Cross-curricular Unit on Portion Size (CUPS): Evaluation of a school-based program integrating nutrition and mathematics.

This cluster randomised controlled trial will investigate the efficacy of a teaching unit integrating nutrition and mathematics in primary school children (CUPS). The goal of the CUPS program is to improve primary school children's portion size estimation skills and nutritional knowledge. This teaching unit will specifically focus on the learning of appropriate portion sizes for each food group and the mathematical concept of volume and capacity. Fake food models, math cubes and measuring cups will be used to teach these two topics. Teaching unit content will be based on the NSW k-6 syllabus and Australian Guide to Healthy Eating. Experienced primary school teachers and researchers in the field of Nutrition and Education developed the lessons involved in this intervention. Schools will be randomly allocated to either the intervention or control group for the study duration. Teachers in the intervention group will be invited for a one-day information session and will be provided with the teaching guidelines and materials. This day will be accredited with the NSW Education Standards Authority (NESA) as professional development towards maintaining their proficiency status. Members of the research team will deliver this information at the University of Newcastle. The control group will receive the workshop and resources on the completion of the program. The teaching unit consists of 4-5 lessons of 40 minutes each which will be delivered over 1-4 weeks. Based on their usual teaching structure, teachers in the intervention group will be asked to plan when they will use the resource material during their classes. As these teachers have to align this with teaching the mathematics curriculum about “Understanding units of Measurement; volume and capacity”, they will be able to choose when to start with the teaching unit and within what time frame this will be delivered (1-4 weeks). The lessons will be provided to the students by the classroom teacher during regular teaching time at the primary schools. The following research methodologies will be used: Portion size estimation skills: will be assessed by determining the ability of a student to estimate the correct portion size of a given food. Math cubes will be used by the children to measure food volume of a set of food models. Nutrition knowledge: will be determined by using a nutrition knowledge survey of 60 multiple-choice questions specifically designed for this study. Six domains will be covered to examine nutrition knowledge including healthy choices, portion/serve sizes and balanced meals, nutritional values, food groups, food safety and labels, and food sources. Attitude towards mathematics: will be assessed using the “How I Feel About Maths Scale” (HIFAMS) by Chapman (2003). Teaching quality: will be measured by coding either the intervention or usual lesson on volume and capacity. The Quality Teaching Lesson Observation Scales (NSW) will be used for these coding sessions. Teacher interviews: will be held to report on the process evaluation. Semi-structured interviews with teachers from the intervention group will focus on the program perceptions, barriers and facilitators of the intervention implementation and delivery. Student focus groups: will be conducted to explore students' perceptions of the CUPS program (intervention group only).