Children in the United States do not consume enough fruits and vegetables. 1 One potential approach to change health behaviors such as fruit and vegetable consumption is to change the decision environment to make certain behavior more likely without altering incentives. 2,3 For example, placing pictures of fruits and vegetables on lunch trays is associated with an increase in fruit and vegetable consumption among school-aged children. 4 This potentially powerful intervention, however, has not been explored among children in early childhood (3-8 years of age), and dietary behavior during this period can be associated with lifelong dietary practices. 5 This study addresses this gap and tests the association between use of plates with fruit and vegetable pictures and consumption of fruits and vegetables among preschool children between 3 and 5 years of age.
BACKGROUND: This paper presents the effectiveness of a multi-component elementary school-based nutrition education program, the Integrated Nutrition Education Program (INEP), which has been in existence for over 25 years. INEP includes components to address multiple layers of influence: hands-on nutrition education lessons in the classroom (student-level), parent education, and outreach (home-level), and facilitation of a planning process to implement policy, system, and environmental (PSE) school changes (school-level). METHODS: Three evaluation tools assessed the effectiveness of the program: (1) classroom plate waste measurement in intervention (N = 149 students) and demographically-matched comparison schools (N = 131 students), (2) pre/post classroom surveys completed by students who participated in INEP (N = 204), and (3) PSE change data from participating schools (N = 47 schools).
RESULTS:Students who participated in the nutrition education program were more likely to consume vegetable-based recipes and vegetables included in classroom nutrition lessons compared to students in comparison classrooms (Chinese vegetable salad: p < .001; couscous salad: p < .001; snap peas: p = .001). Classroom survey analyses showed improvements in student self-efficacy (p < .001), preference for vegetables (p = .005), and knowledge (p < .001). In addition, through a wellness planning process, schools implemented an average of 3.7 PSE changes per school.
CONCLUSIONS:Results demonstrate a multi-component school-based nutrition education program improves student nutrition-related outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.