Examining the influence of a preschool nutrition education program on teaching efficacy and practices: a convergent mixed methods case study

This study examined the influence of a year-long professional development (PD) nutrition education program, Healthy Start (HS), on preschool (preK) teachers’ nutrition teaching efficacy and classroom practices in Philadelphia, PA and Los Angeles, CA. Using a convergent mixed methods case study design, quantitative and qualitative data were collected and analyzed concurrently. Quantitative data from pre- and post-HS surveys completed by 73 preK teachers assessed changes in nutrition teaching efficacy and instructional practices. Qualitative data were gathered from one focus group, five dyadic interviews, and nine individual interviews with 23 teachers to explore perceptions of nutrition teaching efficacy and classroom practices. Paired-sample t-tests demonstrated statistically significant improvements in nutrition teaching efficacy (p < .001; η2 = 0.23–0.38) and classroom nutrition practices (p < .001; η2 = 0.36–0.57). Qualitative findings indicated increased confidence in teaching nutrition, greater use of integrated and hands-on nutrition activities, and enhanced ability to navigate intrapersonal, interpersonal, and institutional challenges, alongside expanded access to resources for students and families. Mixed methods integration showed strong convergence between quantitative and qualitative findings. Overall, participation in HS significantly improved preK teachers’ nutrition teaching efficacy and practices, highlighting the value of sustained, integrated PD that includes modeling, curricular resources, and home – school connections to strengthen preK nutrition education.