Integrating the transtheoretical model and problem-based learning strategies to improve students' dietary behaviors

The purpose of this study was to evaluate the effects of a teaching module about healthy dietary behaviors based on the Transtheoretical Model and Problem-based Learning on elementary school students in Taiwan. This module was expected to increase students' awareness about dietary and health issues, dietary knowledge, outcome expectancy, reinforcement and management skills, social support, self-efficacy, and healthy dietary behaviors. Methods: A nonequivalent experimental-control group design was used with 5^lh grade classes from two elementary schools in Ilan County. The experimental group received instruction in healthy eating during the intervention period, while the control group received no intervention during the same period. Evaluations of formation, process, and outcome were done with questionnaire surveys to collect quantitative data. A closed-ended pretest-posttest questionnaire and another closedended follow-up test questionnaire were used to evaluate the outcome effects. Results: The results supported the hypothesis that this module could produce a positive increase in students' awareness about dietary and health issues, dietary knowledge, reinforcement and management skills, self-efficacy, and healthy dietary behaviors. A follow-up test provided support for continued educational effects on students' healthy dietary behaviors. Conclusions: The results of this study provide a new perspective for future research and teacher training with regard to healthy eating in elementary schools.