Date of Award

Summer 8-10-2018

Level of Access

Campus-Only Thesis

Degree Name

Master of Science (MS)


Food and Nutrition Sciences


Mona Therrien

Second Committee Member

Kathryn Yerxa

Third Committee Member

Alyssa Koomas


Objective: To assess the impact of the 4th H for Health Challenge Curriculum on knowledge, attitudes, and behaviors relating to fruit and vegetable intake, physical activity, and water in 4th and 5th graders.

Design: Pre-test, post-test experimental design with a control and intervention group.

Setting: Intervention group from after-school programs in Brewer and Bangor Maine. Control group from YMCA after-school program in Old Town Maine.

Participants: 4th and 5th graders. Intervention group (n=33, 63.6% 4th graders, 36.4% 5th graders). Control group (n=34, 73.5% 4th graders, 26.5% 5th graders). Mean age for both groups: 9.6 years of age.

Intervention: Six, 1-hour education lessons implemented in youth regular after-school program time.

Methods: Pre-survey administered to intervention and control groups after parents’ consent. Survey tool consisted of 13 questions, four assessing attitudes, four knowledge, and five behavior. Post-survey, consisted of the same questions as the pre-survey, administered to the intervention and control group.

Main Outcome Measures: Changes in youth knowledge, attitudes, and behaviors related to fruit and vegetable intake, water intake, and physical activity.

Analysis: Survey answers tabulated with frequency distribution. Chi-square test used to analyze the differences in responses pre- and post-survey in the intervention and the control group. Chi- square test also utilized to assess differences between the two groups on survey responses. Changes in attitude, behavior, and knowledge scales pre- and post-survey calculated with independent and dependent t-tests. Significance was set at p £0.05 for all statistical analysis.

Results: Intervention group showed a significant improvement in knowledge relating to minutes of physical activity needed per day in comparison to the control group (p=0.02). Intervention group also had positive changes in their attitudes towards choosing fruits and vegetables (p=.009) and water intake (p=.000). Behaviors also improved with regard to choosing water over sugary beverages (p=.000). In comparison, the control group showed significant decline in their attitude and behavior towards water (p=.004) and their consumption of vegetables (p=.036).

Conclusion and Implications: The 4th H for Health Challenge curriculum was effective in improving knowledge, attitudes, and behaviors in the intervention group. Future delivery of the curriculum should incorporate sampling foods in each lesson as a motivator for learning. The survey tool should also be reconstructed to better mirror the curriculum content.

Key Words: Youth, nutrition education, after-school programs, out-of-school time, physical activity, fruit and vegetables, water.