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Insights from the Cancer Control Field:
Nutrition Pathfinders in Monterey County, CA

At a Glance

The Monterey County Health Department uses the EBCCP program, Nutrition Pathfinders, within the county’s public schools to teach students how to make healthy nutrition and physical activity decisions. Read this success story to learn how the county uses Nutrition Pathfinders and how you can use Nutrition Pathfinders in your setting.

Challenges and Lessons Learned

Collaboration To Support Evaluation

Monitoring progress is an important part of using Nutrition Pathfinders in Monterey County. “We assess outcomes using a survey developed by the state Research and Evaluation Unit, but a few years ago, we worked with this unit to validate questions on a survey we developed to assess students’ knowledge gains about nutrition after educating them on the curriculum.” By working with state evaluators, the county has learned more about the impact of the program on the students.

Flexibility of Delivery To Meet Classroom Needs

The Nutrition Pathfinders program has seven 45- to 60-minute lessons. Typically, classroom teachers deliver these lessons over a 4- to 10-week period. In Monterey County, however, health specialists deliver the program about once per month from September to May. There are several advantages of having the health specialists deliver the curriculum. Most importantly, they decrease the time burden on classroom teachers. In addition, offering the lessons monthly reduces the disruptions to traditional educational activities.

Public Health Challenge

Good food choices and physical activity help prevent overweight and obesity. They may also help people avoid health problems such as heart disease, diabetes, and cancer. Many nutrition and physical activity programs start with young children to encourage healthy lifelong choices. These choices include eating healthy foods (e.g., fruits and vegetables) and exercising regularly. In Monterey County, CA, half of fourth-grade students receive free or reduced-price lunch, and fourth-graders do not receive formal nutrition education. By using Nutrition Pathfinders, a nutrition education program, the county aims to boost fruit and vegetable consumption and physical activity among these students.

The Setting

Each year, the Monterey County Health Department of California has used the Nutrition Pathfinders program with hundreds of fourth-grade children across four county schools. The California Department of Public Health gave the county school system a list of evidence-based nutrition programs that included Nutrition Pathfinders. The county’s chronic disease health specialists (i.e., health educators) chose to use Nutrition Pathfinders because the program appeared easy to use and had an in-depth curriculum.

50% of fourth-graders [who participated in the intervention] in Monterey County schools receive free or reduced-price lunches.

This past year we had an increase in fruit consumption, an increase in vegetable consumption, increase in whole grain consumption, and increase in physical activity.

—Monterey County Chronic Disease Health Specialist

The Approach

Nutrition Pathfinders is based in part on the health belief model and social cognitive theory. It teaches students about the five food groups and their nutrients and serving sizes. It also helps students understand food labels and select healthy breakfast and dinner options. Health specialists deliver the seven Nutrition Pathfinders lessons during school. When needed, students can receive the lessons in the language they speak at home.

The Dairy Council of California, which created the program, offers free materials and the support of a state regional coordinator.

The county’s health specialists received training working with the regional Dairy Council Community Nutrition advisor, as well as an educator’s handbook and student workbooks. The health specialists have been using Nutrition Pathfinders with fourth-grade students for more than 3 years. As part of this work, they have been administering surveys and tracking program results to measure the program’s effectiveness. They use a state-developed tool that measures nutrition and physical activity behaviors. The tool includes questions such as “How many servings of fruits, vegetables, and whole grains did you have yesterday?” and “How much physical activity did you do?” The health specialists collect data from participants before and after the program, enter the data in a spreadsheet, and send the data to the Research and Evaluation Unit within the California Department of Public Health. Evaluators analyze the data, provide feedback to the schools, and complete an annual report covering all participating counties in the state. Monterey County has also developed its own questionnaire to measure changes in the students’ nutrition knowledge from before to after the program.

The health specialists who offer Nutrition Pathfinders do not generally work with parents, but parents do play a role in the program. Students complete family homework assignments with their parents to apply the knowledge and skills they learn in the classroom.

There are a few other counties in California that are using Nutrition Pathfinders, including Santa Clara and San Benito counties, and there have been efforts made to share information across counties. Monterey County plans to keep using this curriculum on an ongoing basis.

Questions and Answers

What are the education requirements for a health specialist?

In Monterey County, health specialists deliver the program, but the intervention is typically delivered by classroom teachers. The training curriculum is easy to learn, and people of varying skill levels can teach the program.

Can Nutrition Pathfinders be used with students who are not in the fourth grade?

Nutrition Pathfinders was designed for fourth-graders. The Dairy Council of California has grade-specific nutrition programs for students of all grade levels, from kindergarten through high school.

Find Out More

To learn more about Nutrition Pathfinders and how to use the program at your organization, view the program summary at: https://ebccp.cancercontrol.cancer.gov/programDetails.do?programId=31528235

Contact

The Implementer

CalFresh Healthy Living
http://calfresh.dss.ca.gov/healthyliving/About-Us

The Developer

Trina Robertson, MS
info@dairycouncilofca.org
949-756-7892