Historia Interminable

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Prev Med. Author manuscript; available in PMC 2012 May 1.
Published in final edited form as: Prev Med. 2011 May 1; 52(5): 370–375. doi:10.1016/j.ypmed.2011.02.013.

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Decaying Behavioral Effects in a Randomized, Multi-year Fruit and Vegetable Intake Intervention
Jessica A.Hoffman, Northeastern University Douglas R. Thompson, Thompson Research Consulting Debra L. Franko, Northeastern University Thomas J. Power, Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine Stephen S. Leff, and Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine Virginia A. Stallings Children’s Hospital of Philadelphia and Universityof Pennsylvania School of Medicine

Abstract
Objective—To examine the effects of a multi-component, theory-based, 2.5-year intervention on children’s fruit and vegetable (F&V) consumption, preferences, knowledge and body mass index (BMI). Methods—Four inner city elementary schools in the Northeastern United States were randomized to an intervention (n = 149) or control group (n = 148) in 2005.F&V consumption during school lunch (measured by plate waste), preferences, and knowledge, as well as BMI were assessed five times across 3.5 years (pre-intervention, spring 2006, 2007, 2008 and 2009). Hierarchical linear modeling was used to analyze program outcomes. Results—At the first post-test assessment, children in the experimental group ate 0.28 more servings/lunch of F&V relative tochildren in the control group and changes in F&V consumption were found in each year throughout the program. However, this effect declined steadily across time so that by the delayed one-year follow-up period there was no difference between the groups in F&V consumption. There were persistent intervention effects on children’s knowledge. There were no effects on F&V preferences and BMI throughout thestudy.

Corresponding author: Jessica A. Hoffman, j.hoffman@neu.edu. Disclosure The authors declare that there are no conflicts of interest. This work was supported by the National Institute of Child Health and Human Development [K23HD047480]. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute ofChild Health and Human Development and the National Institutes of Health. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citableform. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Conclusion—Although there was initial F&V behavior change, annual measurements indicated a gradual decay of behavioral effects. These data have implications for the design of school-based F&Vinterventions.

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Introduction
Many research teams have evaluated school-based fruit and vegetable (F&V) interventions. In a systematic review Knai et al. (2006) reported on nine studies that focused on elementary school-age children. Seven of the nine demonstrated significant improvements in children’s consumption as aresult of school-based interventions with effects ranging from 0.30 to 0.99 servings/day. Additionally, Howerton et al. (2007) conducted a pooled analysis across seven school-based studies and found on average children in intervention groups ate 0.45 more servings of F&V relative to children in the control groups. While the duration of the intervention and evaluation tends to be one school year for...