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Increasing children's fruit and vegetable consumption: a peer-modelling and rewards-based intervention

Abstract

Objective: To evaluate a peer-modelling and rewards-based intervention designed to increase children's fruit and vegetable consumption.

Design: Over a 5-month period, children in an experimental and a control school were presented with fruit and vegetables at lunchtime. Children aged 5–7 y also received fruit at snacktime (mid-morning). The intervention was implemented in the experimental school and levels of fruit and vegetable consumption were measured at baseline, intervention and at 4-month follow-up.

Setting: Two inner-city London primary schools.

Subjects: In total, 749 children aged 5–11 y.

Intervention: Over 16 days children watched video adventures featuring heroic peers (the Food Dudes) who enjoy eating fruit and vegetables, and received small rewards for eating these foods themselves. After 16 days there were no videos and the rewards became more intermittent.

Main outcome measures: Consumption was measured (i) at lunchtime using a five-point observation scale; (ii) at snacktime using a weighed measure; (iii) at home using parental recall.

Results: Compared to the control school, lunchtime consumption in the experimental school was substantially higher at intervention and follow-up than baseline (P<0.001), while snacktime consumption was higher at intervention than baseline (P<0.001). The lunchtime data showed particularly large increases among those who initially ate very little. There were also significant increases in fruit and vegetable consumption at home (P<0.05).

Conclusions: The intervention was effective in bringing about substantial increases in children's consumption of fruit and vegetables.

Sponsorship: Horticultural Development Council, Fresh Produce Consortium, ASDA, Co-operative Group, Safeway, Sainsbury, Somerfield, Tesco and Birds Eye Wall's.

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Acknowledgements

The project was supported by the Department of Health, Department for Education and Employment, Department of Environment, Food and Rural Affairs and the Food Standards Agency. We would also like to thank all the school staff, pupils and parents who participated, the education authority for recruiting the schools, and Team Lambeth for supplying fruit and vegetables. We are particularly grateful to Doug Henderson, Colin Harvey, Margaret Charrington, Teresa Wickham and Richard Hutchins for their unfailing support.

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Contributions

Guarantors: CF Lowe, K Tapper and CA Hardman.

Contributors: PJH and CFL were the principal investigators; they devised the intervention, the central experimental design, and provided the theoretical underpinning. They directed the overall programme and contributed to data analysis and interpretation, and to the writing of the paper. KT supervised the data analysis, drafted the paper and contributed to programme development and implementation; data collection, analysis and interpretation; and staff training. CAH, MCJ and JW contributed to programme development and implementation; data collection, analysis and interpretation; and editing of the paper. The measures were designed by PJH, CFL and KT. Chris Whitaker advised on statistical analyses.

Corresponding author

Correspondence to C F Lowe.

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Horne, P., Tapper, K., Lowe, C. et al. Increasing children's fruit and vegetable consumption: a peer-modelling and rewards-based intervention. Eur J Clin Nutr 58, 1649–1660 (2004). https://doi.org/10.1038/sj.ejcn.1602024

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