This project aims to design a nutrition-based educational storybook for preschool children and to evaluate its effect on improving general nutrition behaviors and reducing possible picky eating habits.
This study aims to develop a nutrition-focused educational storybook for preschool children (ages 5-6) and assess its impact on improving eating behaviors and reducing picky eating. Picky eating is common in early childhood and can negatively affect nutrition and growth, potentially leading to health issues later in life. The study will use a crossover design with 60 healthy children from kindergartens in Istanbul. Participants will experience both the intervention (storybook) and control conditions. Parental consent will be obtained, and data confidentiality will be maintained.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
SINGLE
Enrollment
70
In the first week, children in the intervention group were exposed to a structured, story-based nutrition education program. On the first day, the teacher read the designed storybook to the children for approximately 12-15 minutes. Children in the control group continued their routine classroom activities without exposure to nutrition-related content. During the remaining four days of the week, reinforcement activities were implemented to support the main message of the story, which emphasized the importance of fruit and vegetable consumption and healthy eating. These activities were developed in consultation with a child development specialist and were based on active learning and repetition principles. The reinforcement activities included age-appropriate tasks such as coloring, cutting, pasting, and drawing. Specifically, children participated in activities involving coloring story-related characters, selecting and pasting healthy food items onto visual materials, drawing their fa
Bahcesehir University
Istanbul, Turkey (Türkiye)
Choice of Snack (Healthy vs. Unhealthy) Measured by Direct Observation
At the baseline and right after the storybook intervention ends, each child will be offered a snack choice: fruit/vegetables (healthy) or cookies (unhealthy). The selection will be recorded using a standardized observation form. The primary outcome will be analyzed as the number and percentage of children selecting the healthy snack. Unit of Measure: Number and Percentage of Children Choosing a Healthy Snack
Time frame: Baseline (before intervention) and immediately after the storybook intervention ends (5 days of intervention).
NutriSTEP Questionnaire (OBTA Questionnare)
Turkish version of NutriSTEP Questionnaire (OBTA Questionnare) will be used to detect children's nutritional status. The scale will be filled by the parents of the children. It is fast and simple to use to scan eating habits and identify nutritional problems. It is a form that can identify preschool children who are and are not in risky nutritional status.Each question has 2-5 response options, with each option scored from 0 (no risk) to 4 (high risk). The total score is calculated by summing the scores obtained from all questions. Higher total scores indicate greater risk in dietary behavior. The total score can range from 0 to 68. According to the OBTA cut-off points: ≤20 points = low risk 21-25 points = moderate risk ≥26 points = high risk OBTA four It contains 17 questions in the category: * Food and liquid intake * Physical growth and development * Physical activity and sedentary behavior * Factors affecting food intake and nutritional behavior
Time frame: Baseline (before intervention) and immediately after the storybook intervention ends (5 days of intervention)
Nine-Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) Parent-Report
In order to evaluate their nutritional behaviors and detect potential disrupted eating habits, the "Avoidant/Restrictive Food Intake Disorder (ARFID) Parent Questionnaire", which is a 9-item scale that has been validated in Turkish (as ARFID scale) and applied to the parents of individuals between the ages of 2-18, will be filled out by the mothers of the participants. There NIAS has three subscales. The maximum score is 15 for the subscales and the total maximum score is 45 points. As the score increases the risk of ARFID increases too.
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Time frame: Baseline (before intervention) and immediately after the storybook intervention ends (5 days of intervention)
Visual Scales
Various questions will be asked to assess the children's cognitive, automatic, and detailed emotional responses. To measure children's cognitive, automatic and detailed emotional reactions, various questions will be asked and their reactions will be observed using a 4-point visual scale. For example, when measuring cognitive response, "How strong does eating fruit/vegetables make you?" and children's answers will be evaluated using a 4-point visual scale with squares from smallest to largest. Automatic emotional response to children quickly determine whether they like fruits/vegetables or not. Children's immediate liking of fruits/vegetables will be assessed using a two-choice facial expression scale (happy vs. sad). Detailed emotional response will be measured with two questions ("How much do you like fruits/vegetables?" and "How do you like the taste of fruit/vegetables?") using a 4-point facial expression scale (1 = not at all, 4 = like a lot).
Time frame: Baseline (before intervention) and immediately after the storybook intervention ends (5 days of intervention)