HIGH FIVE PLUS

摘要：大约75%的美国成年人和儿童没有按照建议每天摄入5份水果和蔬菜。我们最初的高中五年级项目评估了以学校为基础的干预，包括课程，食堂和四年级学生的家庭成分，在1年的随访中刺激儿童自我报告的水果和蔬菜摄入量每天增加1.58份。在2年的随访中每天服用87份。研究人员假设，加强家庭干预与学校干预相结合，将进一步增加水果和蔬菜的摄入量，超过原来的高中五年级计划所达到的水平。他们的具体目的是：测试强化家庭干预对水果和蔬菜摄入量的影响；以复制高5计划的效果，并通过直接的食堂观察和家长观察来验证孩子们自我报告的摄入量。3个地区的小学（n=33）提供了一个双种族，广泛的社会经济（SES）样本（n=2253）的四年级学生，将根据种族和社会经济状况被封锁在地区内，并随机分配到强化家庭干预组，原始干预组或对照组。结果将在基线和1年至2年的随访后进行评估，并采用我们最初的高5项目的标准化措施。在增强的家庭干预中，基于社会认知理论的行为改变技术将与“认知地图”相结合，“认知地图”基于父母使用名义团体技术定义的问题。调查人员的初步研究确定了三个维度：水果和蔬菜消费的实际方面，食品准备者的控制感和促进者取向。在扩大个体家庭以确认“认知地图”之后，我们将开发工具来评估单个家庭在这些方面的状况，开发以家庭为基础的干预措施来针对这些具体问题，并评估家庭的变化。加强家庭干预试点的成功进行表明，我们将实现高参与率。针对家庭特定问题量身定制的以家庭为基础的干预与有效的以学校为基础的计划相结合，可以实现我们长期改善儿童饮食以预防癌症的总体目标。

ABSTRACT=Approximately 75 percent of U.S. adults and children do not consume the recommended 5 servings/day of fruits and vegetables. Our original High 5 program evaluated a school-based intervention with curriculum, cafeteria and family components for 4th graders that stimulated self-reported fruit and vegetable intake in children by 1.58 servings /day at 1 year follow-up and .87 servings/day at 2 year follow-up. The investigators hypothesize that an enhanced family intervention combined with the school-based intervention will further increase fruit and vegetable intake above that achieved by the original High 5 program. Their specific aims are to: test the effect on fruit and vegetable intake of the enhanced family intervention; to replicate the efficacy of the High 5 program and to validate with direct cafeteria observation and parent observation the self-reported intakes in the children. Elementary schools (n=33) in 3 districts providing a biracial, broad socioeconomic (SES) sample (n=2253) of 4th graders will be blocked within district based on race and SES and randomly assigned to an enhanced family intervention group, an original intervention group, or a control group. Outcomes will be assessed at baseline and after 1 and 2 years follow-up with well-standardized measures from our original High 5 program. In the enhanced family intervention, well-documented social cognitive theory-based behavior change techniques will be combined with a "cognitive map," based on issues defined by parents using the nominal group technique. The investigators' preliminary studies defined 3 dimensions: practical aspects of fruit and vegetable consumption, food preparer's sense of control and facilitator orientation. After expanding the individual family to confirm the "cognitive map," we will develop instruments to assess the status of an individual family along these dimensions, develop a home-based intervention to target these specific issues, and evaluate the changes in the families. The successful conduct of a pilot enhanced family intervention suggests that we will achieve high rates of participation. A home-based intervention tailored to family-specified issues combined with an effective school-based program may achieve our overall goal of long-term improvement in children's diets for the prevention of cancer.