. 2019 Jul 10;22(15):2891–2913. doi: 10.1017/S1368980019001666

Table 2.

Summary of quantitative studies included in the current systematic review on food literacy programmes in secondary schools

	Study details, country	Study design	Sample	Duration of intervention or study	Theory	Food literacy intervention	Food literacy attributes	Outcome measure	Key findings
1	Dewhurst and Pendergast (2011)⁽ ³¹ ⁾, Australia	Cross-sectional	Home-economics teachers (n 186)	Not stated	Not stated	Not applicable	Home-economics teachers’ perceptions on home economics and its relationship to sustainable development	Survey	There is agreement in the cross-cultural comparison findings on the importance of education for sustainable development
2	Dewhurst and Pendergast (2008)⁽ ³² ⁾, Australia	Cross-sectional	Home-economics teachers (n 186)	Not stated	Not stated	Not applicable	Teachers’ perspective on home economics	Survey	The field of sustainable development education has neglected studies of Home Economics education and its teachers’ perceptions about sustainable development education
3	Gracey et al. (1996)⁽ ³³ ⁾, Australia	Cross-sectional	15–16 years (n 391)	Not stated	SCT, TPB, HBM	Not applicable	Nutritional knowledge, beliefs and behaviours	30-item food variety score; fat, fish, soft drinks and water consumption questionnaire	Nutritional knowledge scores were significantly greater in females
4	Jaenke et al. (2012)⁽ ³⁴ ⁾, Australia	Quasi-experimental	11–12 years of age (n 127)	10 weeks	Not stated	Classes assigned to wait-list control, nutrition education only (NE) or nutrition education plus garden (NE+G) groups	F&V intake	Five-item food preference performance assessment tool; 24 h recalls	In the post hoc analysis by gender, both boys and girls in NE+G and NE groups were more willing to taste vegetables compared with control boys and girls post-intervention (P < 0·001, P = 0·02). Boys in the NE+G group were more willing to taste all vegetables overall compared with NE boys at post-test (P = 0·05) and this approached significance for girls (P = 0·07). For overall tasting scores, a group effect was seen in girls only (P = 0·05)
5	Morgan et al. (2010)⁽ ³⁵ ⁾, Australia	Quasi-experimental	11–12 years (n 127), 54 % boys	10 weeks	Not stated	10-week intervention with nutrition education and garden (NE&G), nutrition education (NE) only and control groups. F&V knowledge	Taste vegetables, identify vegetables, willingness to taste vegetables	24 h recalls	School gardens can positively improve primary-school students’ willingness to taste vegetables and their vegetable taste ratings
6	Pendergast and Dewhurst (2012)⁽ ³⁶ ⁾, Australia	Cross-sectional	Home-economics teachers (n 1188)	Not stated	Not stated	Not applicable	Provide insights on food literacy curriculum	Online survey	Differences in home-economic teachers’ understanding on food literacy
7	Ronto et al. (2016)⁽ ³⁷ ⁾, Australia	Mixed method	Home-economics teachers (n 205)	Not stated	Not stated	Not applicable	Examines home-economics teachers’ perspectives of the importance, curriculum, self-efficacy and food environments	20-item cross-sectional survey	Many environmental barriers were reported that could influence food literacy education in Australian high schools such as: lack of teaching materials, facilities and human resources; the perceived inadequacy of the Australian school curriculum; non-supportive school canteens; and negative role modelling
8	Ronto et al. (2016)⁽ ³⁸ ⁾, Australia	Cross-sectional	Home-economics teachers (n 205)	Not stated	ANGELO framework	Not applicable	Home economic teachers’ experience of food literacy education in Australian high schools	Survey	Home economic teachers rated aspects of food literacy including preparing and cooking food, knowing about healthy foods, and food safety and hygiene practices as very important. They indicated animal welfare, where food comes from, and plan and manage time for food shopping to be the least important aspects of food literacy. Home-economics teachers reported that students’ involvement in food literacy activities resulted in healthier diets and improved food practices, but the schools’ food environments are not comprehensively supportive of food literacy
9	Ronto et al. (2016)⁽ ³⁹ ⁾, Australia	Mixed method	Home-economics teachers (n 205)	Not stated	Not stated	Not applicable	Examines home-economics teachers’ perspectives of the importance, curriculum, self-efficacy and food environments	20-item cross-sectional survey	Many environmental barriers were reported that could influence food literacy education in Australian high schools such as: lack of teaching materials, facilities and human resources; the perceived inadequacy of the Australian school curriculum; non-supportive school canteens; and negative role modelling
10	Slater (2013)⁽ ⁴⁰ ⁾, Canada	Mixed methods	Teachers (n 13)	10 years	Not stated	Not applicable	Examined the experiences and perceptions of Home Economics Food and Nutrition (HEFN) programming by teachers and school officials	Administrative records, in-depth interviews and surveys	Results revealed that although enrolment, including boys, increased slightly over the study period, the majority of children do not take HEFN classes. Further, enrolment decreased significantly from grades 7 (45·77 %) to 12 (7·61 %). HEFN education faces significant challenges
11	Zhou et al. (2016)⁽ ⁴¹ ⁾, China	Mixed study	10–15 years of age (n 1058)	9 months	Not stated	Educational intervention consisted of both prize quiz game about nutrition and food safety	Nutrition knowledge, good personal eating habits, the prevention of nutrient deficiency diseases and food safety knowledge	Effectiveness evaluation questionnaires	Nutrition knowledge scores increased for the intervention group
12	Turnin et al. (2016)⁽ ⁴² ⁾, France	Quasi-experimental	13–16·4 years of age (n 580)	1 year	Not stated	Nutri-Advice Kiosk – nutrition skills and food choices	Nutrition skills and food choice	Children’s food choice competency changes and BMI	Across the study, children chose significantly less cheese and pastry or desserts, and significantly more starchy food and dairy, and tended to choose F&V more often
13	Petralias et al. (2016)⁽ ⁴² ⁾, Greece	Quasi-experimental	10·4 years of age (n 25 349)	8-month intervention	Not stated	Students received a daily healthy meal designed by nutrition specialists	Food insecurity	Food Security Survey Module Questionnaire (FSSM)	About 64·2 % of children’s households experienced food insecurity at baseline. The study findings suggest that participation in a school-based food aid programme may reduce food insecurity for children and their families in a developed country in times of economic hardship
14	Tsartsali et al. (2009)⁽ ⁴⁴ ⁾, Greece	Cross-sectional	15–17 years (n 200)	Not stated	Not stated	Not applicable	Adherence to the Mediterranean diet pattern (MDP)	MDP questionnaire, FFQ and KIDMED index score	More than half of participants had poor or very poor actual MDP knowledge. Actual knowledge was the only predictor of MDP adherence
15	Mirmiran et al. (2007)⁽ ⁴⁵ ⁾, Iran	Cross-sectional	10–18 years (mean age 14 (SD 1) years; n 7669)	Not stated	Not stated	Not applicable	Nutritional knowledge and dietary intake	Willett semi-quantitative FFQ; nutritional knowledge, attitudes and practice (KAP) questionnaire; BMI	Significant difference between genders in KAP, with females having higher nutrition knowledge scores. Males had better nutritional practices
16	Venter and Winterbach (2010)⁽ ⁴⁶ ⁾, South Africa	Cross-sectional	17–18 years (n 168)	Not stated	Not stated	Not applicable	Dietary fat knowledge questionnaire	A screening questionnaire for fat intake	The association between fat knowledge scores and intake of the participants was significant
17	Gewa et al. (2013)⁽ ⁴⁸ ⁾, Kenya	Randomised controlled trial	2–15 years of age (n 182)	2 years	Not stated	Schools randomised to one of four snack groups: (i) control (no food supplement); (ii) vegetarian supplement (a feeding based on a traditional local dish); (iii) milk supplement; and (iv) meat supplement	Diet quality, nutrient intake	24 h recalls	There was no evidence that schoolchildren who received supplementary snacks at school experienced reduced intakes at home or that intakes by other family members were increased at the expense of the schoolchild’s intake
18	Klepp and Wilhelmsen (1993)⁽ ⁴⁹ ⁾, Norway	Quasi-experimental	Age not stated (n 447)	12 months	A theoretical framework, organising factors believed to influence the changes in eating patterns of adolescents into four structures: available food products, social environment, personality factors and behavioural factors	Education programme, followed up by a survey	Healthy eating behaviour between males and females	Short FFQ, healthy eating knowledge score	Programme demonstrated ability to integrate curriculum activities designed to modify students’ eating behaviour in home economics courses
19	Øverby et al. (2012)⁽ ⁵⁰ ⁾, Norway	Cross-sectional	Age 10–12 years (n 1488)	7 years	Not stated	No intervention	Frequency of consumption of unhealthy snacks (soda, candy, potato chips) from 2001 to 2008	Questionnaire surveys	Between 2001 to 2008, the frequency of unhealthy snack consumption decreased from 6·9 to 4·6 times/week (P = 0·001). The decrease was largest in the schools that had been included in the national free school fruit programme (22·8 times/week). The effect of the school fruit programmes was significant in reducing the frequency of unhealthy snack consumption in children of parents without higher education (from 7·8 to 4·0 times/week; P = 0·004)
20	da Rocha Leal et al. (2011)⁽ ⁵¹ ⁾, Portugal	Cross-sectional	7th, 8th, 9th grade (mean age 13·5 years; n 390)	2 months	Not stated	Not applicable	Cooking habits and skills, adherence to the Mediterranean diet	KIDMED index score	One in ten adolescents did not know how to cook. Better cooking habits and skills were positively related with adolescents’ adherence to the Mediterranean diet
21	Osler and Hansen (1993)⁽ ⁵² ⁾, Denmark	Cross-sectional	12–14 years (n 674)	Not applicable	Not stated	Not applicable	Nutrition, sugar, fat, fibre	Frequency questionnaire assessing the consumption of fourteen different food items	Adolescents had better knowledge about fat and sugar than dietary fibre. The mean nutrition knowledge increased with healthier dietary habits
22	Chapman et al. (1997)⁽ ⁵⁶ ⁾, USA	Pre–post intervention	14–18 years (n 72, females only)	Not stated	Not stated	Two groups, one control and one experimental. Experimental group received nutrition education	Nutrition knowledge	24 h dietary recall and modified version of nutrition knowledge and attitudes questionnaire	Post-test nutrition knowledge scores increased significantly and were higher than in the control group
23	Evans et al. (2012)⁽ ⁵⁷ ⁾, USA	Quasi-experimental	Low-income adolescents aged 12–14 years (n 214) in 6th grade	10 weeks; three 1 h nutrition education sessions in regular class time, 45 min four times per week in school garden	SCT	The Sprouting Healthy Kids intervention consisted of six components: (i) in-class lessons; (ii) after-school gardening programme; (iii) farm-to-school; (iv) farmers’ visits to schools; (v) taste testing; (vi) field trips to farms	F&V consumption	F&V consumption; motivation for eating F&V; self-efficacy for eating F&V; F&V preference; preference for unhealthy foods; knowledge. Student SHK Questionnaire	Students who were exposed to two or more intervention components scored significantly higher on self-efficacy, knowledge, preferences for unhealthy foods and increased intake of F&V (P < 0·05)
24	Gans et al. (1990)⁽ ⁵⁸ ⁾, USA	Observational	Age not stated (n 105)	1 year	Not stated	Heart Healthy Cook-off programme	Nutrition, food purchasing techniques and heart-healthy cooking methods and education on the relationship between diet and blood cholesterol	Blood cholesterol SCORE (screening, counselling and referral event)	Forty per cent had elevated blood cholesterol level of 170 mg/dl or above. A statistically significant decrease in blood cholesterol level was observed during a 12-week time period. The Cook-off is a fun, effective programme for teaching secondary-school students about heart healthy
25	Huang et al. (2004)⁽ ⁵⁹ ⁾, USA	Cross-sectional	10–19 years (n 301)	Not stated	Not stated	Not applicable	Reading nutrition labels	Fat screener	Boys reading nutrition labels was associated with higher fat intake. Frequency of reading nutrition labels was not associated with healthier diet
26	Jarpe-Ratner et al. (2016)⁽ ⁶⁰ ⁾, USA	Quasi-experimental	8–13 years of age (n 271)	10 weeks	Not stated	Ten-week (2 h/week) chef-instructor-led programme held in cafeteria kitchens after school	Nutrition knowledge, cooking self-efficacy, F&V liking and consumption, and communication to family about healthy eating	Quasi-experimental pre–post survey design	Nutrition knowledge score increased from 0·6 to 0·8, cooking self-efficacy score from 3·2 to 3·6, and vegetable consumption score from 2·2 to 2·4 (all P < 0·05). Increased score for communication about healthy eating (4·1 to 4·4; P < 0·05) 6 months after the end of the course
27	Larson et al. (2006)⁽ ⁶¹ ⁾, USA	Cross-sectional	11–18 years (n 4746)	Not stated	Not stated	Not applicable	Preparation and shopping for food	Youth/Adolescent FFQ	Greater involvement in food tasks was significantly related gender, school grade, race, SES, family meal frequency and weight status
28	Laska et al. (2012)⁽ ⁶² ⁾, USA	Longitudinal cohort	15–28 years (n 1321)	10 years	Not stated	Not appropriate	Enjoyment of cooking, food preparation, relationship between food practices in adolescence	Youth/Adolescence FFQ and Willett semi-quantitative FFQ	Adolescents who helped prepare food for dinner were more likely to engage in food preparation as emerging adults (19–23 years old)
29	Long and Stevens (2004)⁽ ⁶³ ⁾, USA	Quasi-experimental	12–16 years old (n 121)	1 month	SCT and TM	Combination of 5 h of web-based instruction and 10 h of classroom curriculum, compared with nutrition education embedded in the standard school curriculum during a 1-month period	Self-efficacy for healthy eating and eating behaviour	Six questionnaires; Youth/Adolescence FFQ	The intervention group had significantly higher scores for self-efficacy for F&V, self-efficacy for lower fat, usual food choices and dietary knowledge of fat compared with the control group. No difference was found between groups in food consumption. Self-efficacy was significantly associated with dietary knowledge of lower fat, usual food choices, and was inversely associated with lower fat consumption in the hypothesised model of eating behaviour. The intervention was tailored to the social and developmental preferences of adolescents and effectively increased self-efficacy for healthy eating
30	McAleese and Fada (2007)⁽ ⁶⁴ ⁾, USA	Quasi-experimental	10–13 years of age (mean age 11·11 years; n 99)	12 weeks	Not stated	Control group: three 24 h food recall workbooks before and after the intervention. Two treatment groups: (i) garden-based activities; (ii) 12-week nutrition education programme	F&V consumption	24 h recall food workbooks	Greater increase in F&V servings in adolescents in the garden-based nutrition group (0·8 (sd 0·8) to 1·0 (sd 1·4), P < 0·001 for fruit; 1·9 (sd 0·6) to 2·6 (sd 1·7), P < 0·001 for vegetables) compared with controls. Also, significant increases in vitamin A (P = 0·004), vitamin C (P = 0·016) and fibre (P = 0·001) intakes
31	Miller (2014)⁽ ⁶⁵ ⁾, USA	Cross-sectional	Age not stated, 12th grade (n 1800)	2 months	Not stated	Observation of students’ food item choices	Food choice of breakfast selection of milk, juice and yoghurt	Observations and checklists	Secondary-school females were more likely to choose yoghurt than males (OR = 1·931, P = 0·0033). Elementary students who chose no milk were more likely to choose yoghurt than students who chose either white milk (OR = 3·592, P ≤ 0·0001) or chocolate milk (OR = 2·273, P = 0·0005). Secondary students who chose no milk were more likely to choose yoghurt than students who chose white milk (OR = 3·494, P = 0·0060)
32	Pirouznia (2001)⁽ ⁶⁶ ⁾, USA	Cross-sectional	10–13 years (n 532)	Not stated	Not stated	Not applicable	Nutritional knowledge and eating behaviour	CANKAP questionnaire	Females had higher mean nutrition knowledge scores than boys in the 7th and 8th grades. There was no correlation between nutrition knowledge and eating behaviour in both genders in the 6th grade, and a correlation only for males in the 7th and 8th grades
33	Ratcliffe et al. (2011)⁽ ⁶⁷ ⁾, USA	Pre–post quasi-experimental study	11–13 years (n 232)	13 weeks	SCT	236 students completed the Garden Vegetable Frequency Questionnaire and 161 students completed a taste test	Knowledge, attitudes, vegetable consumption	Vegetable Frequency Questionnaire; Garden Vegetable Frequency Questionnaire; 24 h recall	Students were able to identify vegetables and had an increased preference for vegetables generally
34	Schober et al. (2016)⁽ ⁶⁸ ⁾, USA	Quasi-experimental	Age not stated (24 districts)	1 week	Not stated	The LiveWell@School Food Initiative consisted of: (i) a 1 d food services operation seminar for the FSD and financial director and a 2 d culinary workshop for the FSD and their kitchen staff; (ii) on-site chef consultation in school districts; (iii) action planning; and (iv) and equipment grant	Culinary training, action planning and equipment grants	Questionnaire, in-person review of school food records with FSD	Data show that districts changed an average of 17·4 entrées and 19·7 side dishes over the course of the year
35	Trexler and Sargent (1993)⁽ ⁶⁹ ⁾, USA	Cross-sectional	14–18 years (n 600)	Not stated	Not stated	Nutrition knowledge questionnaire	Cholesterol, saturated fat, total fat and sodium	24 h dietary recall	Physiological knowledge of sodium was significantly associated with sodium intake, but other dietary knowledge scores were not associated with dietary intakes
36	Williams et al. (2016)⁽ ⁷⁰ ⁾, USA	Quasi-experimental	8–11 years of age (n 225)	Unclear	SCT, TRA, positive feedback loops	One control school and two intervention schools (three 1 h, assembly-style, hip-hop themed, multimedia classes)	Food purchases and calorie labels	Hip Hop HEAL multimedia classes	A mean total of 225 children participated in two baseline pre-intervention sales with and without calorie labels; 149 children participated in immediate post-intervention food sales; while 133 children participated in the delayed sales. No significant change in purchased energy was observed in response to labels alone before the intervention. However, a mean decline in purchased energy of 20 % (P < 0·01) and unhealthy foods (P < 0·01) was seen immediately following the intervention compared with baseline purchases, and this persisted without significant decay after 7 d and 12 d
37	Caraher et al. (2013)⁽ ⁷¹ ⁾, UK	Quasi-experimental intervention	9–11 years (n 169)	2–4 weeks	Not stated	Professional chefs delivered three sessions to one class over a year	Food, health, nutrition and cookery skills	Vegetable consumption scale, cooking confidence, food preparation	There was an improvement in cooking skills and confidence to prepare food, and average reported vegetable consumption increased after the session with the chef

SCT, Social Cognitive Theory; TPB, Theory of Planned Behaviour; HBM, Health Belief Model; ANGELO, Analysis Grid for Environments Linked to Obesity; TM, Transtheoretical Model; TRA, Theory of Reasoned Action; F&V, fruit(s) and vegetable(s); FSD, food service director; SES, socio-economic status.