Nutrition Education in the K-12 Curriculum: The Role of National Standards: Workshop Summary (2013)

7

Teacher Preparation and Training

Three speakers noted that teachers will need training and professional development to implement nutrition education standards. But the nature and extent of that training will depend on the content of nutrition education, which again emphasizes the role of standards in improving the nutrition knowledge and skills of students.

UNDERGRADUATE TRAINING OF FUTURE TEACHERS

The costs of health care in the United States exceed $20,000 per family, said Esther Okeiyi, professor and program director for the dietetic internship program and didactic programs in dietetics at North Carolina Central University. Given that poor nutrition is a contributor to this cost, nutrition education must be a high priority. “We are not getting to the root of the problem [unless we] address nutrition,” she said.

Okeiyi specifically examined the steps needed to provide training to educate future teachers and the methods used to evaluate that training. At North Carolina Central University, all undergraduates must take a minimum of 124-128 hours to graduate. As part of this requirement, they must take health education and physical education, both of which are 3–credit hour courses. Introduction to Human Nutrition is another 3–credit hour course that is not required for all students, though Okeiyi expressed the opinion that nutrition education is just as important to students as health education and physical education.

All undergraduates who are in health care–related programs or majors such as nursing, nutrition, public health, physical education, or sports and exercise science may take Introduction to Human Nutrition or they may obtain nutrition knowledge from some of their core courses or electives that incorporate nutrition topics. However, Okeiyi expressed concern about whether nutrition is covered adequately in these other courses. Introduction to Human Nutrition covers nutrients, their function in the body, and food services. In contrast, a health education class that could meet the requirement is described as “an introductory study of personal health promotion and disease prevention with an emphasis on changing behaviors from those that threaten health to those that promote lifelong wellness.” In addition, science majors at her university are not required to take Introduction to Human Nutrition. “Again, I have a concern about a science graduate teaching nutrition without having basic preparation in nutrition.”

Majors in the nutrition program at North Carolina Central University take higher level courses that are aimed at preparing them to teach nutrition. However, future teachers do not have to take these courses. “Now that I have come through this workshop, I’m beginning to think that I should make some recommendation to my dean that we require this course for students teaching nutrition in public schools.” The courses teach how

to prepare a teaching package, how to develop goals and student learning outcomes, and how to implement and evaluate the teaching package, “which I think would be appropriate for those teaching nutrition education in public school.”

North Carolina Central University also offers licensure programs at the undergraduate level and for first-degree holders. The licensure program is housed in the School of Education and has various specializations, such as elementary education, middle school education, secondary school education, and a variety of subject-matter and administrative areas. All programs follow accrediting and state standards.

To determine the steps needed to provide training for future teachers, Okeiyi interviewed university program directors involved in the preparation of teachers, state consultants assisting with policy, university teachers who teach nutrition education, and undergraduates. She also examined state policy with an eye toward items that may need to be changed. For example, North Carolina state policy requires that all high school students obtain 1 credit hour of health and nutrition education to graduate. However, there is no minimum number of classroom hours established for instructors that teach nutrition education, and there is no monitoring as to whether the state standards are being met.

The program directors she interviewed stated that their students are being well prepared, both at the undergraduate level and at the licensure level. However, they did not know whether their former students were effectively teaching nutrition education in public schools, nor did they know how many hours of health education or nutrition were being taught.

The state consultants Okeiyi interviewed were not sure if teachers teaching health education were well qualified to teach nutrition. Nor were they sure how many hours were being taught or if students were learning about nutrition, because there are no questions about nutrition on end-of-grade examinations. Finally, they could not attest to the quality or quantity of health courses being taught.

The teachers Okeiyi interviewed said that they did not feel that they were adequately prepared to teach nutrition. Teachers advocated requiring more undergraduate nutrition courses so that teachers would be well prepared. A majority—92 percent—felt that they had effectively changed the dietary behavior of students. However, they also observed that the quantity and quality of the nutrition education delivered had not been assessed, though all agreed that nutrition education is important.

The undergraduates who were interviewed could not remember how many hours of nutrition education they had received in middle or high school. They did not think that the nutrition education they received was effective in changing their personal dietary behaviors and wished that they had learned enough to make informed decisions in college.

On the basis of her assessment, Okeiyi concluded that many students majoring in physical education, public health education, and other non-family and consumer science majors are not being adequately prepared to teach nutrition education. The qualifying requirements to teach nutrition are not standardized, and there are no assessments of the implementation of the quality or quantity of nutrition education by teachers, the state, or program directors. State consultants, program directors, and teachers disagree on how qualified teachers are in implementing nutrition education in public schools. In addition, the implementation of nutrition education varies by school and by teacher.

Okeiyi made several recommendations given her findings. She said there should be continuous direct and indirect assessment of the quantity and quality of nutrition instruction on the knowledge and application of knowledge. Direct assessment could include student work, papers, projects, tests, and observation. Indirect assessment could include survey information, interviews, course grades, or all of these components. Testing should be designed to include questions on healthy living or nutrition education components.

Nutrition education in elementary, middle, and high schools should be taught by “well-qualified,” trained teachers, she said. National, state, and accreditation standards should address the minimum number of credit hours of undergraduate study required to qualify teachers to teach nutrition education. Educators and teachers must know what skills, knowledge, and values students should have acquired in the area of nutrition. In addition, experiential learning such as garden-based curricula, cooking skills for healthful meals, and the quality of the dining experience, including time for meals, should be included in teaching, according to Okeiyi.

Okeiyi suggested that nutrition core courses for those who plan to teach nutrition should include introduction to nutrition (3 credit hours), intermediate nutrition (3 credit hours), food sanitation (2 or 3 credit hours), food science and preparation (3 or 4 credit hours), and nutrition education (3 credit hours), for a total of at least 14-16 credit hours.

Okeiyi also recommended that program directors, professors, and teachers be held accountable through SMART (specific, measurable, achievable, realistic, and time sensitive) goals. Student learning outcome measures should be prepared along with the standards.

Food and nutrition practitioners must work to ensure mandatory, consistent funding for integrated and comprehensive education and promotion programs, Okeiyi said. These programs need to be coordinated at the national level, administered at the state level, and implemented at the local level. They would provide needed infrastructure and help leverage resources among other nutrition-related federal programs.

Increasing the number of trained teachers to teach nutrition educa-

tion in elementary, middle, and high schools is imperative if standards in nutrition education are to be met, Okeiyi continued. National, state, and accreditation standards can continue to drive nutrition education while keeping the focus on learning and improvement. Career development entails educating undergraduate students about career options centered around nutrition education, creating opportunities such as internships and job placement for graduating seniors interested in nutrition education, and involving health care professionals in nutrition education.

Okeiyi listed 12 potential outcomes of such a campaign:

1. Students will gain increased knowledge of nutrition.
2. Students will gain enhanced skills in food purchasing and healthy meal preparation.
3. New knowledge will lead to dietary behavior changes now and in the future.
4. Standards will lead to a consistent curriculum.
5. Obesity rates among children and families will fall.
6. A larger percentage of children will be educated in nutrition.
7. Nutrition education will improve, at both the university level and the school-age level.
8. Nutrition education curricula will become more consistent.
9. Health disparities among socioeconomic disadvantaged groups will decline.
10. The 2020 national and state nutrition health objectives will be met.
11. Health care costs in the government and within families will fall.
12. The quality of life related to being overweight or obese will improve.

STANDARDS AND TEACHER CERTIFICATION

Phillip Rogers, executive director of the National Association of State Directors of Teacher Education and Certification, reviewed the process by which teachers are certified in areas subject to education standards. He began by reviewing a set of guidelines for the accreditation of teacher preparation programs in the United States (Lauer and Dean, 2004):

1. Courses are aligned with national and state content standards.
2. Standards documents are part of course materials.
3. Candidates must identify content standards in lesson plans.
4. Candidates learn to develop lesson plans and assessments aligned to standards.
5. Candidates learn to examine evidence of student learning and modify instructional practice based on needs revealed by evidence.

6.  Candidates learn to differentiate instruction to address all student needs.

7.  The program assesses candidates on both content and pedagogical knowledge and uses the results to monitor the effectiveness of the candidate and the program.

8.  Education faculty collaborate with arts and sciences faculty and with K-12 teachers and administrators to ensure that the program content is aligned with K-12 content standards.

New teachers are much more sophisticated about the use of standards than they were 10 years ago, he said. The faculty in teacher preparation programs work hard to make sure that their courses are aligned with standards, and teacher candidates become thoroughly familiar with standards in the course of their preparation. As a result, new teachers especially understand the importance of aligning their instruction with standards.

Experienced teachers are not ignorant of standards, said Rogers, but neither were they prepared to understand how to use standards in their classrooms. Furthermore, given that a relatively small percentage of teachers are replaced each year in many school districts, certification of teacher preparation programs is necessary but not sufficient. While teacher preparation is important, “if you really want to move this forward in your lifetime, then you’re going to have to heavily develop and invest in professional development of existing teachers.”

Many different groups have been developing standards in various content areas. The National Council of Accreditation of Teacher Education, which at the time of the workshop was changing its name to the Council on Accreditation of Educator Preparation (CAEP), works with these groups in evaluating teacher preparation programs. As the Mid-continent Research for Education and Learning organization has shown, several prominent issues can arise in this process. Sometimes, more than one organization promulgates standards in a particular area, resulting in multiple sources of documents. Also, the definitions of standard can vary, with even the basic terminology not solidly established (as described in Chapter 1).

The wording of standards can vary, which can be confusing to teachers and in teacher preparation programs. Standards also may apply to grade ranges or to specific grades. Finally, a standard can have different levels of generality: “Is it in small pieces; is it in medium pieces; how is it divided up?”

Teacher preparation programs need to be submitted to the state for approval, Rogers observed. The state then reviews these programs to ensure that they align with state requirements. Programs may need to demonstrate points of emphasis that a standards body requires. Accreditation generally

occurs at the state level, though some states simply require national accreditation by CAEP. States also oversee teacher certification and licensure.

The National Association of State Directors of Teacher Education and Certification works with the states on approvals of teacher preparation programs and teacher licensure. In considering whether to incorporate standards-based education into a particular area, important considerations are the need for standards in a particular area, the voices advocating for change, the availability and distribution of materials that reflect standards, the extent to which the standards have been adopted, and updates to the standards. Multiple groups interested in nutrition education standards will have to work together to achieve buy-in and support for standards, and they then will need to maintain the standards once they have been implemented. “All kinds of standards out there are out of date, because the passionate people have gone on.”

“Teachers are under an incredible amount of pressure and stress,” Rogers concluded. “But one thing always stands out: their students come first. And your mission of bringing these nutrition standards forward for the use of teachers is something they’re going to be very interested in, because they’re very interested in their students.”

NUTRITION EDUCATION: INTEGRATION, STAND-ALONE, OR BOTH?

Marilyn Townsend, Cooperative Extension nutrition specialist in the Department of Nutrition at the University of California, Davis—who develops and studies nutrition education programs for nutrition educators—examined in depth an issue that emerged repeatedly during the workshop: the advantages and disadvantages of integrating nutrition education into the rest of the school curriculum versus a stand-alone curriculum on nutrition. With both options, nutrition and physical activity objectives and content first need to be developed, and then this content is aligned with existing education standards. For example, nutrition education can be integrated with mathematics and reading in elementary schools—which are the major topics of attention for elementary school teachers—and with mathematics, English, science, geography, and history in middle and high schools. In addition, nutrition ties in naturally with health education, and physical education. The national school food programs are another venue for nutrition education. Table 7-1 provides a summary of benefits and challenges of integrated and stand-alone nutrition education formats.

However, integration into other curriculum areas can face serious challenges. As an example, Townsend described the Eat Fit program, which was developed in California and shown to be effective shortly before passage of the No Child Left Behind Act. To adapt nutrition education to the new

TABLE 7-1 Benefits and Challenges of Integrated and Stand-Alone Nutrition Education Formats

focus on education standards created by the legislation and provide credibility to the effort, an independent curriculum expert aligned the nutrition content with standards in mathematics, science, English, physical education, and health for each lesson. The result was a set of content standards identified in areas where there is state-mandated testing, and a set of challenge standards where local adoption of standards is optional. Content standards are mandated by the state for all schools and are the basis for standardized testing in subjects such as math and English. Challenge standards are not mandated nor included in standard testing; this pertains to subjects like health, nutrition, or physical education. In a second approach, a nutrition curriculum is developed in conjunction with the standards in other curriculum areas. These other standards did not drive the nutrition

objectives but did affect the design of activities. “With a creative mind, you can tap into those other standards with relative ease.”

Teachers are under great pressure to focus on the basics, Townsend emphasized. They also typically are not trained in nutrition. In addition, the gatekeepers for the curriculum in schools vary from district to district, which can make it difficult to disseminate a nutrition curriculum widely.

However, if standards in mathematics and reading can be met, teachers are willing to teach nutrition. Furthermore, the cost of integrating nutrition into the existing curriculum is minimal, and the integration of science and social studies into mathematics and reading provides a model for the integration of nutrition. Tapping into the Land Grant University’s Cooperative Extension System in each state and other structures for teacher training can make such integration sustainable.

In stand-alone nutrition classes, separate class time is devoted to the subject. Nutrition education could even be handled like physical education, with an entire class going to cooking, tasting, and food storage facilities for instruction by a specialist teacher. However, the stand-alone option also has challenges. Without an extension of the school day, a class in nutrition takes time away from other classes. A dedicated nutrition teacher and special facilities also create additional costs and a demand for space. A pool of credentialed teachers with nutrition coursework does not necessarily exist, and when budget cuts become imperative, which teachers and subjects would be the first to go? “In terms of sustainability I have these cost concerns about the stand-alone approach” to nutrition education in the public schools, Townsend said.

With a combined approach, a separate and formal nutrition class would exist while nutrition activities and content also are incorporated into existing coursework such as mathematics, English, physical education, and science. When considered together with the integrated and stand-alone approaches, the combined approach provides schools with a range of options. This may be most appropriate in the United States, where the range of variation among schools is great. “With the combined approach,” said Townsend, “schools would have access to more options. And the more choices we can give schools, the better.”

Townsend briefly touched upon the fact that knowledge in nutrition is transient. She gave an example of changes in the U.S. Dietary Guidelines every 5 years, and the food guides developed to represent those guidelines to consumers. Eating recommendations have progressed from the basic four food groups to the food wheel to the food guide pyramid to MyPyramid to MyPlate, with concomitant changes in the recommended food group name and serving size of, for example, meat and beans. Townsend implied that an essential question is what is most important to teach students about a food guide such as MyPlate? Remembering the accurate names of food groups?

Memorizing the 5.5-ounce equivalents? Or being able to apply the concepts to meals in real life?

She also called attention to the lack of research on nutrition education’s impact on either education standards or academic performance, which is what most interests educators. To address this lack, Townsend and several colleagues created a protocol and designed a study to examine nutrition education’s impact on academic performance (Horowitz et al., 2008). The study showed that nutrition education can improve academic performance measured by achievement of specific mathematics and English education standards (Shilts et al., 2009). “We could help with adoption of nutrition education curricula if we have a few more studies to show that what we’re recommending can impact academic standards,” she said. “That would be a very important contribution to nutrition education.”