The Effect of Therapeutic Play on Eating Behaviors in Primary School Children

Child Nutrition, Emotional Eating, Feeding Behavior

Healthy Eating, Nutrition Education, Emotional Eating, School-Aged Children, Gamification

Primary health care is a comprehensive, community-based approach that aims to maximize health, well-being, and their equitable distribution through three main components (WHO, 2025). Its key components, identified at the Alma-Ata Conference, include health education; environmental sanitation, particularly food and water; maternal and child health programs, including immunization and family planning; prevention of endemic diseases; appropriate treatment of common diseases and injuries; provision of essential medicines; promotion of healthy nutrition; and mental health promotion (Eren, 1982). It is anticipated that a study aimed at fostering healthy eating habits in children through the use of therapeutic play methods will raise family awareness, facilitate the delivery of effective health education to children, highlight the role of nurses in safeguarding child health, and ultimately improve public health. This study was conducted to determine the effect of the therapeutic play method-applied within the scope of primary health care services in schools-on children's emotional eating behaviors and to foster their belief in their ability to make healthy food choices. Research Hypotheses H1: The mean total scores on the dietary behaviour scale for children in the intervention group are higher than those in the control group. H2: The mean total scores on the emotional eating scale for children in the intervention group are higher than those in the control group. H3: There is a significant relationship between the dietary behaviour scale and the emotional eating scale for children. Variables of the Study Independent variables The independent variables of the study are the children's socio-demographic characteristics (age, gender). On the first day, the children were asked to complete the 'Child and Family Information Form', the 'Eating Behaviour Scale' and the Emotional Eating Scale for Children and Adolescents. A three-week program will be administered to the intervention group by the researchers. A 3-week gamified healthy eating program was implemented for children in the intervention group. In the first week, children used green and red cards to identify whether nutrition-related statements were true or false, followed by explanations of the correct information by the researcher. In the second week, a "Nutrition Heroes" game was conducted. Children matched foods with related nutrients, such as fish with omega-3 and protein, and participated in a group puzzle competition to identify healthy foods. In the third week, activities focused on emotional eating awareness. Children watched a video about emotions, discussed their feelings, and participated interactively in a story about emotional eating. These activities aimed to improve children's healthy eating knowledge and awareness of the relationship between emotions and eating behavior.

Study design The study was conducted as a randomised controlled trial Research Population and Sample Selection The sample consisted of Year 3 and Year 4 pupils attending Alpaslan Primary School in the province of Ankara. Inclusion Criteria Pupils able to read and write in Turkish Pupils in Years 3 and 4 of primary school Children and their families who agreed to take part in the study, Those who do not visit a dietitian Exclusion Criteria Having a diagnosed psychological condition Withdrawal Criteria Those unable to participate fully in the programme Those who did not complete the questionnaires

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Turkey (Türkiye)