An eBook for Oral Health Literacy© curriculum was used as a brief intervention to help school-aged children use their functional health literacy skills of reading, writing, and speaking to learn about oral health hygiene and the importance of choosing healthy food and beverages for their teeth. The curriculum focused on building functional knowledge about oral health hygiene and nutrition behaviors through a health literacy intervention that highlighted the need for reasoned actions when setting food goals for healthy teeth and making decisions to keep teeth healthy and strong. The aims of the study included: 1) determining what children learned about their teeth from two chapters of the eBook for Oral Health Literacy© curriculum and what they remembered from reading the oral health and nutrition stories; 2) determining whether children liked to read and what they liked about the words and the pictures of the stories, and; 3) determining whether children brushed their teeth in the morning and at night; had any cavities; had teeth or mouth pain; and visited the dentist every six months for a dental checkup. The visual textual narrative helped children to build a vocabulary about oral health when reading and writing about health. Children wrote about words and phrases that they recalled after reading each chapter. Their elaborations exemplified the importance of using a constructivist theoretical framework to elicit children’s functional health knowledge about oral health and nutrition. Chi-square results showed that there was a moderate significant correlation between children who reported brushing their teeth in the morning and having been to the dentist in the past year (p = .021).

PURPOSE: We had three purposes for this study: 1) to introduce 2nd and 3rd grade children to the concepts of breakfast and food groups in the MyPlate nutrition model while using an interactive constructivist approach; 2) to evaluate what foods children ate for breakfast over two days and to assess the visual-textual-lexical representations that they constructed to show their thinking about the MyPlate food model; and 3) to explore functional health literacy and inventive spellings from children who learned about food groups over two class sessions. METHODS: Pre to post student assessments focused on self-reported breakfast eating and ability to represent the MyPlate food model during the learning process. Student thinking about those topics were also elicited by multimodal approaches: oral language (conversations), written language (visual-textual-lexical illustrations), and body language (making nutritious snacks). For the latter, students constructed a snack to eat on both days at school and were encouraged to make the food at home to model nutritious eating behavior. RESULTS: Most children who participated in the lesson ate breakfast either at home or at school. Some students chose to communicate in words and pictures when asked to write about the foods they ate for breakfast. Many students illustrated and labeled food groups by drawing and using inventive spellings about their early understandings of the MyPlate food model. From the first to the second day of instruction, breakfasts with three food groups increased from 3% to 7% but breakfasts with two food groups declined from 55% to 41% due to more children (n = 60) eating breakfasts with only one food group on the second day. CONCLUSIONS: Some of the food items that students ate were not sufficient to produce an adequate nutritional benefit. The constructivist pedagogical approach assisted children with multimodal ways to communicate their understanding, including making two different snacks when planning a breakfast with multiple food groups. Functional health knowledge about a nutritious breakfast made with three food groups should be further aligned with functional health literacy skills of speaking and writing in multimodal ways in order to improve health behaviors. Inventive spellings demonstrated a developmental step in learning a vocabulary in a new domain. Use of written words and pictures reflected a positive way to learn health and nutrition, because children represented their understanding in more than one way. RECOMMENDATIONS: By adding fruit to the breakfasts of children who participated in the lessons, almost one-half of the children would be able to increase their consumption from two food groups to three food groups when consuming an ideal breakfast. Future work should elaborate on the role of interactive health literacy in school and home contexts when children are learning about breakfast eating and food groups. Future integration of the MyPlate food model with the National Health Education Standards can foster new classroom assessments that will support students to practice observable nutrition behaviors that can lead to consistent health habits for personal, family, and school health.