Nicklas Theresa, Lopez Sandra, Liu Yan, Saab Rabab, Reiher Robert
USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA.
Founder of Esmartchoice, FutureWise Inc, and Innertainment, Burbank, CA, USA.
Int J Behav Nutr Phys Act. 2017 Feb 7;14(1):16. doi: 10.1186/s12966-017-0468-0.
By 3 years of age, many children have developed a dislike for certain foods, particularly vegetables. Seventy-five percent of young children consume less than the recommended levels for vegetables. The objective of this randomized feasibility intervention was to demonstrate the impact of an innovative approach to increase consumption of vegetable dishes by minority preschool children attending Head Start. The specific aims included the collection of data to assess feasibility and efficacy of the intervention.
Both qualitative and quantitative assessments were conducted. Qualitative data was used for development of the intervention and for program feedback at post assessments. Two hundred fifty-three preschool children (49% boys; 66% Hispanics and 34% African-Americans; mean age 4.4 years) were randomized either to the intervention (n = 128) or the control group (n = 125). The teacher/parent intervention group showed the children videotaped (DVD) puppet shows. Based on the theoretical framework "transportation into a narrative world", three professionally developed characters, unique storylines and an engaging, repetitious song were incorporated in four 20-min DVD puppet shows. Prior to lunch each show was shown for five consecutive days in school and a minimum of once in the home. Digital photography was used in school to assess consumption of vegetable dishes at the lunch meal (quantitative assessment). At home parents were asked to complete the booklet questions corresponding to each DVD; questions could be answered correctly only if parents watched the DVD with their child. A multilevel mixed-effect model was used to analyze the data, adjusting for age, gender, and ethnicity.
Children in the intervention group significantly (p < 0.0001) increased consumption of vegetable dishes from baseline to follow-up compared to no change in the control group. At follow-up, the intervention group continued to have significantly (p = 0.022) higher intake of vegetable dishes compared to the control group. Sixty percent of the mothers completed the booklet's questions with 76 to 98% correct responses.
Using theory-based motivational theater with multiple exposures may be an effective behavioral intervention to increase consumption of vegetable dishes by preschool children that can be easily disseminated to a large sample.
ClinicalTrials.gov; Identifier: NCT02216968.
到3岁时，许多儿童已开始不喜欢某些食物，尤其是蔬菜。75%的幼儿蔬菜摄入量低于推荐水平。这项随机可行性干预研究的目的是证明一种创新方法对提高参加“启智计划”的少数族裔学龄前儿童蔬菜菜肴摄入量的影响。具体目标包括收集数据以评估干预措施的可行性和有效性。
进行了定性和定量评估。定性数据用于干预措施的制定以及评估后的项目反馈。253名学龄前儿童（49%为男孩；66%为西班牙裔，34%为非裔美国人；平均年龄4.4岁）被随机分为干预组（n = 128）或对照组（n = 125）。教师/家长干预组向孩子们播放录像带（DVD）木偶剧。基于“融入叙事世界”的理论框架，在四部20分钟的DVD木偶剧中融入了三个专业制作的角色、独特的故事情节以及一首引人入胜的重复歌曲。每天午餐前，每部剧在学校连续播放五天，在家里至少播放一次。在学校使用数码摄影来评估午餐时蔬菜菜肴的摄入量（定量评估）。在家里，要求家长完成与每张DVD对应的手册问题；只有家长和孩子一起观看DVD，问题才能正确回答。采用多层次混合效应模型分析数据，并对年龄、性别和种族进行了调整。
与对照组无变化相比，干预组儿童从基线到随访期间蔬菜菜肴摄入量显著增加（p < 0.0001）。在随访时，干预组蔬菜菜肴摄入量仍显著高于对照组（p = 0.022）。60%的母亲完成了手册问题，回答正确率为76%至98%。
运用基于理论的激励性戏剧并多次播放，可能是一种有效的行为干预措施，可增加学龄前儿童蔬菜菜肴的摄入量，且易于推广至大量样本。
ClinicalTrials.gov；标识符：NCT02216968。
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