Action Schools! BC — Healthy Eating: Effects of a Whole-school Model to Modifying Eating Behaviours of Elementary School Children
Open accessAbstract
Objectives The rate of obesity and associated risk factors in Canadian youth is increasing at an alarming rate. Nutrition plays an important role in weight maintenance. This study reports the effectiveness of Action Schools! BC---Healthy Eating, a school-based fruit and vegetable (FV) intervention, in effecting change in: 1) students' intake of FV, 2) students' knowledge, attitudes and perceptions regarding FV, and 3) students' willingness to try new FV.Methods Five schools that represented geographic, socio-economic and size variation were recruited as Action Schools! BC--Healthy Eating intervention schools. A second set of five schools were selected as matched healthy eating usual practice schools. Student outcomes were measured at baseline and at 12-week follow-up using self-report questionnaires. Classroom logs and progress reports were used to assess implementation dose and fidelity. The intervention included school-wide activities based on individualized Action Plans addressing goals across six Action Zones.Results Significant differences were found between conditions over time while controlling for baseline levels. Fruit servings, FV servings, FV variety, and percent of FV tried from a fixed list increased in intervention schools. Teachers implemented a mean of 64% of requested classroom dose, and school Action Teams implemented activities across 80% of the whole-school model.Discussion A whole-school framework can impact FV intake, but results were modest due to implementation issues. Further implementation and evaluation are necessary to fully understand the effectiveness of this initiative.
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Food and nutrition literacy, general nutrition knowledge, and obesity-related knowledge generally improved following intervention, although the magnitude and consistency of effects varied across studies.
“Including food and nutrition literacy, general nutrition knowledge, and obesity-related knowledge, generally improved following intervention, although the magnitude and consistency of effects varied across studies [43–55].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
The Knowledge, Attitudes and Perceptions section says knowledge of the importance of fruit and vegetables to disease prevention did not change over time. Although the intervention increased fruit and vegetable consumption and the percentage tried, this paper reports no improvement in the knowledge outcome it measured. (LLM, conf=0.85)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredAnother study reported improvements in nutrition knowledge in both intervention and control groups, but no significant between-group difference was observed.
“Another study reported improvements in nutrition knowledge in both intervention and control groups, but no significant between-group difference was observed [46].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
The “Knowledge, Attitudes and Perceptions” section (page unavailable) says knowledge of the importance of fruit and vegetables to disease prevention did not change over time. That contradicts the claimed improvements in knowledge in both groups; the paper reports an increase in the percentage of fruit and vegetables tried, not in knowledge. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredBehavioral and decision-oriented components were common in included interventions and included food choice, planning, goal-setting, portion awareness, self-efficacy, intention formation, and family or peer reinforcement.
“Behavioral and decision-oriented components were likewise common and included food choice, planning, goal-setting, portion awareness, self-efficacy, intention formation, and family or peer reinforcement [43, 44, 46, 47, 50, 52–56, 61–63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
The Implementation section (page not provided) describes strategies to promote healthy food choices, school action plans with goals, and classroom tasting activities. The Discussion (page not provided) says family involvement was minimal. This paper does not establish that these components were common across interventions, nor does it document portion awareness, self-efficacy, intention formation, or peer reinforcement as components of its intervention. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn 18 of the 21 included studies, the stated primary outcome was improved knowledge of nutrition or obesity prevention.
“In 18 of the 21 studies [43–59, 61–64], the stated primary outcome was improved knowledge of nutrition or obesity prevention, highlighting the field’s didactic focus.”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
The Abstract (page not available) lists fruit-and-vegetable knowledge as one of three outcomes, alongside intake and willingness to try new foods. It does not identify improved knowledge as the primary outcome; intake is listed first. This single intervention study also cannot substantiate the count of 18 out of 21 studies. (LLM, conf=0.85)
Experimental — accuracy not yet measuredNutrition education covering definitions, food groups, and nutrient functions was included in 20 intervention programs.
“Nutrition education—covering definitions, food groups, and nutrient functions—was included in 20 intervention programs [43–59, 62–64].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
The intervention description (page not available in our copy) says Action Schools! BC included classroom learning and weekly classroom activities to promote fruit and vegetable consumption. It does not specify lessons on definitions, food groups, or nutrient functions. As one intervention study, it also cannot establish the citing paper’s count of 20 programs. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Sensory activities, such as repeated tasting, comparing varieties of fruits and vegetables, and discussing flavor, texture, and appearance, were used in included interventions to support acceptance of healthy foods.
“Sensory activities, such as repeated tasting, comparing varieties of fruits and vegetables, and discussing flavor, texture, and appearance, were used to support acceptance of healthy foods [46, 52, 61].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
The intervention description says teachers were asked to conduct monthly fruit-and-vegetable tasting activities. The Discussion reports only one exposure to any given fruit or vegetable, rather than repeated tasting of the same food, and does not describe comparing varieties or discussing flavor, texture, or appearance. It also reports no improvement in willingness to try new fruits and vegetables. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIntervention components and curriculum content were delivered predominantly through school-based, classroom-oriented formats, reported in 18 studies.
“Intervention components and curriculum content were delivered predominantly through school-based, classroom-oriented formats, which were reported in 18 studies [43–47, 49, 51–59, 61–63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
A substantial proportion of included interventions incorporated experiential and skill-based learning, particularly cooking, food preparation, tasting, and sensory activities.
“A substantial proportion of interventions incorporated experiential and skill-based learning, particularly cooking, food preparation, tasting, and sensory activities [45–48, 50, 52, 56, 59–61, 63].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
Intervention durations varied: nine studies lasted not longer than three months, four lasted 4-6 months, and eight lasted 7-12 months.
“Intervention durations varied, with nine studies lasting not longer than three months [45–50, 53, 57, 62], four studies lasting 4–6 months [43, 55, 56, 58], and eight studies lasting 7–12 months [44, 51, 52, 54, 59, 61, 63, 64].”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
Weekly sessions were the most common schedule in included interventions (12 studies).
“Weekly sessions were the most common schedule (12 studies [43–46, 48, 50, 53, 55, 56, 59, 62, 63]).”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
Classroom teachers were the principal facilitators in 19 included studies, often after brief training.
“Classroom teachers were the principal facilitators in 19 studies [43–49, 51–57, 59, 61–64], often after brief training.”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
Meta-regression with a binary country variable (USA vs. other) yielded β ≈ −0.08 (95% CI: −0.47 to 0.31; p ≈ 0.56), indicating that the effects on nutritional behavior did not differ in any straightforward way between US and non-US trials.
“Meta-regression with a binary country variable (USA [50, 52, 56] vs. other [46, 61]) yielded β ≈ −0.08 (95% CI: −0.47 to 0.31; p ≈ 0.56), indicating that the effects on nutritional behavior did not differ in any straightforward way between US and non-US trials.”
From Effects of school-based nutrition literacy Intervention on obesity prevention in school-age students: a systematic review and meta-analysis (2026) · cites this paper as [46]
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- Authors
- Day, M. E., Strange, K. S., McKay, H. A., & Naylor, P.-J.
- Affiliations
- University of Victoria (CA)
- University of British Columbia (CA)
- Venue
- Canadian Journal of Public Health
- Published
- 2008-07
- Volume
- 99
- Issue
- 4
- Pages
- 328-331
- ISSN
- 0008-4263 (ISSN-L)
- 1920-7476
- PMC
- PMC6975680
- OpenAlex
- W1483865954
- Semantic Scholar
- 6716267b65ff733c3286e82109760e224f1c2f15
- Cited by
- 74
- References
- 27
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 7 · 2020: 8 · 2019: 4 · 2018: 5 · 2017: 4 · 2016: 4 · 2015: 7 · 2014: 8 · 2013: 4 · 2012: 7
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Canadian Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- healthy eating, fruit and vegetable intake, school-based intervention, youth obesity, student knowledge and attitudes, willingness to try new foods, implementation fidelity, action plan
- MeSH terms
- British Columbia, Child, Feasibility Studies, Feeding Behavior, Female, Health Education, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Male, Models, Theoretical, Nutrition Surveys, Nutritional Status, Obesity, Pilot Projects, Surveys and Questionnaires, Socioeconomic Factors, Focus Groups, Social Marketing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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