營養教育介入對幼兒蔬菜攝取之影響

Abstract

蔬菜攝取不足是兒童青少年之飲食營養問題，飲食習慣之養成需從小開始，本研究的目的在發展適用於幼兒園的提升蔬菜攝取的幼兒園學習活動及家庭活動並評估其成效。以社會認知理論為基礎發展學習活動內容，在活動設計上採用烹調製作為主的內容，著重於幼兒的實際接觸與品嚐蔬菜等感官經驗，以提高對蔬菜的認識與熟悉感。幼兒園學習活動共計八個單元，每週實施一個單元；家庭活動乃依據幼兒園學習活動發展，包含營養通訊和家庭親子活動兩部分。以台北地區四所幼兒園小班幼兒為對象，其中兩所分別為實驗組一（提升蔬菜攝取的幼兒園學習活動，N=18）和實驗組二（提升蔬菜攝取的幼兒園學習活動加上家庭活動，N=14），另兩所幼兒園的小班幼兒為控制組(N=15)。於介入活動前、活動後一週及活動後八週進行前測、後測與後後測評估，並於後後測評估結束後訪談實驗組各3至4位家長，以瞭解介入計畫之成效。本研究之實驗蔬菜為菠菜和青椒，成效評估採質性及量化評估，質性評估為教室觀察和家長訪談，量化評估為比較教學前後菠菜和青椒的攝取量以及喜好性的變化。以SPSS 12.0版進行描述性統計、卡方檢定、重複量數、單因子共變數分析與二因子共變數分析。研究結果發現，(1)由學習活動實施過程觀察，隨著活動時間，幼兒能夠嘗試原本不敢吃的蔬菜，部分幼兒也表現增加了對蔬菜的喜好性。(2)由家長訪談結果，家長認為提升幼兒蔬菜攝取學習活動加上家庭活動可以明顯增進幼兒對蔬菜的熟悉度與接受性，家長本身也改變自己對孩子的蔬菜教養行為。(3)提升蔬菜攝取的幼兒園學習活動加上家庭活動對幼兒菠菜攝取量具顯著立即效果，但無延宕效果；兩項介入活動皆對幼兒青椒攝取量具顯著立即效果，且以加入家庭活動組的效果較佳，但皆無延宕效果。(4)兩項介入活動對菠菜和青椒的喜好性皆無顯著提升。(5)介入計畫之成效不因幼兒性別而有差異，但因幼兒不同氣質、家庭社經而略有差異。由研究結果歸納，本研究發展之幼兒園學習活動確實可提升幼兒對蔬菜的接受性（攝取量），且在有家庭配合時效果更佳，但欲提升小班階段幼兒對蔬菜的喜好性似乎較為困難，顯示家長應更早讓幼兒接觸與熟悉各種蔬菜，幼兒園也應將飲食教學列為常態性、經常實施的活動單元，並請家長配合相關親子活動，共同協助幼兒建立良好飲食行為。Low vegetable intake is a prevalent problem among children and adolescents in Taiwan. The purpose of this study was to develop a preschool vegetable consumption promotion program. Based on Social Cognitive Theory, the program included eight classroom activities and eight family activities and emphasized exposure to tasting vegetables. The effectiveness of the program was evaluated by a pretest-post-test design Quasi-experiment. Experimental group-1 (N=18) was exposed to classroom activities only; experimental group-2 (N=14) was exposed to both classroom and family activities; and the control group (N=15) participated in no nutrition education activities. The outcomes were evaluated by both qualitative and quantitative methods. The qualitative method involved observation throughout the intervention and parent interviews eight weeks after the intervention. The quantitative method compared the vegetables (spinach and green peppers) consumption and preferences of children one week before (pre-test), one week after (post-test), and eight weeks after (follow-up test) the intervention. From classroom observation, we noted that preschoolers were willing to taste vegetables they did not like with some children showing increased preferences over time. Parents of experimental group-2 reported that their preschoolers had become more familiar with vegetables and exhibited increased acceptance; furthermore, parents from group-2 took account of their food-related parenting and made modifications. Quantitative data indicated that both experimental groups 1 and 2 increased green peppers consumption, but only experimental group-2 increased spinach consumption following intervention. No significant increase in preference for either spinach or green peppers was noted after intervention. No notable differences among intervention effects were noted between genders, and few differences were determined among varying temperaments or socio-economic status of the children. In conclusion, preschoolers exhibited increased acceptance (consumption) of vegetables after the 8-week vegetable consumption promotion program, especially when family involvement was combined with classroom activities. However, increasing preschoolers’ vegetable preferences proved more difficult than gaining their acceptance (consumption) of vegetables. We suggest early introduction of various vegetables into the diet of preschoolers, regular classroom activities designed to increase vegetable consumption in daycare centers, and incorporation of family participation into the nutrition education of preschoolers.