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Nutrition education

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Articles 31 - 60 of 63

Full-Text Articles in Nutrition

Examining The Effectiveness Of A Nutrition Education Intervention For Hispanic Participants, Ginnefer O. Cox, Britt Rotberg, Melanie K. Ng, Sarah T. Henes, Silvia Q. Giraudo Jan 2020

Examining The Effectiveness Of A Nutrition Education Intervention For Hispanic Participants, Ginnefer O. Cox, Britt Rotberg, Melanie K. Ng, Sarah T. Henes, Silvia Q. Giraudo

Journal of the Georgia Public Health Association

Background: The Expanded Food and Nutrition Education Program (EFNEP) Food Talk nutrition education curriculum in the state of Georgia was specifically tailored towards Hispanic EFNEP participants in order to test the effectiveness of the intervention in the Hispanic population.

Methods: 455 Hispanic EFNEP individuals ages 18-61 in the state of Georgia participated in the data collection. Measures collected include a 24 hour diet recall, and a food behavior checklist to compare consumption and food behavior practices both before and after nutrition education intervention.

Results: Measurable objectives of the study include statistically significant (p<.001) in fruit, vegetable and milk consumption and consumption of fruits, vegetables and milk group foods closer to the recommended levels of USDA MyPlate guidelines for the nutrition education intervention group. Results also showed statistically significant (p<.0001) improvements in nutrition-related behaviors.

Conclusion: This study supports a nutrition intervention …


The Impact Of Nutrition Education On Serving Size Comprehension In College-Age Female Students, Carisa Hilton Jan 2020

The Impact Of Nutrition Education On Serving Size Comprehension In College-Age Female Students, Carisa Hilton

CSB and SJU Distinguished Thesis

Background: Nutrition Facts labels are a low-cost informational tool with the potential for encouraging healthful purchasing and eating habits. The use of nutrition labels on packaged foods can promote healthier dietary choices; however, systematic reviews show that consumers may not frequently use nutrition labels to make food choices and do not effectively measure an appropriate serving size, leading to nutrient over-/underconsumption. Objective: The goal of this study was to investigate how female college students use the Nutrition Facts label and measurement tools to estimate one recommended serving size, and if varying nutrition education tools improve serving size accuracy …


Obesity In Adolescents (Handout), Kathy Palys Aug 2019

Obesity In Adolescents (Handout), Kathy Palys

All Student-Created Educational Resources

The handout briefly discusses obesity in the adolescents. It covers possible causes, risk factors, and some simple solutions.


Program Coordinators’ Experiences With Introducing Parent-Focused Health Lessons To A Child-Centered Micronutrient Supplementation Program: An Exploration Of Recent Programmatic Changes In Liahona Children’S Foundation, Shannon Barham Mar 2019

Program Coordinators’ Experiences With Introducing Parent-Focused Health Lessons To A Child-Centered Micronutrient Supplementation Program: An Exploration Of Recent Programmatic Changes In Liahona Children’S Foundation, Shannon Barham

Undergraduate Honors Theses

This paper utilizes survey responses from local coordinators of LCF, an international micronutrient supplementation humanitarian organization, to provide insight into the challenges and personal rewards of providing nutrition education to parents of malnourished children. LCF is based in Utah and operates in 19 countries throughout the world. LCF recently introduced a series of health lessons geared toward parents of malnourished children. A survey was sent to LCF workers in 12 countries in order to gather feedback about the health lessons. Qualitative survey responses are explored, and potential suggestions for future changes to the health lessons are proposed. Additionally, data gathered …


The Impact Of School Nutrition Education And Physical Education Programs On Weight Status Of Obese Children Aged 5-12 Years, Lamia Alotaibi Jan 2019

The Impact Of School Nutrition Education And Physical Education Programs On Weight Status Of Obese Children Aged 5-12 Years, Lamia Alotaibi

Masters Theses

Epidemiological studies indicate that 12.5 million children and adolescents are considered obese (Center for Disease Control and Prevention, 2017). Obesity is on the rise globally, and while it affects both children and adults, early measures can be taken to reduce the number of children who are obese, and therefore, come into adulthood at a higher risk for obesity-related diseases, such as hypertension, cardiovascular disease, and sleep apnea. There are many studies in which programs are implemented and tested for effectiveness; therefore, a systematic review of these studies that examine which factors play into overall obesity prevention and health improvements among …


Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil Jan 2019

Wellness Policy Awareness Among School Leaders And The Impact On Written Policy Scores, Mariah Reil

Electronic Theses and Dissertations

Background: All schools participating in the National School Lunch Program must possess a written School Wellness Policy (SWP) as mandated by the Healthy, Hunger- Free Kids Act of 2010.1 School officials and leaders play a major role in SWP implementation. It is essential to written SWP implementation that school level officials and leaders in the district are aware of the SWP. However, the association between school leader awareness of SWP and policy quality has not yet been studied.
Purpose: The purpose of the present study was to determine if school leader awareness of a SWP impacts the written SWP quality. …


Beware Portion Distortion! 5 Steps To Keep Portions Under Control, Une Applied Nutrition Program Oct 2018

Beware Portion Distortion! 5 Steps To Keep Portions Under Control, Une Applied Nutrition Program

All Student-Created Educational Resources

This handout brings awareness that portion sizes are often distorted and it outlines 5 considerations to help people reduce the amount of food they are eating in a meal.


Reducing Health Risk Through Weight Management, Une Applied Nutrition Program Oct 2018

Reducing Health Risk Through Weight Management, Une Applied Nutrition Program

All Student-Created Educational Resources

This handout discusses the basics of energy balance, risks associated with overweight/obesity and basic introductory nutrition education for overall health, weight management, and disease prevention.


What Are The Effects Of Nutrition Counseling Intervention On The Renal Labs (Bun, Creatinine, Gfr) Among Mexican American Patients With Chronic Kidney Disease Stages 3-4 At 1 Month, 3 Months And 6 Months?, Laura Rosales Jul 2018

What Are The Effects Of Nutrition Counseling Intervention On The Renal Labs (Bun, Creatinine, Gfr) Among Mexican American Patients With Chronic Kidney Disease Stages 3-4 At 1 Month, 3 Months And 6 Months?, Laura Rosales

All Student-Created Educational Resources

This is a quantitative quasi-experiment that will use purposive sampling to recruit the Mexican American adult patients diagnosed with Chronic Kidney Disease (CKD) in Stages 1 and 2 and have not been diagnosed with Diabetes or received nutrition intervention for CKD. The purpose of this research is to identify at what stage nutrition counseling has a significant result on renal labs from patients diagnosed with CKD. The data from this research would provide information needed for medical providers to use in their treatment course for their patients with CKD.


Simple Health Snacks For Parents & Kids, Hannah Harvey Jul 2018

Simple Health Snacks For Parents & Kids, Hannah Harvey

All Student-Created Educational Resources

This pamphlet touches upon risk factors of childhood obesity and obesity in general, and provides lifestyle recommendations for reducing risk and improving health. It includes suggestions for behavior and good habits that can be implemented in daily life to improve health and well-being, as well as various food type and meal suggestions.


Pink And Dude Chefs: Effectiveness Of An After-School Nutrition Knowledge And Culinary Skills Program For Middle School Students To Increase Fruit And Vegetable Consumption, Alyssa S. Vaziri Jun 2018

Pink And Dude Chefs: Effectiveness Of An After-School Nutrition Knowledge And Culinary Skills Program For Middle School Students To Increase Fruit And Vegetable Consumption, Alyssa S. Vaziri

Master's Theses

The rate of overweight and obesity among adolescents aged 12-19 years has more than tripled since 1980, and disproportionately impacts low-income and marginalized populations. Reduction in adolescent obesity rates may result in decreased health risks, decrease healthcare costs, and increased quality of life. Effective intervention methods for adolescent participants have incorporated nutrition knowledge and culinary skill building into afterschool programs. This study examines whether building knowledge, skills, and confidence through a culinary intervention can improve adolescent participants’ choices of healthful foods through increased fruit and vegetable intake.

Pink and Dude Chefs (PDC) is an afterschool nutrition education and culinary skills …


Talking To Teens About Diet, Candace Nelson Apr 2018

Talking To Teens About Diet, Candace Nelson

All Student-Created Educational Resources

This handout empowers parents to help their teens with obesity through a structured weight management treatment plan.


“Your Body Feels Better When You Drink Water”: Parent And School-Age Children’S Sugar- Sweetened Beverage Cognitions, Kaitlyn M. Eck, Aleksandr Dinesen, Elder Garcia, Colleen L. Delaney, Oluremi A. Famodu, Melissa D. Olfert, Carol Byrd-Bredbenner, Karla P. Shelnutt Jan 2018

“Your Body Feels Better When You Drink Water”: Parent And School-Age Children’S Sugar- Sweetened Beverage Cognitions, Kaitlyn M. Eck, Aleksandr Dinesen, Elder Garcia, Colleen L. Delaney, Oluremi A. Famodu, Melissa D. Olfert, Carol Byrd-Bredbenner, Karla P. Shelnutt

Faculty & Staff Scholarship

Sugar-sweetened beverages (SSBs) are a leading source of added sugar in the American diet. Further, ingestion of added sugars from SSBs exceeds recommendations. Thus, interventions that effectively reduce SSB consumption are needed. Focus group discussions with parents (n = 37) and school-aged children between the ages of 6 and 11 years (n = 41) from Florida, New Jersey, and West Virginia were led by trained moderators using Social Cognitive Theory as a guide. Trends and themes that emerged from the content analysis of the focus group data indicated that both parents and children felt that limiting SSBs was important to …


Future Implications Of Using Registered Dietitians In Multidisciplinary Polycystic Ovary Syndrome Treatment, Wendy M. Wolf, Rachel A. Wattick, Pamela J. Murray, Melanie Clemmer, Melissa D. Olfert Jan 2018

Future Implications Of Using Registered Dietitians In Multidisciplinary Polycystic Ovary Syndrome Treatment, Wendy M. Wolf, Rachel A. Wattick, Pamela J. Murray, Melanie Clemmer, Melissa D. Olfert

Faculty & Staff Scholarship

Polycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in females with insulin resistance playing a key role in pathogenesis. The objective of this study was to investigate current trends and future implications of multidisciplinary PCOS clinics with inclusion of dietitians. A two-phase, formative investigation on practitioners was conducted through an anonymous survey followed by focus groups. Survey respondents included 261 health care providers from around the world; the majority (59%) representing multidisciplinary teams. Focus group participants included four dietitians, three physicians, a health psychologist and a licensed nutritionist. Primary barriers for future multidisciplinary clinics included: money/resources, insurance …


Development Of The Meal Framework: A Multiliteracies Approach To Engaging Adolescents In Nutrition Education, Samantha Lee Baker Jan 2017

Development Of The Meal Framework: A Multiliteracies Approach To Engaging Adolescents In Nutrition Education, Samantha Lee Baker

Theses: Doctorates and Masters

Establishing and maintaining a healthy diet is integral in promoting optimal health, growth and development. Moreover, the food choices we make and dietary behaviours we adopt are a reflection of the multiple personal, interpersonal and environmental factors to which we are exposed. Consequently, changing food habits and dietary behaviour is complex and requires the implementation of multifaceted public health strategies. Comprehensive nutrition education provided to adolescents during their school years is one such approach.

Adolescence is a period of rapid psychological and physiological changes. At a socioemotional level, there is a decreased level of dependence on parents and a greater …


Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante Jan 2017

Culturally Competent Nutrition Counseling And Health Outcomes Of Patients On Emergency Dialysis, Edlyn Geraldine Bustamante

Walden Dissertations and Doctoral Studies

Undocumented end stage renal disease (ESRD) patients in the United States only have access to emergency dialysis. To compensate for the lack of regular dialysis these patients must follow strict renal dietary restrictions. However, nutrition counseling by a dietitian is not part of the renal management of patients on emergency dialysis. The purpose of this quantitative quasi-experimental treatment-control study was to assess how the application of nutritional counseling that is both culturally and linguistically competent affects dialysis frequency and biochemical lab values such as serum potassium, phosphorus, and vitamin D of patients in emergency dialysis. The study was grounded on …


Pink And Dude Chefs: Impact Of A Nutrition And Culinary Education Program With Middle School Students In An Afterschool Setting, Jessie R. Bierlich-Wesch Mar 2016

Pink And Dude Chefs: Impact Of A Nutrition And Culinary Education Program With Middle School Students In An Afterschool Setting, Jessie R. Bierlich-Wesch

Master's Theses

The epidemic of adolescent obesity has become one of the greatest public health concerns in the United States. Approximately 20.5% of adolescents of both sexes aged 12-19 years are considered obese. Higher rates of obesity are evident in ethnic minority and lower income status children with the highest prevalence among Hispanic/Latino and Black populations. The causes for obesity are multifactorial in nature and highlight disparities nationwide. These factors include socioeconomic status, education, environment, availability and access to fresh fruits and vegetables, and behavior patterns. Successful intervention methods that have reduced the impact of adolescent obesity have incorporated nutrition knowledge and …


An Evaluation And Exploration Of Nutrition Education In Elementary Schools, Elisha M. Hall Dec 2015

An Evaluation And Exploration Of Nutrition Education In Elementary Schools, Elisha M. Hall

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

Childhood obesity is a significant problem in the United States. Obese children suffer from a variety of physical, emotional, and social consequences. To curb or reduce this problem, school-based nutrition education interventions have become more common. However, little research has been conducted concerning nutrition-related socioeconomic disparities in behavior change constructs for low and high income children, which is integral to forming appropriate theory-based interventions and allocating resources appropriately. Research into classroom teachers’ perspectives is also an area in need of strengthening to better inform interventions. Finally, the School Enrichment Kit Program (SEKP), a current interactive, classroom-based, nutrition and physical activity …


Food Resource Management Education With Snap Participation Improves Food Security, Lucia Kaiser, Virginia Chaidez, Susan Algert, Marcel Horowitz, Anna Martin, Concepcion Mendoza, Marisa Neelon, David C. Ginsburg Apr 2015

Food Resource Management Education With Snap Participation Improves Food Security, Lucia Kaiser, Virginia Chaidez, Susan Algert, Marcel Horowitz, Anna Martin, Concepcion Mendoza, Marisa Neelon, David C. Ginsburg

Department of Nutrition and Health Sciences: Faculty Publications

Objective: To determine the influence of Supplemental Nutrition Assistance Program (SNAP) and participant demographics on nutrition education outcomes.

Methods: At program enrollment (pre) and 1 month later (post), a statewide convenience sample of adults, who participated in the Plan, Shop, Save, and Cook program, completed a 7-item questionnaire to evaluate change in resource management skills (RMS) and running out of food before the end of the month.

Results: Percent of participants (n = 3,744) who reported behavioral improvements in RMS ranged from 38.8%in comparing prices to 54% in reading labels. Female gender and Hispanic ethnicity were positively related to pre–post …


Cooking Healthy, Eating Smart (Ches): Evaluating The Feasibility Of Using Volunteers To Deliver Nutrition And Food Safety Education To Rural Older Adults, Morgan Getty Aug 2014

Cooking Healthy, Eating Smart (Ches): Evaluating The Feasibility Of Using Volunteers To Deliver Nutrition And Food Safety Education To Rural Older Adults, Morgan Getty

All Theses

Due to their limited resources, rural, older adults in the United States are at risk for poor diet-related health outcomes. Nutrition education is a key component in improving health outcomes in older adults. Cooking Healthy, Eating Smart (CHES) is a nine-lesson curriculum designed to teach rural, older adults culturally appropriate nutrition and food safety information. Funding to hire health professionals to deliver such a curriculum is limited, presenting the need to explore a less expensive mode of dissemination. In this community-based, participatory research study, a formative evaluation and feasibility study were conducted to examine the use of volunteers to deliver …


Pink And Dude Chefs: A Nutrition And Culinary Intervention For Middle School Students, Tianna R. Sheehan May 2013

Pink And Dude Chefs: A Nutrition And Culinary Intervention For Middle School Students, Tianna R. Sheehan

Master's Theses

Pink and Dude Chefs: A nutrition and culinary intervention for middle school students

Tianna Sheehan

The prevalence of obesity in US adolescents has more than tripled in the past 35 years, and the greatest impact has been among low-income and minority racial/ethnic populations. Adolescents report inadequate fruit and vegetable intake, an overconsumption of sweetened beverages, and a high reliance on fast food locations for meals or snacks; increasing the risk of adolescent obesity. Building knowledge and skills through culinary interventions may empower middle school students to create and also choose healthful foods.

Pink and Dude Chefs, a six-week nutrition and …


Developing An Online Certification Program For Nutrition Education Assistants, D. Christofferson, N. Christensen, Heidi Leblanc, M. Bunch Sep 2012

Developing An Online Certification Program For Nutrition Education Assistants, D. Christofferson, N. Christensen, Heidi Leblanc, M. Bunch

Nutrition, Dietetics, and Food Sciences Faculty Publications

Objective: To develop an online certification program for nutrition education paraprofessionals to increase knowledge and confidence and to overcome training barriers of programming time and travel expenses. Design: An online interactive certification course based on Supplemental Nutrition Assistance Program-Education and Expanded Food and Nutrition Education Program core competencies was delivered to employees of both programs. Traditional vs online training was compared. Course content validity was determined through expert review by registered dietitians. Parameters studied included increase of nutrition knowledge and teaching technique/ability, educator satisfaction, and programming costs related to training. Setting: Utah State University Extension. Participants: Twenty-two Supplemental Nutrition Assistance …


Impact Of The Home Food Environment On Dietary Intake, Obesity And Cardiovascular Health Of U.S. Children And Adolescents, Aged 6–19, Melissa A. Masters Aug 2012

Impact Of The Home Food Environment On Dietary Intake, Obesity And Cardiovascular Health Of U.S. Children And Adolescents, Aged 6–19, Melissa A. Masters

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

Youth obesity is an ongoing problem in the United States. Obese children and adolescents are likely to be obese as adults and have an increased risk of developing chronic diseases, including coronary heart disease, earlier in life. The multifactorial nature of obesity continues to challenge researchers and health professionals to determine methods for preventing and reducing childhood obesity. Research has suggested that obesity is a normal response to an “obesigenic” environment. Emerging as one of the most influential environments in obesity and behavior development is the home food environment. However, little is understood about the role of the home food …


Comparing The Effectiveness And Acceptability Of The Jump Into Foods And Fitness (Jiff) And Quest For Health Nutrition Interventions Within An African-American Population, Jermaine Shaw Aug 2010

Comparing The Effectiveness And Acceptability Of The Jump Into Foods And Fitness (Jiff) And Quest For Health Nutrition Interventions Within An African-American Population, Jermaine Shaw

All Theses

The severity of the obesity epidemic has increased the necessity for nutrition education programs. These programs must be culturally and age appropriate in order to be more effective in bringing about positive behavior changes in the target populations.
This study examined the effectiveness and acceptability of the Jump into Foods and Fitness (JIFF) and Quest for Health nutrition education programs within a pre-adolescent African-American population. Two classes from the Boys and Girls Club of Sumter, S.C. were randomly assigned to one of the nutrition education programs. Class one was assigned to the JIFF curriculum, and included 23 participants. Class two …


Dvd Multimedia Nutrition Education Curriculum For Self-Study, J. Tawzer, Heidi Leblanc, Nedra K. Christensen, Janet Anderson, Jennie Murri Jan 2010

Dvd Multimedia Nutrition Education Curriculum For Self-Study, J. Tawzer, Heidi Leblanc, Nedra K. Christensen, Janet Anderson, Jennie Murri

Nutrition, Dietetics, and Food Sciences Faculty Publications

The State of Utah has one of the highest food insecurity rates in the nation. It is ranked in the top 4% in the nation of being food insecure and 34% of the state is considered low-income, defined as at or below 185% of poverty level (LeBlanc, Christofferson, & Christensen, 2008). These trends place Utah’s low-income population at increased risk of obesity and chronic disease. The Center of Hunger and Poverty reported a high rate of obesity among low-income individuals, with hunger, poverty, and obesity frequently occurring at the same time (USDA, 2009). With limited income, quantity is often more …


Fruit And Vegetable Consumption In Four Elementary Schools After Implementation Of Nutrition Education Programs, Lori Nelson Jan 2010

Fruit And Vegetable Consumption In Four Elementary Schools After Implementation Of Nutrition Education Programs, Lori Nelson

Master's Theses and Doctoral Dissertations

Nutrition education programs in schools often promote fruits and vegetables with the goal of increasing consumption among children. This study determined whether nutrition education programs increased fruit and vegetable intake in four elementary schools in Florida from October 2008 to October 2009. School A offered the U.S.D.A. Fresh Fruit & Vegetable Program; School B had a Student Wellness Advisory Council, OrganWise Guys and CATCH; School C had OrganWise Guys and CATCH; School D had no nutrition education programs. Students’ favorite fruits and vegetables at breakfast and lunch were compiled. An increase in fruit intake was observed in three out of …


Nutrition-Related Practices And Attitudes Of Kansas Skipped-Generation(S) Caregivers And Their Grandchildren, Mary Meck Higgins, Bethany J. Murray Jan 2010

Nutrition-Related Practices And Attitudes Of Kansas Skipped-Generation(S) Caregivers And Their Grandchildren, Mary Meck Higgins, Bethany J. Murray

Department of Nutrition and Health Sciences: Faculty Publications

Despite growing numbers, the nutrition practices and attitudes of skipped-generation(s) kinship caregivers regarding feeding the dependent children in their care have not been examined. In this qualitative study, transcriptions of semi-structured interviews with 19 female and four male skipped-generation(s) Kansas caregivers (ages 47 to 80, 92% non-Hispanic whites, 83% female, 78% grandparents and 22% great-aunt or great-grandparent caregivers; caring for a range of one to four children, ages three to 18, for an average of nine years) were content analyzed for how their nutrition-related practices and attitudes had changed since parenting the first time. Sub-themes regarding practices included: being more …


Tailoring Messages To Individual Differences In Monitoring- Blunting Styles To Increase Fruit And Vegetable Intake, Pamela Williams-Piehota, Amy E. Latimer, Nicole A. Katulak, Ashley Cox, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey Nov 2009

Tailoring Messages To Individual Differences In Monitoring- Blunting Styles To Increase Fruit And Vegetable Intake, Pamela Williams-Piehota, Amy E. Latimer, Nicole A. Katulak, Ashley Cox, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

Objective

To examine whether messages matched to individuals' monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information.

Design/Setting

Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later.

Participants

531 callers to a cancer information hotline who did not meet the 5 A Day guideline.

Intervention

A brief telephone-delivered …


Child Feeding Practices And Nutrition Education Needs Of The Latino Population In South Carolina, Claire Kirkpatrick Dec 2006

Child Feeding Practices And Nutrition Education Needs Of The Latino Population In South Carolina, Claire Kirkpatrick

All Theses

The Latino population in South Carolina is rapidly growing. Much of this population is low-income and many have a low level of education. Latinos have a greater incidence of obesity and the resulting diseases than other ethnicities and Latino children are no exception. It is important to provide nutrition education to caregivers so that child overweight and obesity can be prevented in this population. In order to provide effective nutrition education it is essential to know what behaviors need to be targeted. This study used qualitative and quantitative methods to examine the child feeding practices used by this population to …


Effects Of The Implementation Of A Pilot Nutrition Education Program In A Rural Appalachian County., Leigh A. Davenport Aug 2005

Effects Of The Implementation Of A Pilot Nutrition Education Program In A Rural Appalachian County., Leigh A. Davenport

Electronic Theses and Dissertations

The purpose of the study was to determine if nutrition knowledge would increase, indicated by improvements in pretest and posttest scores, following implementation of a nutrition lesson plan. The subjects included 532 fourth through eighth grade students from Johnson County, a rural county in northeast Tennessee. The lesson plans and pretests and posttests were developed to be appropriate for each grade level, with increased complexity in higher grades. The principal investigator graded the pretests and posttests and analyzed the data using SPSS. The results showed a significant improvement from pretests to posttests for all grades given a p-value of <0.05.