Choose Health: Food, Fun, & Fitness (CHFFF) is a direct education curriculum for 8-15 year olds (3rd-8th graders) that uses experiential learning to teach healthy eating and active play. Designed for use by paraprofessional and professional educators in a variety of settings, the goal is to improve the following research-based behaviors for preventing obesity and chronic disease: eating more vegetables, fruits, and whole grains; consuming fewer sweetened beverages and high-fat, high-sugar foods; and increasing active play. The curriculum is available in both print and virtual versions.

Target Behavior: Healthy Eating, Physical Activity and Reducing Screen Time

Intervention Type: Direct Education

CHFFF targets elementary and middle-school aged children in schools and other sites including after-school and summer programs. CHFFF was developed collaboratively with SNAP-Ed and Expanded Food and Nutrition Education Program (EFNEP) professionals, and piloted by nine SNAP-ED/EFNEP counties in New York piloted the intervention in 2010. The original curriculum was completed in 2011, a major update was done in 2015, and a new virtual version was created in 2020 and revised version was released in 2022. CHFFF is used in all 50 states and three territories, primarily in SNAP-Ed, EFNEP and/or 4H programs.

Setting: School (Learn), Other: After-school & summer programs, clubs, libraries, & other similar youth sites

Target Audience: Elementary School, Middle School

Race/Ethnicity: All

CHFFF includes six usually-weekly lessons. Based on the Social Cognitive Theory, each 45-90 minute lesson includes offering hands-on nutrition and problem solving activities, preparing or tasting healthy snacks, playing active games, and setting weekly goals. Lessons are scripted in simple language to make them easy to teach and are structured based on the 4 As dialogue approach to ensure youth interaction and engagement: Anchor to past experience, Add new information, Apply by doing, and a goal-setting Away. Activities include comparing Nutrition Facts Labels on food packages, visualizing the amount of sugar in drinks and fat in fast foods, and using photos of real food to create meals for a day with recommended cups of vegetables and fruits.

All CHFFF materials, including the virtual version and its training videos, are available here (see links at left to navigate). A revised 2022 version with updated food package labels with the new Nutrition Facts Label and various updated visuals is now available for users to print. Instructions for printing the complete new version or for updating current copies are provided

• Curriculum (both print and virtual):
  • 6 lessons in English and Spanish
• Teaching Kit (print version):
  • 22 posters
  • Numerous visuals including 61 food package labels and 28 fast food cards
  • Seven 2-page family newsletters
  • One 2-page worksheets
  • 12 game instruction cards
  • 14 recipes
• 2-day Group and Individual Training Guides
• Fidelity and Progress Notes Form
• How CHFFF Meets National Health Education Standards Document
• Training clips of virtual version for learning lesson content
• Instructional Videos for CHFFF Games

The 2022 curriculum and teaching kit (itemized above) are available for users to print themselves or via a printing service; printed copies are not available. Instructions for printing the complete new version or for updating current copies are provided. The 2015 curriculum and teaching kit can be purchased via the 4-H Mall for $46, and then updated per the instructions.

 

In 2015, CHFFF was evaluated using a quasi-experimental (delayed intervention control group) study in NY EFNEP. After receiving CHFFF, youth significantly improved their dietary scores including overall quality (p<.001), vegetable intake (p<.001), fruit intake (p<.01), soda/fast food intake (p<.05), and intent to consume soda/fast food (p<.001). Youth also increased the frequency with which they read Nutrition Facts labels (p<.001) and shared about healthy eating with their family (p<.001), and were more likely to have tried a new food (p<.001) (Wolfe and Dollahite, 2021).

Additionally, CHFFF conducted a community-based evaluation between 2013 and 2015 in which paired t-tests showed significant (p<.01) positive changes before to after CHFFF education for consumption of vegetables, fruits, sweetened drinks, nutrition label reading, and other food and activity behaviors. These results can be found here.

Evidence-based Approach: Research-tested

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

	Readiness and Capacity – Short Term (ST)	Changes – Medium Term (MT)	Effectiveness and Maintenance – Long Term (LT)	Population Results (R)
Individual		MT1, MT2, MT3
Environmental Settings
Sectors of Influence

• MT1h. Drinking fewer sugar-sweetened beverages (e.g., regular soda or sports drinks)
• MT2b. Read nutrition facts labels or nutrition ingredients lists
• MT3a. Physical activity and leisure sport (general physical activity or leisure sport)

CHFFF provides a Fidelity and Progress Notes Form for monitoring how the lessons are taught and uses the national EFNEP 3^rd – 5^th and 6^th-8^th pre-post surveys for evaluation.

Website: The CHFFF website includes an overview of existing evidence, training resources, supplemental curricular materials, and teaching resources.

Contact Person:
Annette O-Hara, Division of Nutritional Sciences, Cornell University
607-255-0049
FNEC-admin@cornell.edu

 

*Updated as of August 8, 2023