Parental involvement and association with adolescents' fruit and vegetable intake at follow-up: Process evaluation results from the multi-component school-based Boost intervention.

Sanne Ellegård Jørgensen,Pernille Due,Rikke Krølner,Thea Suldrup Jørgensen,Anne Kristine Aarestrup

doi:10.1186/s12966-016-0435-1

Abstract

BackgroundBased on the assumption of parental influence on adolescent behavior, multicomponent school-based dietary interventions often include a parental component. The effect of this intervention component is seldom reported and the evidence is inconsistent. We conducted a systematic process evaluation of the parental component and examined whether the leveal of parental involvement in a large multi-component intervention: the Boost study was associated with adolescents’ fruit and vegetable (FV) intake at follow-up.MethodsThe Boost study was targeting FV intake among 1,175 Danish 7th graders (≈13- year-olds) in the school year 2010/11. The study included a school component: free FV in class and curricular activities; a local community component: fact sheets for sports- and youth clubs; and a parental component: presentation of Boost at a parent-school meeting, 6 newsletters to parents, 3 guided student-parent curricular activities, and a student-parent Boost event. Study population: Students whose parent replied to the follow-up survey (n = 347). Data: Questionnaire data from students, parents and teachers at 20 intervention schools. Process evaluation measures: dose delivered, dose received, appreciation and level of parental involvement. Parental involvement was trichotomized into: low/no (0–2 points), medium (3 points) and high (4–6 points). The association between level of parental involvement and self-reported FV intake (24-h recall), was analyzed using multilevel regression analyses.ResultsThe Boost study was presented at a parent-school meeting at all intervention schools. The dose delivered was low to moderate for the three other parental elements. Most parents appreciated the intervention and talked with their child about Boost (83.5 %). High, medium and low parental involvement was found among 30.5 %, 29.6 % and 39.4 % of the students respectively. Parental involvement was highest among women. More men agreed that the parental newsletters provided new information.Students with a medium and high level of parental involvement ate 47.5 and 95.2 g more FV per day compared to students with low level/no parental involvement (p = 0.02).ConclusionsStudents with a high level of parental involvement ate significantly more FV at follow-up compared to students with a low level/no parental involvement. Parental involvement in interventions may improve adolescents’ FV intake if challenges of implementation can be overcome.Trial registration ISRCTN11666034. Registered 06/01/2012. Retrospectively registered.

Highlights

Based on the assumption of parental influence on adolescent behavior, multicomponent school-based dietary interventions often include a parental component
This study demonstrates that involving parents in multicomponent school interventions may improve the fruit and vegetable (FV) intake among adolescents
The process evaluation of the parental component in the Boost study indicates that: 1) parents appreciated the Boost study overall, 2) using existing structures in the school such as parent-school meetings may facilitate successful involvement of parents in interventions, and 3) low delivery of parental intervention components is a major barrier for parental involvement in school-based interventions

Summary

Introduction

Based on the assumption of parental influence on adolescent behavior, multicomponent school-based dietary interventions often include a parental component. The effect of this intervention component is seldom reported and the evidence is inconsistent. We conducted a systematic process evaluation of the parental component and examined whether the leveal of parental involvement in a large multi-component intervention: the Boost study was associated with adolescents’ fruit and vegetable (FV) intake at follow-up. Children and adolescents of parents with low socioeconomic position are more likely to have a poorer diet, characterized by high intake of fats and sugars, and inadequate intake of FV [17, 18, 24, 25]. Fruit and/or vegetable consumption tend to be lower among children from single parent families than among children living with two adults [18]

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