Abstract
BackgroundBy 3 years of age, many children have developed a dislike for certain foods, particularly vegetables. Seventy-five percent of young children consume less than the recommended levels for vegetables. The objective of this randomized feasibility intervention was to demonstrate the impact of an innovative approach to increase consumption of vegetable dishes by minority preschool children attending Head Start. The specific aims included the collection of data to assess feasibility and efficacy of the intervention.MethodsBoth qualitative and quantitative assessments were conducted. Qualitative data was used for development of the intervention and for program feedback at post assessments. Two hundred fifty-three preschool children (49% boys; 66% Hispanics and 34% African-Americans; mean age 4.4 years) were randomized either to the intervention (n = 128) or the control group (n = 125). The teacher/parent intervention group showed the children videotaped (DVD) puppet shows. Based on the theoretical framework “transportation into a narrative world”, three professionally developed characters, unique storylines and an engaging, repetitious song were incorporated in four 20-min DVD puppet shows. Prior to lunch each show was shown for five consecutive days in school and a minimum of once in the home. Digital photography was used in school to assess consumption of vegetable dishes at the lunch meal (quantitative assessment). At home parents were asked to complete the booklet questions corresponding to each DVD; questions could be answered correctly only if parents watched the DVD with their child. A multilevel mixed-effect model was used to analyze the data, adjusting for age, gender, and ethnicity.ResultsChildren in the intervention group significantly (p < 0.0001) increased consumption of vegetable dishes from baseline to follow-up compared to no change in the control group. At follow-up, the intervention group continued to have significantly (p = 0.022) higher intake of vegetable dishes compared to the control group. Sixty percent of the mothers completed the booklet’s questions with 76 to 98% correct responses.ConclusionUsing theory-based motivational theater with multiple exposures may be an effective behavioral intervention to increase consumption of vegetable dishes by preschool children that can be easily disseminated to a large sample.Trial RegistrationClinicalTrials.gov; Identifier: NCT02216968
Highlights
By 3 years of age, many children have developed a dislike for certain foods, vegetables
There were no significant differences in demographic characteristics between the control and intervention groups
0.0001) increased consumption of vegetable dishes from baseline to follow-up compared to no change in the control group
Summary
By 3 years of age, many children have developed a dislike for certain foods, vegetables. Seventy-five percent of young children consume less than the recommended levels for vegetables. The objective of this randomized feasibility intervention was to demonstrate the impact of an innovative approach to increase consumption of vegetable dishes by minority preschool children attending Head Start. This research focused on increasing consumption of vegetable dishes in two low-income minority groups, African-American (AA) and Hispanic-American (HA), that have disproportionately higher risk for developing obesity [26, 27] and cancers [28] later in life. Since children’s food preferences and practices are initiated early in life (e.g. 2- to 5-year-olds) [29,30,31,32,33,34], early dietary intervention programs will have immediate nutritional benefit for young children, and should reduce chronic disease risk when these learned habits are carried into the adult years [35,36,37]
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