INCREASING SCHOOL SNACK BAR FRUIT AND VEGETABLE INTAKE

水果、果汁和蔬菜（FJV）摄入量不足以及膳食脂肪摄入量高与几种癌症的风险增加有关。儿童目前的含脂肪量和脂肪摄入量不符合建议的指导方针，国家数据表明，儿童在整个上学期间的水果摄入量有所下降。以前的学校干预针对的是学生只能选择学校午餐的小学。当学生升入中学或高中后，他们可以在小吃店吃到有竞争力的食物。这些食物通常是高脂肪的，不含很多FJV。本研究建议在中学食堂制定、实施和评估环境干预（增加FJV的可用性和可及性）和食堂FJV营销计划，以增加FJV的消费，并评估个人和社会影响对谁改变的影响。将与中学生、教师和学校餐饮服务人员进行焦点小组讨论，以设计和评估可获得性和营销计划。在最初的两个月基线监测期之后，干预措施将分两个阶段实施。首先，在三个月的时间里，食堂小吃店将增加FJV和低脂食品的供应和可及性。这将持续两个月，增加FJV营销计划。在最后两个月内，干预部分将被撤回；我们将继续观察，看看学校的做法和小吃店的食物选择是否会回到基线水平。在此期间，将收集每周FJV和低脂食品的销售情况，以监测干预结果。在整个研究期间，通过对学生午餐的日常观察获得消费数据。这种设计将允许单独测试增加FJV可用性与增加社会营销计划的可用性的效果，并评估个人和社会环境变化机制。在中学食堂成功的饮食行为改变干预将促进采用健康的癌症预防饮食行为。本研究的积极结果应该适用于有小吃店的中学。

Inadequate intakes of fruit, juice, and vegetables (FJV) and high intakes of dietary fat are associated with increased risks for several cancers. Children's current FJV and fat intakes do not meet recommended guidelines and national data indicate a decline in children's fruit consumption through the school years. Previous school interventions targeted elementary schools where students only have the choice of the school lunch meal. When students move to middle schools and beyond, they have access to competitive foods at snack bars. These foods are usually high in fat and do not include many FJV. This research proposes to develop, implement, and evaluate an environmental intervention (increasing FJV availability and accessibility) and a cafeteria FJV marketing program in middle school cafeterias to increase FJV consumption, and to assess the effect of personal and social influences on who changes. Focus groups discussions will be conducted with middle school students, teachers, and school food service staff to design and evaluate the availability and marketing program. The intervention will be implemented in two phases following an initial two-month baseline monitoring period. First the availability and accessibility of FJV and low fat foods will be increased in the cafeteria snack bar for three months. This will be continued for another two months, adding the FJV marketing program. During the final two months, the intervention component will be withdrawn; observations will continue to see if school practices and snack bar food selections return to baseline. Weekly sales of FJV and low fat foods will be collected during this period to monitor intervention results. Consumption data will be obtained through daily observations of student lunches during the entire study period. This design will allow separate tests of the effect of increased FJV availability alone versus increased availability with a social marketing program, and assess personal and social environmental mechanisms of change. Successful dietary behavior change interventions in middle school cafeterias will promote the adoption of healthy cancer preventive dietary behaviors. Positive findings from this study should be applicable to middle schools where snack bars are available.