Efficiency of an intervention study on nursing students’ knowledge and practices regarding nutrition and dietary habits

ABSTRACT

Poor eating habits and hazardous weight-control measures are prevalent among university students. Hence, practical and efficient intervention programs are necessary to enhance nutritional awareness and promote healthy dietary practices encompassing food choices and diet quality. This study aims to evaluate the efficiency of an intervention study on nursing students’ knowledge and practices regarding nutrition and dietary habits. A quasi-experimental research design with pre-post phases was used to study 250 nursing students at the College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, in the Kingdom of Saudi Arabia. The sample was non-randomized and taken from March 2023 until the end of May of the same year. The closed-ended questionnaire focused on participant demographics, knowledge, and practices relating to nutrition and eating habits. The survey was divided into three main sections. Technical terms were consistently defined throughout the questionnaire, and the language used was clear and objective. The research adhered to conventional academic structure and formatting, following the guidelines of the relevant style manual. Grammatical correctness and precise word choice were ensured, and filler words were avoided. The participants in the study displayed an increase in knowledge scores from 33.7 ± 4.6 in the pre-test to 52.6 ± 7.2 in the post-test. Moreover, prior to program implementation, their overall nutrition practice scores stood at 64 ± 9.5, but after the program, the score had risen to 107.7 ± 4.22. A significant difference in the total knowledge and practice scores was identified between the pre- and post-test phases, with an a p-value of 0.001. The nursing students’ scores for both knowledge and practical application of nutrition and eating habits showed a significant increase following the implementation of the program. Therefore, it is imperative to introduce well-structured training programs on nutrition and promote healthy diet habits for all medical faculties, paramedics, and applied health institutions across Saudi Arabia.

KEYWORDS:

• Dietary habits
• educational program
• knowledge
• nursing students
• practices

1. Introduction

Chronic diseases such as obesity, diabetes, cardiovascular disease, and a variety of malignancies are greatly facilitated by unhealthy eating habits and poor diet quality [1]. Nutritional issues have therefore received more attention in the last 10 years. 7.9 million deaths and 187.7 million disability-adjusted life-years lost in 2019 have been attributed to diet-related risk factors [2]. Non-communicable diseases (NCDs) continued to account for the largest proportion of all deaths in 2019 (74.4%) and grew by 20.5% between 2009 and 2019 [3].

The World Health Organization has developed numerous strategies to combat NCDs, but a study that included 194 countries found that only 33.8% of the 19 strategies proposed for 2020 have been implemented. Therefore, it is critical to support strategies that address both the environment and healthy diets to prevent NCDs and the morbidities caused by these diseases [4]. Improving society’s knowledge about nutrition and its importance is one of the most important tactics [5].

Nutrition knowledge plays a key role in the development of healthy eating habits, which in turn contribute to maintaining a healthy or appropriate body weight [6]. There is a clear link between nutrition knowledge and eating habits that ensures the intake of important nutrients throughout the life cycle [7]. Formal or informal nutrition education can improve knowledge and have a positive impact on food intake [8].

Nutrition is also an important aspect of life. The role of nutrition is also evident in routine health care, illustrating the direct relationship between nutrition and health. Over-nutrition and under-nutrition are common consequences of poor nutrition, and both are risk factors for other chronic diseases [9]. Non-communicable diseases, including diseases and disorders related to obesity, can be reduced and controlled through good nutrition education. For example, diabetes can be effectively managed through nutrition education by learning about carbohydrates and proper daily amounts [10]. Hypertension can also be controlled or maintained by educating a patient about the DASH diet (Dietary Approaches to Stop Hypertension). In addition, the Mediterranean Diet has shown improvements in or prevention of erectile dysfunction, depression, breast and ovarian cancer, obesity, diabetes, and asthma [11].

All students, especially nursing candidates, regardless of age, must follow the necessary dietary and physical activity guidelines to improve their overall health and academic performance [12]. In addition, it is critical for nursing students to develop and maintain good nutrition and lifestyle habits throughout their academic careers, as these behaviors are likely to persist into adulthood or maturity and have a significant impact on their long-term health [13]. Nutrition education, according to experts, promotes general nutrition knowledge and encourages students to engage in activities. This shows that awareness of healthy eating is growing and is a great strategy for changing eating behaviors [14]. As students gain new experiences and transition from adolescence to adulthood, they are at a crucial developmental stage that is particularly important for building health-related behaviors as they gain more independence and personal freedom [^15].

In addition, students, especially in nursing schools, are usually very busy and must manage and balance a variety of activities. Many students indulge in unhealthy eating habits during this critical time, skipping breakfast and meals, dieting, consuming fast food, and also reducing their physical activities [16]. In addition, students usually leave their parents’ home, spend a lot of time studying, occasionally have a part-time job, and do not pay much attention to the quantity and quality of their meals [15].

Furthermore, students’ diets include high-energy foods such as candy bars, cookies, and crackers, as well as fried or fast foods, and they often turn to convenience foods that take only a few minutes to prepare. A heavy workload due to academic obligations also often affects students’ eating habits [17]. In addition, students do not consume the required amounts of vegetables, fruits, and fiber and increase their intake of nutrients such as fats, sodium, and sugars. As a result, they develop unhealthy eating habits and exhibit undesirable behaviors [11].

Future non-communicable diseases are also a direct result of these unhealthy eating habits. To choose a balanced and nutritious diet, nutrition education is critical. This information could be instrumental in reducing the burden of non-communicable diseases [12]. Numerous studies have been conducted to determine the level of nutrition awareness among schoolchildren worldwide [17]. BMI is an important indicator of the prevalence of obesity in the general population. However, in other cases, it may overestimate or underestimate obesity [14].

Moreover, due to the country’s recent economic boom, young people in Saudi Arabia lead sedentary lifestyles and eat high-fat, low-fiber diets. Riyadh is the largest metropolitan area in Saudi Arabia and the Gulf States and has experienced tremendous economic and demographic growth, especially in the last decades of the last century. Riyadh’s social diversity, demographics, and economic characteristics contribute to its distinctive identity. In addition, the city hosts all diplomatic missions abroad and government agencies [8]. Therefore, the present study was conducted to evaluate the effectiveness of an intervention study on nursing students’ knowledge and practices regarding nutrition and dietary habits at Prince Sattam University in Saudi Arabia.

2. The aim of the study

Evaluate the efficiency of an intervention study on nursing students’ knowledge and practices regarding nutrition and dietary habits.

3. Methods

3.1. Setting

The study was conducted in the Nursing Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia.

3.1.1. Study design

The study used a quasi-experimental pre-post design without a control group.

3.1.2. Subjects and sample size

The sample size was determined using the Raosoft calculator. The researcher calculated the sample size using current statistics and found that there are 19,155 nursing students in Saudi Arabia. Due to the lack of previous research, a conservative estimate of 50% was derived for Saudi nursing students’ knowledge and practices regarding dietary habits. To achieve a 95% confidence interval and a 5% margin of error, 384 samples were needed. However, in the end, the study included 250 samples. Owing to the challenges encountered while attempting to conduct a random assignment of participants to groups or locations and the search for a fitting control group, the randomization process could not be completed. Additionally, it was difficult to randomly assign students to the selected class, as there was no foreseeable way to prevent interactions between the control and intervention groups. Thus, the study employed a non-random selection method known as ‘purposive sampling’ to recruit participants, considering their availability and willingness to participate.

The study enrolled Saudi undergraduate nursing students aged 18 to 25. They were physically and mentally healthy, and they are currently enrolled in a nursing program at the College of Applied Medical Sciences. Participants were contacted through email, social media, and brochures distributed to relevant departments and student organizations. Fluency in English and informed consent were prerequisites for participation.

4. Tools of data collection

4.1. One tool was used in this study

4.1.1. A structured interview questionnaire

It was developed by the researcher to collect the data after reviewing relevant literature [1, 2, 3, 4, 10]. This tool was comprised of three parts:

4.1.2. The first section

The first section contains queries pertaining to socio-demographic features. These questions are classified into subcategories of student-related queries (e.g., age, gender, and birth order) and queries pertaining to the students’ households (e.g., parent’s age, educational level, and family size).

4.1.3. The second section

The second section comprises two types of questions on students’ nutrition knowledge: six multiple-choice questions and eleven open-ended questions that prompt students to detail their understanding of the primary food groups, including low- and high-calorie foods, calcium- and vitamin D-rich foods, iron- and fiber-rich foods, and potential health issues from consuming fast food and high-fat diets. For all 17 questions examining the participants’ comprehension of the nutritional status of the students, a score of either ‘Yes,’ ‘No,’ or ‘I don’t know’ was recorded. For all 17 questions examining the participants’ comprehension of the nutritional status of the students, a score of either ‘Yes,’ ‘No,’ or ‘I don’t know’ was recorded. For all 17 questions examining the participants’ comprehension of the nutritional status of the students, a score of either ‘Yes,’ ‘No,’ or ‘I don’t know’ was recorded. One point was awarded for reliable responses and zero points for unreliable ones. From the total of these scores, a score between 0 and 17 was calculated per participant. Then, a percentage between 0% and 100% was calculated based on the grade. After dividing the participant’s total number of accurate responses by 17, the percentages were multiplied by 100. The mean and SD were used to calculate the score for the knowledge gap.

4.1.4. The third section

It involves 30 queries on dietary habits and practices and is responded to with the options ‘always,’ ‘sometimes,’ or ‘never.’ Ten questions ask students to recall how often they consumed fruits, vegetables, fats, sugar, etc. in the past month, along with queries regarding food intake frequencies such as cereals, vegetables, fruits, fats, etc. For each of these ten questions, participants must select one of three responses: ‘Yes,’ ‘No,’ or ‘I don’t know.’ A mark of one point was awarded for correct answers to each of the ten questions measuring the participants’ understanding of the students’ nutritional situation, whereas no points were provided for incorrect answers. The scores were aggregated for each participant to establish a mark ranging from 0 to 10, and this generated a percentage ranging from 0% to 100%. The total number of correct answers given by the participant was divided by 10 to calculate the percentage, which was then multiplied by 100. The difference in the knowledge score was determined using the mean and standard deviation.

4.2. Reliability and validity of the questionnaire

To develop the questionnaire, the authors of this study analyzed all available previously published research concerning ‘nutrition problem epidemiology’ and ‘nutrition knowledge and practices’. The authors searched multiple databases, including CDC, WHO, PubMed, EMBASE, Cochrane Library, and Google Scholar, for published research up until 20 February 2023. To evaluate the content validity of the questionnaire, the translation-back-translation method was employed. To ensure uniformity and reduce potential bias, an a bilingual expert translated the survey from English into Arabic, and the accuracy of the data was verified by seven professors who have expertise in public health and related fields. Additionally, the survey was piloted with 25 nursing students (whose data was not included in the final analysis) to confirm the clarity of the questions. The questionnaire’s internal consistency was assessed via Cronbach’s alpha, which produced satisfactory levels of reliability (Cronbach’s alpha = 0.88).

5. Procedure

The study was approved by the Standing Committee on Bioethics Research (SCBR-069-2023) after obtaining informed consent from the participants. The researchers initially met the participants outside of their regular classes held in conventional classrooms. The data collection lasted for three months, starting in March and May 2023. The study encompassed four stages, which included assessment, program formulation, implementation, and evaluation.

During the assessment phase, the researchers discussed the study’s objectives and the different elements of the data collection questionnaire with the students in a neutral manner. The instructional program was developed during the program implementation phase by utilizing the findings from the initial evaluation as well as previous research studies. The pamphlet covered all aspects concerning the state of nutrition in a simple yet effective manner, with colorful illustrations and written in Arabic for ease of reading. It followed an a logical structure, ensuring causal connections between statements, and technical terms were explained when first introduced. The text used clear, objective language that avoided biased, figurative, or ornamental language, with consistent use of technical terms. The formatting adhered to academic standards while maintaining a balanced, objective tone without filler words or subjective evaluations. Grammatical correctness was prioritized throughout.

The program was composed of four sessions, each lasting approximately one hour. In the initial session, the researcher furnished an outline of the program, which included its components, objectives, significance, methods of implementation, tools utilized, and how to put them into practice. The second session provided a concise introduction to the importance of sound nutrition for human well-being, outlining core concepts and defining balanced, nutritious meals and the characteristics that compose them, as well as discussing healthy eating habits and cautioning against the detrimental impact that fast and junk food can have on human health. During the third session, various health issues and malnutrition-related problems, such as obesity, kwashiorkor, marasmus, and anemia, were examined in detail. The fourth session covered techniques for managing and preventing health problems related to nutrition.

A total of 10 groups, consisting of 25 students each, participated in the program. The program was conducted over a period of 10 weeks, with each group receiving four sessions per week, each lasting an hour. In total, participants received 40 hours of training (10 groups x 4 hours), and the researcher emphasized the significance of consistent attendance and active involvement. In each session, various teaching and learning methods were employed, such as interactive lectures, group discussions, demonstrations and re-demonstrations, instructional media involving data presentations and laboratory models, and printed handouts.

During the evaluation stage, we assessed whether the study’s objectives were met through the use of pre- and post-nutrition instructional guidelines. The primary aim of this phase was to evaluate the outcomes of the guidelines’ intervention. The phase concluded exactly one month after the program’s launch.

6. Data analysis

The Statistical Package for Social Sciences (SPSS) version 26.0 (IBM Corp.; Armonk, NY, USA) was used to conduct the data analysis. Descriptive statistics such as frequencies, percentages, means, and standard deviations were utilized to summarize the data. To assess the normality of continuous data, the Shapiro-Wilk test was performed and indicated that the data followed a distributed normality. The relevant items’ answers were summed up to calculate knowledge and practice scores for the respondents. The means and standard deviations of these scores were presented. The independent t-test or one-way analysis of variance (ANOVA) was employed to compare the knowledge and practice assessments of different groups.

A multivariate logistic regression analysis was conducted to identify predictors of acceptable nutrition knowledge and practice among nursing students. The dependent variables were knowledge and practice scores, while the independent variables included parents’ educational background, gender, age, academic year, history of chicken pox, and academic performance. Odds ratios (ORs) with 95% confidence intervals (CIs) were computed to determine the magnitude and direction of the association.

7. Results

Table 1 indicates that 64% of the examined sample were under 20 years of age, with a mean age of 21.8 ± 1.1. The table also showed that 60% of the sample was female, and 53.2% of them were in their third academic year. Regarding the participants’ birth order, 66% of them declared being 2nd born or later, with a mean ± SD of 1.9 ± 1.1. Additionally, 43.6% of the participants reported achieving a GPA score ranging from 2.5 to 3.74.

Table 1. Distribution of the studied sample according to Socio-demographic characteristics (n = 250).

	Frequency (n)	Percent (%)
Age:
<20	160	64.0
20+	90	36.0
Range	20.0–24.0
Mean± SD	21.8 ± 1.1
Median	21.00
Sex:
Male	100	40.0
Female	150	60.0
Educational year:
2^nd year	55	22.0
3^rd year	133	53.2
4^th year	62	24.8
Birth order:
1	85	34.0
2+	165	66.0
Range	1.0–11.0
Mean± SD	1.9 ± 1.1
Median	2.00
Last GPA
<2.5	60	24.0
2.5–3.74	109	43.6
≥3.75	81	32.4

GPA: Grade Point Average.

Table 2 demonstrates that 42% of the mothers sampled were aged between 40 and 60 years old, with a Mean± SD of 42.1 ± 6.0. Additionally, the results show that 52.8% of these mothers had basic or intermediate levels of education, and 72% of them did not report any higher qualifications. Furthermore, of the sampled fathers, it was observed that 41.2% were aged less than 45, with a Mean± SD of 45.1 ± 5.5. Additionally, the table presented data indicating that 76% of the analyzed sample’s fathers possessed basic to intermediate levels of education, and 84.4% of them were employed.

Table 2. Distribution of the studied sample according to their parents’ characteristics (n = 250).

	Frequency (n)	Percent (%)
Mother age:
<40	105	42.0
40-	85	34.0
45+	60	24.0
Range	31.0–58.0
Mean± SD	42.1 ± 6.0
Median	44.00
Mother education:
Illiterate	8	3.2
Basic/Intermediate	132	52.8
University	110	44.0
Mother job:
Not working	180	72.0
Working	70	28.0
Father age:
<45	103	41.2
45-	78	31.2
50+	69	27.6
Range	35.0–62.0
Mean± SD	45.1 ± 5.5
Median	45.00
Father education:
Illiterate	10	4.0
Basic/Intermediate	190	76.0
University	50	20.0
Father job:
Not working	39	15.6
Working	211	84.4

According to the data presented in Figure 1, the main source of knowledge regarding nutrition and eating habits for the majority of students (64%) is social media, followed by TV and radio (18%), family and friends (8%), health campaigns (7%), and healthcare providers (3%). This highlights the critical need for reliable information sources and the significant impact that social media wields in respect of information sharing.

Figure 1. Distribution of the studied sample according to sources of information about dietary habits.

Table 3 shows a considerable increase in the total knowledge score on nutrition and food habits from 33.7 ± 4.6 before the intervention to 52.7 ± 7.2 after it. According to statistical analysis, there was a significant difference in the investigated sample’s knowledge of nutrition and eating habits before and after the program’s implementation (p 0.001).

Table 3. Distribution of the studied sample according to their total dietary habits knowledge score (n = 250).

Parameter	Pre	Post	t-Test	P
Balanced meal	18.4 ± 6.6	29.0 ± 33.4	7.36	≤0.001
Nutritional problems	7.8 ± 1.8	12.8 ± 1.4	47.96	≤0.001
Proteins	87.5 ± 6.5	138.3 ± 5.9	103.41	≤0.001
Carbohydrates/calories	36.1 ± 3.4	53.3 ± 0.8	93.57	≤0.001
Fat	45.7 ± 6.2	65.0 ± 2.9	115.87	≤0.001
Vitamins/minerals	7.0 ± 1.4	9.4 ± 1.6	2.68	≤0.001
Fruits/vegetables	48.6 ± 6.2	59.9 ± 3.2	115.89	≤0.001
Total Knowledge	4.6 ± 33.7	7.2 ± 52.6	69.7	≤0.001

Table 4 displays that the practice scores were 64 ± 9.5 prior to program implementation and 107 ± 7.4.2 following program completion. The results indicate a great statistical significance (p 0.001) in the variation of practices among the study sample towards nutrition and dietary habits.

Table 4. Distribution of the studied sample according to their total reported nutritional practice (n = 250).

Parameters	Pre	Post	t-Test	P
Total dietary habits	48.6 ± 7.4	87.5 ± 6.5	192	≤0.001
Total eating habits	78.1 ± 11.6	116 ± 1.59	118	≤0.001
Overall nutritional practices:	64 ± 9.5	107.7 ± 4.22	70.8	≤0.001

Table 5 shows the variability in the discrepancies between the pre-intervention and post-intervention knowledge and practice scores among 250 participants with different demographic factors. The mean difference in knowledge scores was 28.68 ± 9.56, and the mean difference in attitude scores was 19.48 ± 5.49 overall. The findings indicate a significant correlation between age, gender, educational attainment, and previous GPA with variations in scores for knowledge and practice. Individuals under 20 years of age exhibited a markedly lower mean difference in knowledge and practice scores compared to those aged 20 and above.

Table 5. Variation in differences of (post minus pre) knowledge and reported practices score with different demographic factors.

		The difference in Knowledge score		The difference in practice score
	N	Mean ± SD	Significance	Mean ± SD	Significance
Overall	250	28.68 ± 9.56		19.48 ± 5.49
Age (years):			t = 43.56;		t = 24.19;
<20	160	18.20 ± 5.72A;C	P ≤ 0.001	14.10 ± 5.69A;C	P ≤ 0.001
20+	90	21.64 ± 8.02B;C		15.17 ± 7.11B;C
Sex:			t = 8.89.56;		t = 4.8;
Male	100	19.39 ± 4.58	P ≤ 0.001	13.45 ± 6.08	P ≤ 0.001
Female	150	20.81 ± 8.02
				15.05 ± 6.60
Educational Year			F = 51.70 P ≤ 0.001		F = 13.83 P ≤ 0.001
2nd year	55	18.90 ± 6.76A; B		13.93 ± 6.22B
3rd year	133	21.0 ± 4.45 A; C		12.66 ± 7.88 C
				16.51 ± 6.49 B; C
4th year	62	24.50 ± 8.77 B; C
Last GPA			F = 129.91		F = 15.07
<2.5	60	19.30 ± 5.50C	P ≤ 0.001	13.75 ± 6.62C	P ≤ 0.001
2.5–3.74	109	31.61 ± 6.83B; C		18.33 ± 7.47B; C
≥3.75	81	54.58 ± 9.65 B; C		32.79 ± 8.58A; C

Significant differences between each group in A; B; and C were found using Bonferroni posthoc multiple comparisons.

Females achieved significantly higher practice scores compared to males. Additionally, participants in their fourth year of study demonstrated significantly higher knowledge scores when compared to those in their second or third year. Finally, individuals with a higher last GPA achieved significantly better scores in both knowledge and practice when compared to those with a lower last GPA. The use of Bonferroni post hoc multiple comparisons to establish significant differences between each group in A, B and C, suggests that the findings are reliable and robust. These outcomes underline the significance of demographic factors when appraising the effectiveness of interventions designed to enhance knowledge and practices related to a particular health matter like nutrition and dietary habits.

Table 6 presents the findings from the multiple linear regression model for the knowledge score that best fits the data. Education and intervention were two of the predicted factors in the model. The results demonstrate that the intervention variable significantly predicted the knowledge score (p < 0.001) with a standardized coefficient of 0.32, indicating that the intervention improved the knowledge score. However, it was discovered that education had a slightly negative effect on knowledge scores, with a standardized coefficient of −0.16 and a p-value of 0.054. The ANOVA analysis displayed the overall significance (p0.001) of the model, indicating that the model matched the data effectively. Moreover, the ANOVA results demonstrated that the model was statistically significant, with an F-value of 109.76 and a p-value below 0.001, suggesting an exceptional fit of the model to the data.

Table 6. Best fitting multiple linear regression model for the knowledge score (n = 250).

Variables	Unstandardized Coefficients		Standardized Coefficients	t-test	p-value	95% Confidence Interval for B
	B	Std. Error				Lower	Upper
Constant	−21.28	7.51		−6.479	<0.001	−42.58	−18.00
Intervention	49.77	3.62	0.77	4.616	<0.001	34.34	85.09
Education	5.46	1.00	0.13	9.425	0.017	0.45	8.41

r-square = 0.61.

Model ANOVA: F = 109.76; p < 0.001.

The results of the multiple linear regression model for the practice score, which best fits the data, are presented in Table 7. Education and intervention are among the anticipated variables in the model. The analysis indicates that the intervention variable significantly predicts the practice score, evidenced by its standard coefficient of 0.32 and high statistical significance (p < 0.001). Therefore, the intervention led to a notable improvement in the practice score. However, it was found that schooling had no statistically significant negative effects on practice scores, with a normalized coefficient of −0.16 and a p-value of 0.054. The ANOVA model highlights the overall significance of the model (p < 0.001), indicating that the model as a whole provided a good fit to the data.

Table 7. Best fitting multiple linear regression model for practice score (n = 250).

	Unstandardized Coefficients					95% Confidence Interval for B
Variables	B	Std. Error	Standardized Coefficients	t-test	p-value	Lower	Upper
Constant	50.06	5.46		27.340	<0.001	53.20	76.90
Intervention	18.71	3.18	0.32	3.991	<0.001	4.40	18.03
Education	−11.16	7.70	−0.16	−1.947	0.054	−18.46	0.19

r-square=0.61.

Model ANOVA: F=109.76; p<0.001.

8. Discussion

College students transition into adulthood by gaining new experiences, personal freedom, and a stronger sense of identity. However, during this period, there is a tendency to skip meals, engage in unhealthy dieting practices, and consume fast food frequently, resulting in little to no exercise. Poor dietary and exercise habits can increase the risk of developing osteoporosis, obesity, hyperlipidemia, diabetes, and cancer later in life [18]. Therefore, this study aimed to investigate the impact of an educational intervention program on nursing students’ understanding and adherence to dietary patterns and nutrition practices.

The study findings indicated that after the implementation of the health education programme, the overall knowledge and practice scores of the sample significantly improved. Moreover, there was a highly statistically significant variation in the sample’s understanding of nutrition and eating habits. A multiple linear regression analysis further demonstrated the influence of education level and intervention in determining knowledge scores.

The study sample’s young age and above-average percentage of parents without college degrees could explain their lack of knowledge regarding nutrition and eating habits. Social media was the main source of information about nutrition for most participants, however, it can propagate misconceptions and false information about dietary patterns. Their failure to fulfil ward duties, disinterest in attending seminars or lectures, or unwillingness to educate themselves on nutrition and eating habits may contribute to their inadequacy.

The research by Alzaben et al. [4] confirmed that the nutrition awareness program augmented pupils’ nutritional knowledge but did not significantly influence their dietary habits. In the future, nutritional education initiatives should allocate separate programmes for staff and students, focusing on one group at a time. Furthermore, Bashatah [19] concluded that implementing educational interventions targeting food intake and physical activity promotion in nursing colleges could enhance students’ nutritional knowledge and habits.

Lua and Wan Putri Elena [20] stated that the interventions resulted in significant changes to the eating behaviours and perspectives of college students. In order to ensure high-quality research in this field, it is important to address the methodological issues that have been identified. Additionally, Xia et al. [21] found that following the intervention, there was a significant increase in the health professional students’ understanding of nutritional counselling and their confidence when conducting nutritional counselling conversations with patients. As a result, they were able to simulate more such conversations than before.

Similarly, Riley, Haggard-Duff and Long [22]concluded that “research suggests that nursing and healthcare curricula currently lack the ability to improve students’ knowledge of healthy dietary habits, and there is a specific lack of training in food insecurity screening, assessment and referral to resources.” Additionally, research shows the advantages of offering online courses created with validated models and frameworks. The involvement of inter-professional experts, a curriculum innovation model, and pertinent learning resources and units can prove advantageous in instructing nursing learners about the accurate identification, management, and effects of food insecurity in academic establishments.

Additionally, Nash, et al [23] have revealed that students studying to become nurse practitioners and dentists could benefit from including an inter-professional education program in their health professions curriculum. When working with students from different academic programs, it is essential to consider and address logistical concerns. Also, Kim [24]demonstrated the usefulness of a short-term nutritional education program for nursing students, which should be implemented for providing nutrition education to clients and healthcare professionals. Additionally, Mancin et al. [25] identified the efficacy of nutrition-focused and active teaching methodologies in improving the understanding of nutrition among undergraduate nursing students. Similar strategies should also be adopted for postgraduate education.

Furthermore, the findings suggest that education level is a significant predictor of knowledge scores, which is consistent with prior research emphasizing the vital role of education in enhancing knowledge and awareness regarding nutrition and dietary habits [26]. The study found a positive correlation between higher knowledge scores and higher education levels, indicating the potential importance of education in promoting understanding and awareness of nutrition and dietary practices. The findings of the study align with previous research which has indicated that a higher level of education predicts greater understanding of healthy nutrition and dietary habits (Egg et al. [26].

On the contrary, Buxton and Davies [27] found no statistically significant differences in nutrition knowledge levels across age groups, gender, work experience, or educational background of respondents (p < 0.05). These findings corroborate with other studies which suggest a need for more nutrition training among nurses. The implications of these results are important for nursing education curriculum planning at the undergraduate level within universities.

9. Conclusion and recommendation

Overall, the successful execution of the instructional program resulted in the achievement of all goals and objectives relating to the participants’ knowledge and behaviours. Additionally, the intervention yielded highly significant statistical improvements. Overall, the successful execution of the instructional program resulted in the achievement of all goals and objectives relating to the participants’ knowledge and behaviours. The initial study participants exhibited a lack of knowledge and expertise. However, the implementation of the educational program led to noticeable enhancements in both domains. Overall, the successful execution of the instructional program resulted in the achievement of all goals and objectives relating to the participants’ knowledge and behaviours. Overall, the successful execution of the instructional program resulted in the achievement of all goals and objectives relating to the participants’ knowledge and behaviours. It is crucial to receive appropriate training in this field and sustained, in-depth guidance on any prospective dietary concerns. The appraisal of information is paramount, particularly when research demonstrates a substantial escalation in related and specialized expertise, similar to prior nutritional conditions such as obesity and anaemia.

The study’s findings carry considerable weight for healthcare providers and legislators endeavouring to promote healthy eating and nutritional practices. These programs can be instrumental in heightening public awareness and adherence thanks to their potent impact on both understanding and conduct pertaining to eating habits. The absence of a noteworthy correlation between educational level and practice scores indicates that additional interventions may be necessary to improve dietary habits and related nutritional issues. Subsequent investigations should examine the effectiveness of multiple intervention programmes and their long-term impact on societal attitudes towards dieting. Overall, this research presents findings for establishing practical methods that could effectively promote awareness of nutrition and dietary practices, ultimately preventing and managing under- and over-nutrition, and addressing other pertinent nutrition-related concerns.

10. Limitation

The study has some limitations that must be acknowledged. Firstly, it was carried out only in a single educational institute, which may restrict the application of the findings to other settings. Secondly, the study relied on data that was self-reported, which may have been influenced by social desirability bias. Lastly, the study failed to evaluate the influence of other factors, for example cultural or religious beliefs, on knowledge and practices related to dietary habits. Not applicable (text already adheres to the principles.

Acknowledgments

The authors extend their appreciation to the Deputyship for Research & Innovations, Ministry of Education in Saudi Arabia for funding this research work through the project number (IF2/PSAU/2022/03/22113).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19932820.2023.2281121

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The authors reported that this research project was funded by the Deputyship for Research & Innovation, Ministry of Education in Saudi Arabia.