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School-based Internet-tailored fruit and vegetable education combined with brief counselling increases children's awareness of intake levels

  • Resiti T Mangunkusumo (a1), Johannes Brug (a1), Harry J de Koning (a1), Johan van der Lei (a2) and Hein Raat (a1)
  • DOI: http://dx.doi.org/10.1017/S1368980007246671
  • Published online: 01 March 2007
Abstract
AbstractObjective

Children's fruit/vegetable intake is still below recommended levels. This study applied Internet-tailored advice for schoolchildren and Internet-supported brief dietary counselling (with child and parent) within preventive health care to promote fruit/vegetable intake.

Setting/subjects

The study involved 30 seventh-grade classes (16 in the intervention group and 14 in the control group) with a total of 675 children aged 9–12 years, of whom 495 were allowed to participate.

Design

A cluster-randomised baseline–post-test experimental design was applied. During school hours, all children completed Internet-administered questionnaires on fruit/vegetable intake and related determinants. Children in the intervention group received immediate online individually tailored nutrition feedback. For each child in the intervention group, a nurse received information concerning the assessment of fruit/vegetable intake via the Internet to support a 5 min counselling protocol to promote fruit/vegetable intake. Children completed a similar post-test questionnaire 3 months after the first assessment. Intention-to-treat analyses were conducted using multilevel regression analyses.

Results

A total of 486 children (98% of 495) participated (263 in the intervention group, 223 in the control group); 240 child–parent couples in the intervention group attended the counselling. Awareness of inadequate fruit intake (odds ratio (OR) = 3.0; 95% confidence interval (CI) = 1.8–5.3) and knowledge of recommended vegetable intake levels (OR = 2.7; 95% CI = 1.8–4.1) were significantly more likely at post-test in the intervention group than in the control group. No significant effects were found on intake or other determinants.

Conclusions

A compact, integrated two-component intervention can induce positive changes in knowledge and awareness of intake levels of fruit/vegetables among schoolchildren. To induce changes in intake levels, more comprehensive interventions may be needed.

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*Corresponding author: Email h.raat@erasmusmc.nl
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