Structured program, along with enhanced nutrition education and social support may be key drivers, Rutgers researchers find

Is there a way to encourage college students to make healthier food choices in their daily diets? Yanhong Jin, a professor with the Department of Agricultural, Food and Resource Economics at the Rutgers School of Environmental and Biological Sciences (SEBS), and Mary Wagner, an associate professor at Rutgers Ernest Mario School of Pharmacy (EMOP), wanted to find out.

Jin and Wagner, along with their research students, presented their findings at the American Association of Psychiatric Pharmacists annual meeting in Atlanta. They also made presentations at Rutgers, including at the 2023 Rutgers Active Learning Symposium and the 2023 Pharmacy Research Day.

Q. Why did you choose to study the eating habits of college students? And why do you hope to change them?

Jin: Nearly one quarter of Americans skip breakfast daily. Among college students, almost half do not regularly eat breakfast. Skipping breakfast is associated with negative health outcomes and poor academic performance. Our study investigated the effects of the Healthy Eating Challenge, a structured 10-day healthy eating program focusing on the first meal of the day. Nutrition education, self-discovery and reflection, and community support was integrated into the course program, to help promote behavioral change.

Wagner: Treatment guidelines for chronic disease often include food-related life-style change, but it is often difficult to make sustained behavioral changes. Another object of this study was to teach the students about the behavioral change process so that they could better understand it and make lifestyle changes aimed at improving health. For the EMOP students, ultimately, they will use these techniques as they interact with their future clients and patients.

Q. How did you design your study?

Wagner: This study consisted of two cohorts including Rutgers University students from SEBS and EMOP. We collaborated with a New Jersey-based nonprofit organization, Eating for Your Health, and adapted one of the organization’s flagship programs, “Healthy Eating Challenge,” for our students.

The participants completed pre-study and post-study surveys and evaluated how they felt after eating meals from recipes provided in the challenge, based on the non-profit’s concept of How You Feel is Data®. Program facilitators met with participants on the first, fifth and tenth day in a group setting to discuss the participants’ experiences and the assigned readings.

Jin: This structured challenge incorporated various components such as self-reflective journaling, reading materials, and social support. Student participants were encouraged to establish their learning goals and objectives to facilitate behavior modification. The SEBS student participants actively engaged in creative expression exercises, showcasing their challenge journey through the creation of infographics and videos. These visual mediums allowed them to express their experiences and reflections in a unique and captivating way. These exercises also played a significant role in fostering active learning.

Q. What did you find?

Wagner: We found that both SEBS and EMOP student participants were willing to make and maintain behavioral changes after the challenge. Significant differences between students from SEBS and EMOP were present. SEBS participants indicated a greater readiness for behavioral changes before and after the project compared with EMOP students. This may be explained by the fact that the challenge was better aligned with course content for the SEBS students. In addition, the pharmacy students’ responses may reflect the fact that nutrition is not emphasized in their course content.

Jin: We noted several factors affecting behavior and the potential for change. The most common barriers were lack of awareness of what constitutes a healthy food choice, limits on time needed to prepare food, the perceived higher cost of healthy foods, unfamiliarity with cooking and inadequate facilities to store and cook food. The most significant factor that would allow for more healthy eating differed among the school groups. SEBS students said improving their cooking skills would help them eat healthier food. Pharmacy students said they would be encouraged by gaining a better understanding of nutritional information.

Q. Why are these findings important?

Jin: Teaching the concept of behavioral change and its mechanisms to college students remains a challenge. Our research findings showcased that a well-designed and integrated healthy eating program, such as the challenge, has the potential to educate college students about how to make positive behavioral changes. More innovative programs such as this are needed to teach concepts of behavioral change and modification.

Wagner:  Life-style changes are often the first recommendation when it comes to reducing the impact of chronic disease. By understanding a theory that helps people understand a person’s readiness to change – known as the Transtheoretical Model of Change -- and the impact of patient autonomy, health care providers can better help their clients make important life-style changes. If people are not motivated to make changes, more creative approaches are needed to help them increase their readiness.

Q. What are some practical ramifications of your work?

Wagner:  By including course curricula that teaches the principles of behavioral change, nutrition and lifestyle medicine, faculty members can help students modify their own behavior to enhance their health. We’ve seen evidence that hands-on projects that align closely with course content help solidify and reinforce the concepts of behavioral modification.

Q: What plans do you have personally to apply your work to benefit students’ health?

Jin: In the fall, we will be offering a Byrne seminar course to first-year students at Rutgers that will include the Healthy Eating Challenge as part of that course content. This course will provide students with the opportunity to explore and learn about issues related to food and health, including the impact of food on personal health, types of innovative and sustainable agriculture that supports the environment, and ways in which food access and affordability impact health.

Wagner: We are preparing two manuscripts based on our current research. One will highlight how we can use an integrated, evidence-based, hands-on program to teach behavior models and behavioral modifications among college students. The second manuscript will focus on the differences between these two student cohorts, which is a part of the honors thesis for our research students.