Long-term impact of a school-based nutrition intervention on home nutrition environment and family fruit and vegetable intake: A two-year follow-up study

• Main Authors: Allison N. Marshall, Christine Markham, Nalini Ranjit, Gregory Bounds, Joanne Chow, Shreela V. Sharma
• Format: Article
• Language: English
• Published: Elsevier 2020-12-01
• Series: Preventive Medicine Reports
• Subjects: School-based intervention; Fruit and vegetable intake; Low-income populations; Dietary behavior; Sustained impact
• Online Access: http://www.sciencedirect.com/science/article/pii/S2211335520302059

Long-term data on maintenance of intervention effects of health promotion programs targeting fruit and vegetable (F&V) intake in children is lacking. We conducted a two-year follow-up of Brighter Bites, a school-based nutrition education and food co-op intervention found to be effective in increasing child intake of F&V. A one-group, pre-post evaluation design was used to assess the two-year post intervention impact of the program on child and parent dietary intake and home nutrition environment. In 2016–2017 school year, we conducted a follow up of 262 parent-child dyads who had previously participated in Brighter Bites in a 2013–2015 evaluation study in six low-income Texas elementary schools. Child dietary intake was measured using a parent-reported food frequency questionnaire, and surveys measured parent F&V intake, and home nutrition environment. Results of a multi-level regression analysis showed that, two years post-intervention, as compared to baseline, there was a significant increase in child intake of fruit, vegetable, and fiber, and significant decreases in total fat intake and percent daily calories from sugary beverages (p < 0.05). Parent dietary data showed significant increases in fruit intake, and intake of F&V combined (p < 0.05). Changes in home nutrition environment included: increased frequency of cooking behaviors, increased usage of nutrition facts labels in making grocery purchasing decisions, and increased food availability of F&V (p < 0.05). This study demonstrates potential long-term sustained impact of a comprehensive school-based intervention among low-income children and their families.