Evaluation of an interactive multimedia program on calcium and folate composition of foods

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Michalsky, Linda Oldfather

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An interactive multimedia (IMM) program on calcium and folate composition of foods was developed and evaluated as an adjunct to traditional nutrition curricula. Subjects were 600 students enrolled in introductory and advanced nutrition courses at 7 universities in the United States. Changes in cognitive performance were assessed with multiple choice questions; attitude and self-efficacy were measured by 5-choice Likert-type rating scale items. One-day food records were collected pre- and post-intervention from introductory students. Student t-tests were used to compare change scores between groups. Pearson correlation coefficients identified relationships between variables. Average cognitive gains of 11%±17% (mean ± standard deviation) for introductory and 13%±12% for advanced experimental (IMM) groups differed from gains of 6%±15% and 3%±9% for comparable controls, respectively (p≤.001); however, mean posttest scores of 45%±18% for introductory and 52%±12% for advanced IMM students were below the 70% typically needed for passing grades. Self-efficacy gains of 21%±15% for introductory and 5%±11% for advanced experimental students were greater than gains of 11%±14% and 0.3%±12% for respective controls (p≤.007). Changes in attitude of 4%±7% versus 3±7% for introductory IMM subjects and controls, respectively (p=.007) were small; changes in attitude among advanced groups did not differ. Behaviorally, nutrient density as measured by intake/1000 kcal indicated a mean gain of 51 mg calcium for IMM students versus a decrease of 29 mg among controls (p=.019). For folate, the mean gain of 46 µg for the IMM group compared to the increase of 12 µg for controls did not reach significance (p=.057). Instructional method was correlated with changes in cognition, attitude, self-efficacy, and calcium/1000 kcal for introductory students, but only with changes in cognition and self-efficacy for advanced students (p≤.05). Stronger motivational techniques may have promoted better cognitive performance. However, acquisition of knowledge and promotion of self-efficacy regarding application of food composition knowledge were enhanced with IMM intervention. Food selection behavior as indicated by consumption of calcium/1000 kcal improved with IMM use. Incorporation of the IMM program into traditional nutrition curricula may enhance both educational and food behavioral outcomes.