Assessment of Diabetes Nutrition Knowledge and Impact of Nutrition Education Programs on Home Economics Teachers


Principle Investigator: Dr. Roula Barake – Nutrition Department 
Investigator: Mrs. Fatima Ismail– Nutrition Department
Co-investigator: Mrs. Dima AlKaed- Nutrition Department

Background
Diabetes, obesity, vitamin D deficiencies and iron deficiency anemia are among some of the many conditions prevalent across school children in Kuwait. The Ministry of Education (MoE) recognizes the importance of developing the skills of educators and improving teachers’ nutrition knowledge and curricula in schools, as well as the role this may play in reversing or contributing to better manage these conditions. As such, and in collaboration with the Dasman Diabetes Institute - Kuwait, the nutrition department is now working to develop a robust program assessing knowledge, improving skills and raising awareness of home economics teachers. This is the first-of-its kind program to be initiated, developed and implemented in Kuwait.

Aims
The aim of this program was to assess the Diabetes nutrition knowledge of 25 home economics teachers from public schools in Kuwait, and develop a diabetes nutrition education training program then measure the impact of the program on teachers’ knowledge, skills and empowerment.

Methodology
A program was developed to address theoretical and practical aspects of nutrition education for diabetes, obesity, anemia, celiac disease, vitamin D deficiency, healthy cooking, food label reading and bone health. Additionally, the training program was designed to develop skills in measuring waist to hip ratio, calculating body mass index (BMI) and classifying categories of obesity. Twenty-five home economics teachers attended this program, ages ranged from 30 -50 years.  Participants were randomly selected from intermediate and secondary schools representing all 6 governorates of the State of Kuwait. A 3-day-per-week program over one month was delivered in different formats, interactive lectures, workshops, practical training sessions for developing skills of collecting data for research, developing skills in food label reading, measuring body mass index, waist to hip ratio, physical activity and live cooking demos. Pre-assessment and post assessment data were collected where applicable and evaluation of classes were conducted to address learners’ needs and improve the program.

Results
Teachers diabetes nutrition knowledge improved significantly between pre and post intervention (7.8 ± 5.7, 15.7 ± 2.1; p<0.001). Similarly, knowledge about vitamin D deficiency causes, dietary sources, and target levels was significantly improved before and after intervention (6.6 ± 3.8, 13.9 ± 1.2; p<0.001). Skills in food label reading, BMI calculation, obesity classification, and waist-to-hip ratio measurement and calculation also improved, with scores ranging from 35% to 100%. The use of descriptive words such as “valuable”, “enjoyable”, “beneficial”, and “interesting’ scored highest, while expressions such as “boring”, “unclear”, “repetitive” or “waste of time” were never selected and did not contribute to overall score. This therefore indicates that the teachers’ evaluation of delivery of classes, workshops and practical sessions was highly favorable.

Discussion
Findings from this study indicate that diabetes nutrition knowledge and nutrition knowledge in general among home economics teachers is not optimal. Nutrition knowledge among teachers attending nutrition education programs has improved significantly. Teachers attending practical sessions and workshops developed skills in taking proper measurements of hip to waist ratio, calculating BMI and classifying obesity in the correct categories. Empowering teachers and developing their knowledge may contribute to help their students cope with, and manage diabetes, obesity, and other health conditions better.

Assessment of diabetes nutrition knowledge and impact of nutrition education programs on home economics teachers