ABSTRACT
Many nutrition programs include classroom-based education. Schoolteachers are relied upon to deliver these programs despite gaps in nutrition education motivation, knowledge, and self-efficacy. Teacher professional development (PD) for these nutrition education programs has been identified as a strategy for improving program effectiveness, yet many interventions do not include a PD component and still fewer describe it. A literature search was conducted between January and February 2017; articles were collected from PubMed, ERIC, and EBSCOhost. Article inclusion criteria were as follows: 1) published in an English-language peer-reviewed or scholarly journal, 2) published after 2000, 3) empirical research, 4) research conducted in a K-12 classroom, 5) research included nutrition education component, and 6) program delivered by a classroom teacher. Twenty-seven interventions were identified. A team of 2 researchers performed content analysis based on an evidence-based set of 7 PD components to assess if and how these components were incorporated before, during, or after program implementation. Little information was provided that described the role of teacher PD in the course of delivering nutrition education in classroom-based programs. The most common elements of PD described in the literature were the time spent in PD and follow-up with instructors during or after program implementation. There was a notable lack of methodologic description of teacher PD, and this limited reporting may decrease researchers’ ability to work with teachers in a consistent and effective manner.
Keywords: nutrition education, teacher professional development, school interventions, overweight, obesity, child, adolescent, nutrition
Introduction
As concerns about childhood obesity increase, so have efforts to reverse this trend. Schools are an often-targeted institution for nutrition education and food reform (1). Based on the role that schools play in children's lives and the importance of role model and community support, schools and teachers have become partners in these efforts for several reasons. First, children spend significant time in schools and have frequent contact with educators throughout a kindergarten through 12th grade (K-12; precollege) education (2), facilitating opportunities for adults to provide support as children grow, mature, and begin asserting independence in nutrition choices (3). Second, children eat ≥1 meal/d at school, even if those meals are prepared outside of the school setting (2, 3). Increasingly, children eat 2 and even 3 meals at school (4, 5), providing opportunities for children to simultaneously be nourished by and educated about food. Finally, several studies positively correlate nutrition, health, and academic performance (6–10).
No K-12 nutrition education standards exist, yet federal recommendations encourage school-based nutrition education, and experts continue to discuss the merits of national nutrition education curriculum standards and learning objectives (11). However, no guidelines are available for duration or educator professional development (PD) in nutrition education (12).
Teachers may deliver classroom-based nutrition education alone or with researchers and professional nutrition educators (13). Whatever the role, when teachers deliver nutrition education, they are responsible for improving students’ nutrition knowledge, self-efficacy, and behavior. This is similar to teacher responsibility for learning outcomes from instruction in traditional subjects such as math, science, and civics (1). Although teachers agree that nutrition education is important to a healthy school environment (13, 14), teachers may not feel prepared to deliver nutrition and behavior change–related instruction. Common barriers include lack of preservice nutrition training, lack of in-service PD, and few PD opportunities (6, 15–18). Furthermore, teachers with fewer nutrition skills are less likely to present nutrition information as often or with as much emphasis as teachers with a nutrition background (14, 19). Teachers may be less likely to implement nutrition education because of time and curriculum constraints and may not perceive nutrition education as aligning with district or national guidelines (7, 20).
Barriers to implementing nutrition education may be addressed with effective PD that emphasizes how nutrition education curriculum can help students, teachers, and districts meet education goals. However, current nutrition education literature may not describe or explain PD elements included in successful programs.
Although there is no established evidence base for teacher professional development within the field of nutrition education, the literature on high-quality teacher PD across all subject areas is growing and accessible. K-12 education researchers have identified the following primary PD goals: 1) to change teachers’ classroom practices, 2) to change teachers’ attitudes and beliefs, and 3) to change student learning (21). These goals align with nutrition education goals: changing student knowledge, action, and behavior (1). Thus, high-quality teacher PD should be an important component of nutrition education.
This article will synthesize research in school-based nutrition education and teacher PD to describe the role that PD could play in ensuring high-fidelity implementation and positive student outcomes from nutrition education: 1) by identifying and describing a priori characteristics of effective and high-quality teacher PD from evidence and studies in educational research (21, 22) and 2) by deductively and systematically identifying these characteristics in the context of nutrition education.
Characteristics of Teacher PD
Two reviews of teacher PD from K-12 literature offered models for PD programming: Guskey's Model of Teacher Change (21) and Desimone's Core Conceptual Framework (22). Model components were derived from empirical studies examining teacher change and have been synthesized and are described below.
Webster-Wright (23) made an important distinction between PD (planned, systematic events that may be episodic and more didactic) and continuous professional learning that takes place across an educator's career. This article focuses on the former (PD) because nutrition education programs are often grant funded or short term. To align terminology between the education and nutrition education literature, this article uses PD to describe all activities taken on by teachers to improve teacher and student performance (21, 22), as this is the more commonly used term in K-12 settings.
Many teachers report engaging in a variety of PD activities to enhance teaching ability (21). Activities may include workshops, conferences, and other organized activities meant to encourage and engage teachers (22). Education researchers have identified several factors critical to effective PD, including the following: content focus, active learning strategies, coherence, duration, collective participation, follow-up, and feedback (21, 22).
Content focus
Content focus describes PD based on a specific subject (e.g., science, nutrition, or language arts) and a focus on how students best learn this content (22). Some researchers consider it the most powerful PD feature and it has been associated with increased student learning (22, 24). Furthermore, increasing content knowledge is a primary reason teachers report participating in PD (25).
Although PD with content focus is different from PD focusing on pedagogic strategies or general instructional principles (26), content-focused programs do not demand the exclusion of pedagogy, modeling, or instructional behaviors and theories. When conceptualizing PD, content or subject matter focus can increase teacher knowledge gains and implementation of PD skills (26).
Active learning
Just as teachers engage students, it is important that teachers be engaged in active learning during PD (26). Active learning engages learners in physical and cognitive participation (22) and allows learners to participate in the educational process by reflecting on how students might interact with material in the classroom.
Active learning emphasizes skill development over the transmission of information (27) and takes several forms: observation, classroom activity planning, and reviewing student work (26, 27). If student work or classroom artifacts are unavailable, facilitators may employ other active learning strategies such as case studies (28).
Coherence
Before implementing PD, it is important to understand the core beliefs, knowledge, and values of the teacher, school, and district to ensure that PD is coherent with these ideologies. It is also necessary to understand any district, state, and national standards to which curricula must adhere. Understanding what educators consider essential to their integrity and the integrity of educational programs can help ensure that programs have value to the audience (22). One common criticism of teacher PD is that materials do not adhere to the core beliefs or instructional goals of the education program of the teacher, school, or district (26).
Coherence encourages communication across and within disciplines to ensure that PD promotes school reform in a common direction (26). This type of communication enhances adherence to assumed values, sustains successful activities, helps facilitate larger changes, and solves potential and existing problems caused by the introduction of new and innovative techniques (26).
Duration
Mastery of knowledge and skills communicated through PD is rarely conferred in one sitting. Duration in the context of PD is a matter of total time spent in an activity and a measure of time over which an activity is completed (22). For example, PD lasting 8 h could be presented either as a 1-d workshop where teachers met for 8 h or a 4-wk program where teachers met for 2 h each week.
Although researchers have not identified an exact time or span needed for PD to be effective, there is support for the idea that duration should last ≥20 h and should include activities spread over time (e.g., a semester, a month) (22). PD programs more effectively support learning and implementation needs when they are intensive and sustained rather than brief or intermittent (29).
Collective participation
For collective participation to occur, teachers must have opportunities to interact with other teacher participants that they consider like themselves (e.g., teachers from the same school, subject-matter or grade-level teachers from across a district) to build a meaningful network (22). Collective participation may include staff members and administration from schools or school districts to support teachers in the implementation of newly learned classroom strategies (29). Arrangements that build networks of teachers through collective participation can create learning communities where teachers support each other and share ideas (30).
Follow-up
Follow-up helps engage teacher learners in continued dialog during program implementation (21) and should be multidirectional, with contact initiated by teacher-learners and facilitators. Multidirectional dialog can provide support and feelings of control in the implementation process. For novel programs to be implemented and to increase the likelihood that a program will continue to grow, follow-up should be embedded as a natural part of the learning process (21).
Researchers assert that change in teachers’ beliefs and attitudes happen after implementation in a classroom and change in student outcomes (21). Therefore, follow-up and support are crucial to changing teacher practice, beliefs, and attitudes. Follow-up should be coupled with support for teacher needs and pressure to instigate change in teacher behavior (21).
Feedback
Teachers regularly provide feedback to students to gauge comprehension and encourage achievement. Providing teachers with feedback on student progress is essential to help teachers gauge PD effectiveness and make subsequent changes in instruction (21). Feedback should encourage teachers to use skills learned during PD and increase program buy-in. Without appropriate feedback to reassure teachers that students are learning, improving skills or performance, and achieving at a high level, it may not be plausible to expect teachers to change beliefs and attitudes about an educational program (21).
Based on the elements of high-quality PD described above, the purpose of this study was to describe and assess K-12 nutrition education literature for PD elements through a systematic and comprehensive content analysis.
Methods
This systematic review was conducted in January–February 2017, and the content analysis followed an established framework for comprehensive literature evaluation (31). Eligible articles were empirical studies presenting methods or results from a K-12 nutrition education intervention delivered by a classroom teacher that could also include physical activity or general health information. Classroom teachers were identified as primary or core concept teachers such as science, math, or language arts; physical education instructors or lunchroom staff were not considered for this review because they typically already possess some background in nutrition education. Articles were excluded on the following grounds: 1) not published in English, 2) not published in a peer-reviewed or scholarly journal, 3) published before 2000, 4) not an intervention (e.g., a review of literature, perspective, or position paper), 5) took place outside of the K-12 setting (e.g., pre-kindergarten and university settings), or 6) if the authors were unable to retrieve the text through reasonable means. Process evaluation texts were considered for inclusion if they reported evaluation of a larger classroom-based intervention.
Three databases—PubMed, ERIC, and EBSCOhost—were systematically searched for the terms: school (elementary school, middle school, intermediate school, high school, K-12, secondary school), teacher (educator), nutrition (food, energy balance-related behavior), education (lesson, intervention, curricul*, program*), and childhood obesity (childhood overweight, adolescent overweight, adolescent obesity). This search yielded 250 unique citations. Two authors reviewed titles and abstracts to determine whether they appeared to meet inclusion criteria. Discrepancies were resolved through consensus. Two authors then reviewed 74 full texts for eligibility. Articles were excluded because they were not published (n = 2), not an intervention (n = 7), did not include a classroom component (n = 7), were not conducted in a K-12 setting (n = 6), did not include a nutrition education component (n = 7), were not delivered by a classroom teacher (n = 13), or because researchers were not able to retrieve a full text (n = 1). Thirty-one articles representing 27 unique interventions were included in this review (Table 1). Figure 1 provides details on the systematic process of identifying studies eligible for inclusion.
TABLE 1.
K-12 nutrition education intervention descriptions1
| Sample size, n | |||||
|---|---|---|---|---|---|
| Program (reference) | Location(s) | Study type | Age level | Students | Schools |
| ADOS (32) | France and Switzerland | QENC | MS/HS | 1300 | 9 |
| Agua para Ninos (Water for Kids) (33) | USA and Mexico | NRCT | ES | 1318 | 4 |
| APPLES (34) | UK | Group RCT crossover | ES | 634 | 10 |
| Athletes in Service Fruits and Vegetable Promotion Program (35,36) | USA | CRCT | ES | 297 | 4 |
| Brighter Bites (37) | USA | Pilot; feasibility | ES | 57 | 1 |
| CHF3 (38) | USA | QENC | ES | 32, 51 | 2 |
| Choice, Control, and Change (39) | USA | CRCT | MS | 1136 | 10 |
| COPE (40) | USA | CRCT | HS | 779 | 11 |
| DOiT (41, 42) | Netherlands | NRCT | HS | 1486 | 29 |
| Food Dudes (43) | Italy | NRCT | ES | 672 | 3 |
| Growing Healthy Kids (44) | USA | QENC | ES | 7861 | 18 |
| HealthMPowers (45) | USA | QENC | ES | 16,591 | 40 |
| HEALTHY (46, 47) | USA | CRCT | MS | 1736 | 42 |
| Jump Into Action (JIA) (48) | USA | QENC | ES | ∼12,000 | 154 |
| Just for Kids! (49) | USA | RCT | ES | 160 | 3 |
| Louisiana Health Study (50) | USA | CRCT | ES/MS | 2709 | 33 |
| MA-CORD (51) | USA | QENC | ES/MS | 8108 | — |
| Making the Grade with Diet and Exercise (52) | USA | QENC | ES | ∼405 | 1 |
| NFSC/LAUSD Hybrid Intervention (53) | USA | NRCT | ES | 1528 | 12 |
| Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) (54) | Australia | CRCT | MS | 357 | 12 |
| Nutrition Based Comprehensive Intervention Study on Childhood Obesity (NISCOC) (55) | China | CRCT | ES | 9750 | 6 |
| Pathways to Health (Pathways) (56) | USA | QENC | ES | 925 | 12 |
| Promotion and Provision of Drinking Water (57) | Germany | CRCT | ES | 2950 | 32 |
| Survey of Childhood Diabetes (58) | India | QENC | unclear | 610 | 2 clusters |
| TAKE 10! (59) | USA and Norway | QENC | ES/MS | 840 | 1 |
| Toy Box (60, 61) | 7 European countries | — | ES | 309 | — |
| Waves (62) | UK | CRCT | ES | 1392 | 54 |
1CRCT, cluster randomized controlled trial; ES, elementary school (grades K-5); HS, high school (grades 9–12); K-12, kindergarten through 12th grade; middle school (grades 6–8); NRCT, nonrandomized controlled trial; QENC, quasiexperimental, no comparison; RCT, randomized controlled trial.
FIGURE 1.
Flow diagram of study selection. K-12, kindergarten through 12th grade.
Two authors reviewed eligible interventions to assess how teachers were trained as part of the intervention. Articles were assessed for the following elements: 1) mentions of teacher PD, 2) time of PD (e.g., teacher PD prior to the intervention, teacher PD during the intervention, or teacher PD after the intervention), and 3) descriptions of teacher PD identified above. Roundtable discussions to reach consensus were used to resolve disagreements.
Results
Study descriptions, including location, study type, age level, and sample size (student and school), are given in Table 1. PD delivery tools and approaches are described in Table 2. Table 3 includes PD elements assessed by intervention.
TABLE 2.
PD delivery tools and approaches1
| Program (reference) | PD timing | In-person delivery | Trainer identified | Materials provided | Primary delivery mode |
|---|---|---|---|---|---|
| ADOS (32) | a,b,c | × | × | d, e | g |
| Agua para Ninos (Water for Kids) (33) | a,c | × | — | d | g |
| APPLES (34) | a | × | — | — | g |
| Athletes in Service Fruits and Vegetable Promotion Program (35, 36) | c | e | f | ||
| Brighter Bites (37) | a | × | × | — | — |
| CHF3 (38) | a,c | × | — | d | g |
| Choice, Control, and Change (39) | a,b | × | — | — | — |
| COPE (40) | a | × | × | d | g |
| DOiT (41,42) | b | d, e | f | ||
| Food Dudes (43) | a | × | × | d | g |
| Growing Healthy Kids (44) | a,b | × | — | d | g |
| HealthMPowers (45) | a | × | — | d | — |
| HEALTHY (46, 47) | a, b | × | × | d | g |
| Jump Into Action (JIA) (48) | a | × | × | d | g |
| Just for Kids! (49) | a | × | d | g | |
| Louisiana Health Study (50) | a | — | — | — | — |
| MA-CORD (51) | a,b,c | × | — | e | g |
| Making the Grade with Diet and Exercise (52) | — | — | — | — | — |
| NFSC/LAUSD Hybrid Intervention (53) | a | × | — | — | — |
| Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) (54) | a,b | × | × | — | — |
| Nutrition Based Comprehensive Intervention Study on Childhood Obesity (NISCOC) (55) | a | × | × | d | g |
| Pathways to health (Pathways) (56) | a,b | × | × | d | g |
| Promotion and Provision of Drinking Water (57) | — | — | — | — | — |
| Survey of Childhood Diabetes (58) | — | — | — | — | — |
| TAKE 10! (59) | a | × | × | — | — |
| Toy Box (60, 61) | a,b | × | × | — | — |
| Waves (62) | a | × | — | — | — |
1Superscript letters indicate PD properties: apreintervention; bduring intervention; cpostintervention; dprint materials; eelectronic materials; fprint/electronic primary; gin-person primary; PD, professional development.
TABLE 3.
HQPD elements assessed by intervention1
| Program (reference) | Content focus (n = 8) | Active learning (n = 6) | Coherence (n = 7) | Duration (n = 10) | Collective participation (n = 6) | Follow-up (n = 13) | Feedback (n = 0) | HQPD elements |
|---|---|---|---|---|---|---|---|---|
| ADOS (32) | × | × | × | — | — | × | — | 4/7 |
| Agua para Ninos (Water for Kids) (33) | × | — | — | × | — | × | — | 3/7 |
| APPLES (34) | — | — | — | — | — | × | — | 1/7 |
| Athletes in Service Fruits and Vegetable Promotion Program (35, 36) | — | — | — | — | — | × | — | 1/7 |
| Brighter Bites (37) | — | — | — | — | × | × | — | 2/7 |
| CHF3 (38) | — | — | × | — | × | × | — | 3/7 |
| Choice, Control, and Change (39) | — | — | — | — | — | — | — | 0/7 |
| COPE (40) | — | × | — | × | — | × | — | 3/7 |
| DOiT (41, 42) | — | — | — | × | — | — | — | 1/7 |
| Food Dudes (43) | — | — | — | — | — | — | — | 0/7 |
| Growing Healthy Kids (44) | × | × | — | × | × | × | — | 5/7 |
| HealthMPowers (45) | — | — | — | — | — | — | — | 0/7 |
| HEALTHY (46, 47) | — | — | — | × | × | × | — | 3/7 |
| Jump Into Action (JIA) (48) | — | — | — | — | — | — | — | 0/7 |
| Just for Kids! (49) | × | — | — | — | — | — | — | 1/7 |
| Louisiana Health Study (50) | — | — | — | — | — | — | — | 0/7 |
| MA-CORD (51) | — | — | × | × | × | × | 4/7 | |
| Making the Grade with Diet and Exercise (52) | — | — | — | — | — | — | — | 0/7 |
| NFSC/LAUSD Hybrid Intervention (53) | — | — | × | — | — | — | — | 1/7 |
| Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) (54) | — | — | — | × | — | — | — | 1/7 |
| Nutrition Based Comprehensive Intervention Study on Childhood Obesity (NISCOC) (55) | × | × | × | × | — | — | — | 4/7 |
| Pathways to health (Pathways) (56) | — | — | — | × | — | × | — | 2/7 |
| Promotion and Provision of Drinking Water (57) | — | — | — | — | — | × | — | 1/7 |
| Survey of Childhood Diabetes (58) | — | — | — | — | — | — | — | 0/7 |
| TAKE 10! (59) | × | × | × | — | — | — | — | 3/7 |
| Toy Box (60, 61) | × | × | × | × | × | 5/7 | ||
| Waves (62) | × | — | × | — | — | — | — | 2/7 |
| Percentage | 30% | 22% | 26% | 37% | 22% | 48% | 0% |
1HQPD, high-quality professional development.
Of the 27 interventions assessed for descriptions of teacher PD, 89% (n = 24) mentioned direct teacher PD or feedback in some combination before (n = 22; 81%), during (n = 9; 33%), or after (n = 5; 19%) program delivery to students. The most frequently mentioned type of PD was an in-person PD session (n = 21; 78%). Eleven interventions provided information about PD delivery, including who presented the PD. Several interventions provided information about print (n = 13; 48%) or electronic (n = 4; 15%) resources, which were identified as the primary mode of PD in 2 interventions and supplemental to in-person PD sessions in 13 interventions; the remaining interventions did not provide enough information about materials to identify how they were used in PD.
Descriptions of PD elements were vague in most interventions. No intervention included descriptions of all PD elements, and only 5 included a mention of more than half of the recommended elements. The most commonly reported PD feature was follow-up after the intervention period, mentioned in 13 studies (48%). However, most of this follow-up was for process evaluation and focused on fidelity to the intervention, requests for technical assistance, or teacher intention to implement the program again. Teachers who provided feedback in several studies suggested additional or more robust teacher PD as part of a more comprehensive plan to enhance delivery, program efficacy, and to improve outcomes. PD duration was the second most commonly mentioned element of teacher PD, identified in 10 studies (37%). PD duration most commonly referenced the overall time in PD (e.g., 4-h PD, 5-min instruction video), and only 1 study described multiple PD sessions to engage teachers in the intervention development process (60, 61).
Content focus, considered the most important element of PD, was only mentioned in 8 interventions (30%), and was described largely in terms of the specific curriculum being reviewed, or in terms of trainers providing teachers with background information on issues related to child nutrition (e.g., obesity, hydration). Seven studies (26%) mentioned PD for the curriculum that aligned with currently existing standards. In 1 study, teachers were encouraged to tailor the curriculum to meet the needs of their particular classroom (62). Active learning techniques were identified in 6 studies (22%). Most active learning techniques included mentions of observation, modeling, and classroom activity planning. Five studies (19%) described some aspect of collective participation, where teachers were trained with or in addition to potential partners in a community of practice. To facilitate collective participation, teachers in these studies were either trained by grade level or subject matter, or administrators and staff from their schools were trained alongside teachers. No studies provided examples of feedback.
Although few studies provided evidence or descriptions of teacher PD, several offered suggestions for improving programs by engaging classroom teachers in some type of PD or by improving consistency in teacher delivery of program materials. Teachers requested a curriculum and PD that aligned with educational standards, additional follow-up, more comprehensive PD, and support from administration as elements of PD that may improve program implementation and effectiveness.
Conclusions
This systematic review presents nutrition education literature published in peer-reviewed and scholarly journals focusing on information about teacher PD in K-12 classroom-based programs. Although it is clear that many school-based nutrition education interventions leverage classroom teachers as partners in delivering the intervention, the strategies by which this partnership is forged are not consistently or comprehensively reported in the resulting publications. This presents a challenge for researchers or practitioners who look to the literature in an effort to design replicable or evidence-based interventions.
Classroom teachers often cite lack of subject matter knowledge in nutrition and lack of formal training in nutrition education as a major barrier to the implementation of nutrition education programming in classrooms (3, 6, 15). Effective PD that focuses on nutrition education curriculum content and behavior change techniques is critical to ensure that teachers are well versed in concepts that will be taught to students. But in addition to teaching basic nutrition or food science concepts, nutrition educators are responsible for instructing students in behavior change techniques. Effective PD for nutrition educators must include information about subject matter as well as behavior change training (22, 63).
Although the K-12 education literature has established components of effective teacher PD, the findings from this review demonstrate few descriptions of teacher PD in the literature and no comprehensive PD programs that include content focus, active learning, coherence, duration, collective participation, or follow-up. However, teachers responding to researchers in the studies reviewed here point out a desire for PD activities. For example, teachers in the CHF3 program suggested to researchers that nutrition education materials include copies of nutrition education competencies aligned with the California Health Education Content Standards (38). Provision of such materials may demonstrate coherence with teacher and classroom values, as well as with state education standards.
The present review has several strengths and limitations. The studies included here represent the most comprehensive published nutrition education literature with details of teacher PD to date, and this review used a priori elements of teacher PD from empirical education research to deductively evaluate these studies for their level of reporting (21, 22). However, information about teacher PD remains vague, and studies include little about the PD curriculum, teacher involvement in PD, length of time, or material covered. A major limitation of this study is that elements of teacher PD can only be assessed to the extent that they are reported in the original research. Furthermore, it is difficult to determine evidence-based approaches to effective teacher PD from this literature as teacher PD for nutrition education interventions has not been linked to outcomes for either teachers or students. Although this is a limitation for the present review, it presents an even more serious limitation for the broader body of nutrition education literature: a lack of consistent reporting on these or any element of teacher PD decreases the ability to replicate these interventions or synthesize their results.
Researchers and policy makers target schools for nutrition education with good reason. Schools are the place where children spend approximately half of their waking hours (3), where they eat 1–3 meals/d, and where children and adolescents have continuous contact with adult role models who shape their knowledge and decision-making skills (3). Nutrition educators and researchers have the opportunity to make schoolteachers true partners in school-based nutrition education interventions. But doing so requires understanding the teachers’ educational and PD needs, their motivations, and the barriers they face in implementing these programs. This review of teacher PD in nutrition education has demonstrated how current reporting of these programs reflects a disconnect between evidence from the field of education about effective teacher PD, and how teacher PD is designed and implemented in school-based nutrition education programs. More cohesive language to describe and report teacher PD programs and activities, and using well established components of the framework described above, may improve how receptive teachers are to classroom nutrition education programs and improve the likelihood that PD will enhance nutrition education.
Future studies should examine teacher PD in successful nutrition education programs with high levels of teacher buy-in. The initial step is for researchers to consistently report how teacher PD is implemented and then link how this nutrition education PD improved teacher attitudes, self-efficacy, practice, and student outcomes. The frameworks from the K-12 literature identified here and used as a guide for evaluation of nutrition education literature may serve as a starting point for such consistency, providing definitions of PD components that can be used in research literature and program development (21, 22).
As progress is made towards the integration of nutrition education materials into classrooms and core subject material, partnerships between educators, researchers, and nutrition professionals will be important to program success and to comprehensive program evaluation. Through these partnerships and a shared understanding of evidence-based guidelines for PD, researchers will be able to expand upon the role that effective teacher PD plays in enhancing teacher acceptance of programs, increasing implementation, and ultimately facilitating changes in student knowledge, self-efficacy, and behaviors.
Acknowledgments
All authors read and approved the final manuscript.
Notes
MB was supported by an NIH T32 training grant (NHLBI007343) and is currently supported by an NIH T15 training grant (NLM007079). Author disclosures: CGD, MB, AA, PK, PAA, and VCS, no conflicts of interest.
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