Increasing fruit and vegetable intake among children: comparing long-term effects of a free distribution and a multicomponent program

• Published in: Health education research 2008-12, Vol.23 (6), p.987-996
• Main Authors: Reinaerts, E., Crutzen, R., Candel, M., De Vries, N. K., De Nooijer, J.
• Format: Article
• Language: English
• Subjects: Behavior Change; Behavior Modification; Biological and medical sciences; Child; Child Health; Child Nutrition Sciences; Children; Classrooms; Comparative Analysis; Consumption; Diet; Dietary Services - methods; Eating Habits; Elementary Education; Elementary School Students; Elementary Schools; Ethnicity; Feeding Behavior; Followup Studies; Fruit; Health Education; Health Education - methods; Health Promotion - methods; Health technology assessment; Healthy food; Humans; Intervention; Interventions; Medical sciences; Miscellaneous; Netherlands; Nutrition; ORIGINAL ARTICLES; Outcome Measures; Parent Participation; Parent School Relationship; Program Effectiveness; Program Evaluation; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; School Health Services; School Size; Schools; Secondary Schools; Sustainability; Teaching Methods; Time on Task; Toxicology; Vegetables
• ISSN: 0268-1153; 1465-3648
• DOI: 10.1093/her/cyn027

The aim of this study was to evaluate and compare the effectiveness of two primary school-based interventions on children’s fruit and vegetable (F&V) consumption on the long term (2 years after the start of the interventions). Six primary schools were recruited and randomly assigned to (i) a daily free distribution program for the whole school or (ii) a multicomponent program consisting of a classroom curriculum and parental involvement (without free F&V), and six schools served as controls. Follow-up measurements were conducted at the end of the intervention (Follow-up I) and 1 year later (Follow-up II). Random coefficient analyses for longitudinal data showed that the effects of both interventions did not differ between the two follow-up measurements. The results showed similar effects for the free distribution program and the multicomponent program in increasing children’s fruit consumption over time (respectively, 7.2 and 15.2 g day−1). The distribution program also increased children’s vegetable consumption over time (3.25 g day−1), even after repeating the analyses using a pessimistic scenario. Despite the large dropout and its consequences for generalizability of our results, the distribution program is considered as the preferred intervention of the two, and implementation on a larger scale should be investigated.