address the objectives, planning the program design, planning program adoption and implementation, and evaluation. The use of intervention-planning techniques, coordination of nutrition and physical education interventions, using technological advances such as CD-ROMs, incorporation of policy changes into intervention efforts, and dissemination of effective programs are all trends that will influence the future development of effective nutrition programs for adolescents.

Section snippets

Review of Adolescent Nutrition Interventions

In a 1995 monograph, Lytle (27) reviewed nutrition interventions directed at the general school-aged population. The review included 43 studies: 17 studies conducted since 1990 and 26 studies conducted before 1990 and described in 2 previously published reviews of nutrition education programs (31), (32). Although most reported studies were conducted in school settings, some were conducted in other settings such as grocery stores (n=l), libraries (n=l), summer youth nutrition education camp

Behavioral Focus

Although the Knowledge, Attitudes, Behavior model has been used for many school-based interventions, it has not been shown to be particularly effective for school-aged children (27). The goal of knowledge-based nutrition programs is to enhance the knowledge, skills, and attitudes of the target population regarding broad nutritional issues. As a result, this model has been successful in increasing knowledge among children but has not been particularly effective for changing nutrition-related

Needs Assessment

The first step in planning effective interventions is knowledge of the problem and the population, both of which can be gained through a thorough needs assessment. When designing a nutrition education intervention, it is important to build in enough time for the needs assessment.

A needs assessment of the population can be accomplished through literature review, review of data collected previously, or baseline data collected specifically for the proposed project. Data for the project can be

Evaluation of Interventions

Evaluation of interventions is necessary to determine the effectiveness of the nutrition education effort. Evaluation can include process and outcome measures. Process measures, which are collected as the intervention progresses, evaluate fidelity, dose, and ease of implementation (88), (89). Data from process measures can be used to interpret program outcomes or to further refine an intervention. Extensive overviews of process evaluation measures and techniques are provided by CATCH (88), (90)

Future Directions in Nutrition Education Programs

Development of nutrition education programs for adolescents is becoming increasingly important with the rising prevalence of chronic diseases with nutritional roots, such as type 2 diabetes and obesity. Future directions in adolescent nutrition education programs include a focus on mediating factors, combining nutrition with physical education programs, an increasing emphasis on outcome-based programs, incorporation of technology into tailored interventions, dissemination of existing effective

Applications

A great majority of nutrition interventions targeting children and adolescents have been conducted through schools (27), (68), (118), primarily because schools provide an appropriate setting to reach approximately 98% of children in the United States (119). In addition, in school settings, continuous and concentrated contact with children can be maintained, interventions can be made more cost-effective, and they can occur within the context of the child's natural environment (68). Thus, schools

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    Copyright © 2002 American Dietetic Association. Published by Elsevier Inc. All rights reserved.