Increasing Fruit and Vegetable Intake Among Children

 描述(申请人提供)：尽管富含水果和蔬菜(FV)的饮食对健康有好处，但美国儿童并没有摄入这些食物的推荐水平；尤其是生活在低收入家庭的儿童。由于低收入儿童倾向于吃学校提供的午餐(包括FV)，小学自助餐厅是改善这一重要人群的饮食决策的便利场所。改善健康饮食的社会学习理论方法在学校被证明是有效的(见Evans等人的荟萃分析，2012)；这种方法使用榜样和切实的激励来鼓励重复品尝FV。尽管社会学习方法产生了良好的短期和长期结果(例如，Jones等人，在出版社)，但它是不切实际的--学校负担不起有形的回报，也没有实施这些干预措施所需的可自由支配的劳动力。这种不切实际促使了Fit Game的发展，这是一种以学校为基础的干预措施，将社会学习理论与游戏设计原则相结合。其结果是一种低成本、低努力的健康饮食干预措施，显著增加了四所经济不同小学的FV消费量(Jones等人，2014a，b；Joyner等人，正在筹备中)。目前建议的第一个目标是修改Fit Game，使其进一步鼓励培养长期健康的饮食习惯。这将通过两种方式实现。首先，在Schell Games(宾夕法尼亚州匹兹堡)游戏设计专家的帮助下，Fit Game的持续时间将从~6周延长到10周；后者是新的饮食习惯达到其自动线的间隔(Lally等人，2010年)。其次，扩展的Fit游戏将针对长期健康饮食的三个潜在中介：内在动机 食用FV，了解富含FV的饮食对健康的促进作用，以及饮食自我效能。该提案的第二个目的是评估Fit游戏对一至五年级学生FV消费的短期和长期影响。这将在一项随机临床试验中完成，该试验招收了四所低收入学校。两所学校将玩Fit游戏，两所学校将作为不干预控制学校。各学校对FV消费的衡量标准将是相同的。FV消耗将在Fit游戏期间以及Fit游戏结束后的2周、3个月和9个月进行两次评估。该提案的第三个目标是评估Fit Game针对的三个潜在中介因素(内在动机、FV促进健康特性的知识和饮食自我效能)是否被证明是 FV消费的变化。我们假设他们会这样做。如果成功，Fit游戏将鼓励人们养成更健康的饮食习惯，并在游戏结束后保持较高的FV消费水平。由于Fit游戏是一种易于学校实施的低成本干预措施，该项目的成功将为我们扩大干预力度做好准备，以便它可能会影响更多学校的孩子们的健康饮食习惯。

 DESCRIPTION (provided by applicant): Despite the health benefits of a diet rich in fruits and vegetables (FV), US children do not consume the recommended levels of these foods; this is particularly true of children living in low-income families. Because low-income children tend to eat school provided lunch (which includes FV), elementary school cafeterias are a convenient location for improving dietary decision-making in this important population. The social-learning theory approach to improving healthy eating has proven effective in schools (see meta-analysis by Evans et al., 2012); this approach uses role modeling and tangible incentives to encourage the repeated tasting of FV. Although the social-learning approach yields good short- and long-term outcomes (e.g., Jones et al., in press) it is impractical - schools cannot afford tangible rewards and they do not have the discretionary labor needed to implement these interventions. This impracticality motivated the development of the FIT Game, a school- based intervention that integrates social-learning theory with game-design principles. The result is a low-cost, low-effort healthy eating intervention that has significantly increased FV consumption in four economically diverse elementary schools (Jones et al., 2014a, b; Joyner et al., in preparation). The first aim of the current proposal is to modify the FIT Game so that it further encourages the development of long-term healthy eating habits. This will be accomplished in two ways. First, with the aid of game design experts at Schell Games (Pittsburgh, PA) the duration of the FIT Game will be expanded from ~6 weeks to 10 weeks; the latter is an interval across which new eating habits reach their asymptote of automaticity (Lally et al., 2010). Second, the expanded FIT Game will target three potential mediators of long-term healthy eating: intrinsic motivation to consume FV, knowledge of the health-promoting properties of a diet rich in FV, and dietary self-efficacy. The proposal's second aim is to evaluate the short- and long-term effects of the FIT Game on FV consumption of 1st-5th graders. This will be accomplished in a randomized clinical trial enrolling four low-income schools. Two schools will play the FIT Game and two will serve as no-intervention control schools. The measurement of FV consumption will be identical across schools. FV consumption will be assessed twice during the FIT Game and at 2-weeks, 3-months, and 9-months after the FIT Game concludes. The proposal's third aim is to evaluate if the three potential mediators targeted by the FIT Game (intrinsic motivation, knowledge of the health- promoting properties of FV, and dietary self-efficacy) prove to be significant mediators of changes in FV consumption. We hypothesize that they will. If successful, the FIT Game will encourage the development of healthier eating habits and will maintain high levels of FV consumption after the game concludes. Because the FIT Game is a low-cost intervention that is easy for schools to implement, success in this project will prepare us to scale-up the intervention so that it may impact children's healthy eating habits in far more schools.