Program

Jan 16, 2013

 

OVERVIEW

The 5-a-Day Power Plus program is a multi-component, school-based dietary intervention for 4th and 5th graders. The intervention focuses on increasing students’ fruit and vegetable consumption. In an experimental study in which 20 paired schools were randomly assigned, schools assigned to implement the 5-a-Day Power Plus program were compared with schools that received no intervention. Following the intervention, students from intervention schools were observed consuming significantly more servings of fruits and vegetables during lunchtime than were students from control schools. Twenty-four hour dietary recalls also revealed significantly greater consumption of fruits among treatment students.

DESCRIPTION OF PROGRAM

Target population: 4th and 5th grade students

The 5-a-Day Power Plus program is a multi-component intervention based on social learning theory. The program includes two curricula: “High 5” for 4th graders and “5 for 5” for 5th graders. Each curriculum includes sixteen 45-minute classroom lessons that are implemented twice a week for eight weeks. Lessons include skill-building and problem-solving activities and provide students with opportunities to prepare and taste healthy snacks. As part of the program, students form teams and take part in fruit and vegetable eating competitions at lunch.

During students’ 4th grade year, the program provides information/activity packets for parents to complete with their children. During students’ 5th grade year, students are provided with snack packs that they can take home and use to prepare nutritious snacks for their families.

As part of the program, the food service staff attends a two-hour training session on the curriculum and encourages students to eat more fruits and vegetables with their school lunch. Cafeterias provide students with an increased variety of fruits and vegetables and advertise these products with posters and displays.

EVALUATION(S) OF PROGRAM

Perry, C. L., Bishop, D. B., Taylor, G., Murray, D. M., Mays, R. W., Dudovitz, B. S., … Story, M. (1998). Changing fruit and vegetable consumption among children: The 5-a-Day Power Plus Program in St. Paul, Minnesota.  American Journal of Public Health, 88(4), 603-609.

Evaluated population: A total of 1,612 4th grade students from 20 elementary schools in the St. Paul, Minnesota public school district served were evaluated. Of the student enrolled in the fourth grade (N=1,750), 48 percent of these students were White, 25 percent were Asian-American, 19 percent were African-American, 6 percent were Hispanic, and 1 percent were Native American. More than 60 percent of the students received free or reduced-cost school lunch.

Approach: The 20 participating schools were matched into pairs and then, within pairs, randomly assigned to either the treatment group or the delayed program condition. Schools assigned to the delayed program control group received no intervention during the study. Schools assigned to the treatment group implemented the 5-a-Day Power Plus intervention during students’ 4th and 5th grade years. Intervention lessons were taught by 4th and 5th grade teachers who took part in a one-day training prior to the commencement of the intervention. Intervention schools received support from the Minnesota 5-a-Day Coalition. Coalition partners supplied schools with food, presentations, and other educational and incentive materials.

Baseline assessments were administered during the winter of students’ 4th grade year.  The intervention took place during the spring of students’ 4th grade year and the fall of their 5th grade year. Follow-up data were collected during the winter of students’ 5th grade year. All students completed health behavior questionnaires at baseline and at follow-up.  A subset of students (34 students per school) completed 24-hour food recalls and were observed during school lunch so that their lunchtime fruit and vegetable consumption could be assessed.

Results: Lunchtime observations revealed that students from treatment schools were consuming significantly more servings of fruits and fruits and vegetables combined than were students from control schools. However, no impact was found on servings of vegetables alone. A significantly larger proportion of treatment participants’ daily calorie intake was attributed to fruits and fruits and vegetables combined, but no effects were seen for vegetables alone. At lunchtime, treatment schools were also consuming more fiber than control schools; however, this finding was only marginally significant.

Though treatment boys did not significantly differ from control boys on lunchtime vegetable consumption, treatment girls were observed consuming significantly more vegetables than control girls. Treatment students on the whole were observed consuming significantly more Vitamin A and Vitamin C than control students, reflecting differences among girls only. There was no significant difference between groups on lunchtime consumption of fat, saturated fat, folacin, iron, or calcium.

On the 24-hour diet recalls, students from treatment schools reported consuming significantly more servings of fruit than students from control schools, but did not report consuming significantly more servings of vegetables or fruits and vegetables combined.

A significantly larger proportion of treatment participants’ daily calorie intake was attributed to fruits and fruits and vegetables combined, but no effects were seen for vegetables alone. Diet recalls further revealed that treatment students were deriving a significantly lower percentage of their calories from fat and were consuming significantly more calcium. Diet recalls did not reveal significant differences between groups on consumption of Vitamin A, Vitamin C, saturated fat, folacin, iron, or fiber.

On the health behavior questionnaires that students completed, students from intervention schools reported consuming significantly more servings of fruits and vegetables every day than students from control schools. These students also reported asking for fruits and vegetables more often, perceived a greater need for fruits and vegetables as part of their diet, and perceived their teachers as supporting the consumption of fruits and vegetables to a greater extent. No significant differences emerged between students from control schools and students from treatment schools on perceptions of family consumption of fruits and vegetables or perceptions of family, friends, or school cooks as supporting the consumption of fruits and vegetables.

SOURCES FOR MORE INFORMATION

References

Perry, C. L., Bishop, D. B., Taylor, G., Murray, D. M., Mays, R. W., Dudovitz, B. S.,… Story, M.  (1998). Changing fruit and vegetable consumption among children: The 5-a-Day Power Plus Program in St. Paul, Minnesota. American Journal of Public Health, 88(4), 603-609.

Website: http://rtips.cancer.gov/rtips/topicPrograms.do?topicId=102266&choice=default

KEYWORDS: Children (3-11), Males and Females (co-ed), Skills-Training, School-based, Parent or Family Component, Elementary, Nutrition, white/Caucasian, black/African-American, Asian, Hispanic/Latino, Urban, Manual is Available.

Program information last updated on 7/3/2012.