Increasing Fruit and Vegetable Intake Among Children

 描述（由申请人提供）：尽管富含水果和蔬菜（FV）的饮食对健康有益，但美国儿童并没有摄入这些食物的推荐水平;生活在低收入家庭的儿童尤其如此。由于低收入儿童倾向于吃学校提供的午餐（包括FV），小学食堂是改善这一重要人群饮食决策的便利场所。改善健康饮食的社会学习理论方法已被证明在学校有效（参见Evans等人的荟萃分析，2012）;这种方法使用角色模型和有形的激励措施，以鼓励重复品尝FV。虽然社会学习方法产生了良好的短期和长期结果（例如，Jones等人，这是不切实际的-学校负担不起有形的奖励，也没有实施这些干预措施所需的自由裁量劳动力。这种不切实际的做法促使了FIT游戏的发展，这是一种基于学校的干预措施，将社会学习理论与游戏设计原则相结合。结果是低成本、低努力的健康饮食干预，在四所经济上不同的小学中显著增加了FV消费（Jones等人，2014 a，B; Joyner等人，正在筹备中）。目前提案的第一个目的是修改FIT游戏，以便进一步鼓励养成长期健康的饮食习惯。这将通过两种方式实现。首先，在Schell Games（Pittsburgh，PA）的游戏设计专家的帮助下，FIT游戏的持续时间将从约6周扩展到10周;后者是新饮食习惯达到其自动性渐近线的间隔（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， 消费FV，富含FV的饮食的健康促进特性的知识，以及饮食自我效能。该提案的第二个目的是评估FIT游戏对1 - 5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，该试验招募了四所低收入学校。两所学校将参加FIT游戏，两所学校将作为无干预控制学校。FV消耗的测量将在学校之间是相同的。FV消耗将在FIT比赛期间以及FIT比赛结束后的2周，3个月和9个月进行两次评估。该提案的第三个目的是评估FIT游戏针对的三个潜在介质（内在动机，FV促进健康特性的知识和饮食自我效能）是否被证明是重要的介质。 FV消费的变化。我们假设他们会。如果成功，FIT游戏将鼓励健康饮食习惯的发展，并在游戏结束后保持高水平的FV消费。因为FIT游戏是一种低成本的干预措施，学校很容易实施，这个项目的成功将使我们准备扩大干预措施，以便它可以影响更多学校的儿童健康饮食习惯。

 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.