Choose Health: Food, Fun, and Fitness (CHFFF)

Cornell University Division of Nutritional Sciences and Healthy People

Overview

Choose Health: Food, Fun, & Fitness (CHFFF) is a direct education curriculum for third to sixth 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.

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

Intervention Type: Direct Education

Intervention Reach and Adoption

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 in 2010, nine SNAP-ED/EFNEP counties in New York piloted the intervention. Currently, 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

Intervention Components

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.

Intervention Materials

All CHFFF materials are available here.

  • Curriculum:
    • 6 lessons in English and Spanish
  • Teaching Kit:
    • 16 posters
    • Numerous visuals including 56 food package labels and 28 fast food cards
    • 7 2-page family newsletters
    • 2 worksheets
    • 32 game instruction cards
    • 12 recipes
  • 2-day Group and Individual Training Guides
  • Fidelity and Progress Notes Form
  • How CHFFF Meets National Health Education Standards Document
  • Instructional Videos for CHFFF Games

Intervention Materials

The full curriculum and teaching kit can be purchased for $155. This includes all printed items (spiral bound lessons, 16 laminated posters, numerous visuals including 56 food package labels & 28 fast food cards, 7 2-page family newsletters, 2 worksheets, 32 game instruction cards, & recipes).

This is optional as all files can be downloaded for free as well.

Evidence Summary

In 2015, CHFFF conducted 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 soda/fast food intent (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) (Submitted for publication 5/19).

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

Evaluation Indicators

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)

Evaluation Materials

CHFFF provides fidelity and pre- and post-tools for monitoring and evaluation purposes.

Additional Information

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

Contact Person:
Wendy Wolfe, PhD

Research Associate, Division of Nutritional Sciences, Cornell University

607-255-2677
ww16@cornell.edu