GREEN Project: HERO Campaign Somawina Nwegbu, Lauren Todd, Lauren Wood, Emily Wong
Background Diets of US Children 80-90% of 4-13 year olds do not meet recommendations for fruit and vegetable consumption (ADA 2008) 17% of children aged 2-19 were classified as obese in 2010 (Ogden 2010) Adulthood chronic diseases are now impacting children
Background Food in the School Opportunity to make an impact Up to two meals and multiple snacks consumed by students daily 55.8 million children participate in National School Lunch Program (USDA 2011) Problem Access and availability does not always translate to consumption of healthful foods
Background Food Waste An estimated 12% of total calories of school lunches are wasted (Ralston 2008) What about forcing children to take food? No impact on consumption Doubles waste (Price & Just 2009) Food waste tend to be lower calorie foods with higher levels of nutrient density, particularly fruits and vegetables
Past Interventions Healthy Eating Focus Cafeteria Power Plus Intervention Project FIT Plate Waste Focus Great Taste, Less Waste International Programs General Healthfulness Healthy Buddies What It Means to Be Healthy
Formative Research Process Key Information Interviews (Part 1) Population Representative Columbus Elementary School in Medford, MA Middle class, diverse environment Interest in improvement of childhood nutrition Key Informant Interviews (Part 2) Cafeteria and Kitchen Staff Cafeteria Observation Focus Groups Eight 3 rd Graders Six 4 th Graders
Focus Group Guide Attitudes and Beliefs towards Fruits and Vegetables Taste Presentation Other Characteristics Expectations about Fruits, Vegetables, and Food Waste Subjective Norms about Food Waste Campaign Ideas
Formative Research Findings Focus Group Findings: Acceptability of fruits and vegetables Taste Some Texture Strong parental and teacher influence Favor for interactive, hands-on activities Posters in hallways and cafeteria space Observation Findings: Disregard for food waste and ecological impact
Aims, Hypotheses, & Limitations Aims Increase fruit and vegetable consumption by 3 rd and 4 th grade children (compared to baseline) Reduce plate waste of fruits and vegetables served in schools by 3 rd and 4 th grade children(compared to baseline Hypothesis A school-based, year-long Social Marketing campaign guided by key constructs from Social Cognitive Theory will significantly increase consumption and decrease waste of fruits and vegetables by third and fourth grade children compared to baseline. Limitations Communications-based campaign, not an intervention Timing, cost, and uncontrollable factors
Campaign Components and Materials Social Marketing Materials (Environment) Interactive Components (Behavior) Newsletter to Influence the Home Environment
Social Marketing Materials Logo Posters and Decorated Trash Cans Mascots Glass Cling
Branding & Logo Implementation ealthy ating ewards everyne
Mascots Mascots Diverse, heroic Focus on saving the Earth Three Appearances Beginning of the first semester Goal: to introduce the campaign Statement through PA system Appearance in the cafeteria End of the first semester Incorporated into already existing assembly End of the year to announce contest winners
Posters and Decorated Trash Cans Posters in the cafeteria space Posters on the trash cans to discourage waste of fruits and vegetables Glass cling icons and food descriptions on the lunch line in front of fruit and vegetable offerings Table top cling signs (semester 2) reinforcing messages
Sample Poster 1
Sample Poster 2
Sample Poster 3
Table Top Cling
Interactive School-based Components “Be a HERO” Contest Public Announcement System Jingle Public Announcement System Messages
“Be a HERO” Fruit & Vegetable Consumption Contest Goal: Create a competition in which students track fruits and vegetables that they try Method Utilization of a “passport” to track fruit and vegetable consumption at lunch Child gets a sticker for each day he or she tries a fruit or vegetable Lunch monitors already in place will distribute the stickers In line with HERO theme, appropriate rewards distributed to everyone, with greater incentives for higher consumption
Public Announcement System: Jingles Based on formative research Students accustomed and attentive to PA system announcements Excited about integration of music and campaign messaging Requested variety of musical styles Logistics: Mimicking morning announcements Played every Friday during Semester 1 Sample: “You can be a Hero”
Public Announcement System: Student HERO Messages Goal: provide students with opportunity to share positive, personal messages that support the HERO message over the PA system at lunch Messages created over holiday break: their favorite fruits and vegetables, how they are a HERO 2 students selected to deliver message each Friday: Sample: “I’m Makayla and my favorite fruit and vegetables are strawberries and red peppers. I’m a HERO because I eat fruits and veggies from all the colors of the rainbow!
Influencing the Home Environment: Parent Newsletters Literature and formative research confirmed the strong parental influence on food behaviors of children at this age Goals: Provide information and support to parents around campaign elements, fruit and vegetable purchasing, consumption and preparation Monthly Newsletter components: Update on campaign events Recipes highlighting specific fruits and vegetables Spotlight on individuals adhering to tenets of campaign Packing and shopping guides Talking points and suggestions for FV-based activities
Process Evaluation Ongoing measure of progress of campaign materials to reach the desired aims Includes measures of reach, dose delivered, dose received and fidelity of each campaign component Insert screen shot of portion of chart???
Outcome Evaluation Intermediate outcomes: 1) Improved self-efficacy and attitudes towards fruits and vegetables Validated survey modified from GREEN project(baseline and end line) 2) Parents read and act on strategies from newsletters Detachable portions of newsletters request feedback Long term outcomes: 1) Increased fruit and vegetable consumption Collect the contest passports (baseline, every 2 months, and end line) Plate waste serves as a proxy 2) Decreased plate waste of fruits and vegetables Tally the number of food trays with leftover fruits and vegetables Conducted by research assistants at baseline, midline and end line
Should I put long term outcomes on this slide (and ST on the previous?) Or leave them on one slide?
Implementation Timeline Screen shot of implementation timeline. Honestly I think we could get rid of the next 2 slides and just go over the screen shot????
Timeline Review First Semester September 1-15: Begin training 16-30: Campaign Implementation Overview Mascot Introduction (3 rd week of school) “Be a HERO” Contest PA System Jingle Glass clings Posters Signs on Trash Cans Mascot Assembly Parent Newsletters
Timeline Review Second Semester Overview “Be a HERO” Contest (all semester) Glass clings (continues all semester) Posters (rotated in January, remain hung all semester) Table-top clings (beginning this semester) Signs on Trash Cans (continues all semester) Parent Newsletters (monthly) Student HERO Messages (all semester) Mascot Assembly
Q & A ealthy ating ewards everyne
Bibliography American Dietetic Association. Position of the American Dietetic Association: Nutrition Guidance for Healthy Children Aged 2 to 11 Years. Volume 108, Issue 6, Pages June Baik JY, H. Lee. Habitual plate-waste of 6- to 9-year-olds may not be associated with lower nutritional needs or taste acuity, but undesirable dietary factors. Nut Res Dec;29(12):831- Begley, K, AR Haddad, C Christensen, and E Lust. A Health Education Program for Underserved Community Youth Led by Health Professions Students. American Journal of Pharmaceutical Education 73.6 (2009): 98. Print. Bergman E, NS. Buergel; TF Englund; and A Femrite. Relationships of Meal and Recess Schedules to Plate Waste in Elementary Schools. Journal of Child Nutrition & Management, Spring No.24. Bryant, CA., A Courtney, R. McDermott, M Alfonso, J. Baldwin, J Nickelson, K. McCormack Brown, R DeBate, LM. Phillips, Z Thompson, and Y Zhu. Promoting Physical Activity Among Youth Through Community-Based Prevention Marketing. Journal of School Health 80.5 (2010): Buzby, J.C., and J.F. Guthrie (2002). Plate Waste in School Nutrition Programs: Final Report to Congress, E-FAN , U.S. Department of Agriculture, Economic Research Service, March Story M, Kaphingst KM, Robinson-O'Brien R, Glanz K. Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health. 2008;29:
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