A Piaget-Based Nutrition Education Intervention in Preschool Children

Primary outcomes

1. Change in Food Consumption

   Time frame: Baseline and immediately after completion of the six-week intervention

   In the Food Consumption Frequency Questionnaire, there are foods that include 7 food groups (dairy group, meat group, vegetable group, fruit group, grain group, oil/margarine group, and sweet group) aimed at determining the child's food consumption status (Güneş et al., 2016). Food consumption frequency is recorded in nine different categories (>6/day, 4-5/day, 2-3/day, 1/day, 5-6/week, 2-4/week, 1/week, 1-3/month, 1-none/month). The Food Consumption Frequency Questionnaire specific to Turkish children was developed by Güneş and colleagues in 2016. The form includes not only food items but also commonly used ingredients in Turkish cuisine. During the development phase of the form, a food atlas containing the most frequently consumed foods, beverages, and some Turkish dishes was used.

2. Change in Nutrition Behavior Scale (NBS) Score

   Time frame: Baseline and immediately after completion of the six-week intervention

   In determining eating behaviors, the Nutrition Behavior Scale developed by Edmundson et al. (1996) and adapted for Turkish children by Öztürk and Erdoğan (2010) was used. The scale consists of fourteen different items, each containing two different food items-low-fat, high-fat, salty, and unsalted-depicted in pictures and presented as choices, to determine children's food consumption. Students are asked to indicate which of the two comparable food items in each question item they eat more. The scale items receive a value of -1 for unhealthy food and +1 for healthy food. The total score ranges from -14 to +14. A high total score on the scale indicates a healthy eating habit. The reliability of the scale has been reported as r=0.76 (Öztürk, 2010).

3. Change in Children's Eating Behavior Questionnaire (CEBQ) Subscale Scores

   Time frame: Baseline and immediately after completion of the six-week intervention

   Developed by Wardle et al. in 2001, the CEBQ (Children's Eating Behavior Questionnaire) is a Likert-type questionnaire answered by parents, consisting of 8 subscales, that evaluates children's eating behavior across 35 items on a 5-point scale (1=never, 5=always). In the original study where the scale was developed, an eight-dimensional factor structure emerged during the development of the questionnaire, and it was shown that the total variance explained by these eight subscales ranged between 50% and 80%. The Cronbach's alpha coefficients of the eight sub-dimensions ranged between 0.74 and 0.91. The validity and reliability of the scale in Turkey were conducted by Yılmaz and colleagues (2011). This 35-item questionnaire consists of 8 subscales that evaluate the behaviors of enjoying food, food craving, drinking passion, satiety craving, emotional overeating, emotional undereating, slow eating, and food neophobia. The Cronbach's alpha coefficients obtained from ÇYDA's study were 0.69