Table 1.
Description of studies included in the review that assess the impact of an intervention of vegetable intake in the home and community settings
| Reference | Study design; duration; setting; target | Population: sample size (N); Age M ± SD (range); % male | Intervention description; contact with intervention | Data time points; Comp; CG | How was vege intake measured? | Intake pre‐intervention | Intake post‐intervention | Intake at Follow‐up | Change in vege consumption |
|---|---|---|---|---|---|---|---|---|---|
| Annesi et al. 2009 | Cohort; 12 weeks; ASP; children | 43 9 ± 1.3 years (7–12 years) 49% | Youth fit for life program included PA, behavioural skills training, health and nutrition education. Contact: 3 × 45 min sessions/week (20 min Cardio PA/session), 2 × 20 min/week strength training, 20 min × 1/week behavioural skills, health and nutrition info 5–7 min/session) | TP: baseline, post‐I Comp: not stated CG: none | FFQ (2 items): frequency/week | 9.93 (SD ± 5.15) | 12.47 (SD ± 7.21) | — | t 42 = 2.12, P = 0.02, d = .49 |
| Bayer et al. 2009 | Cluster RCT; 2 years; Kindy; Children & teachers & parents | 64 kindy's, 1605 children 6 ± 0.4 years (5–6 years) 52–64% | ‘TigerKids’ behavioural intervention targeted at: PA games at kindergarten, F&V consumption and habit formation of ≥2 FV portions/day & drinking water in kindy. Information materials & day‐to‐day activities to teachers, phone hotline for teacher support, information for parents, internet platform with info for teachers & families & shared FV plates offered. Contact: ~5 h/week | TP: baseline, 3–9 m, 12–20 m Comp: not stated CG: usual care | FFQ: portions/day converted to % high V consumer ≥2portions | — |
# of high vege cons umers' sample 1: I: 323, 38.6% (35.3–42.0) C: 155, 33.9% (29.6–38.5) P = 0.0960 sample 2: I: 366, 42.7% (39.4 to 46.1) C: 151, 33.6% (29.2 to 38.1), P = 0.0013 |
—0 | Intervention effects Sample 1: OR 1.26 (0.98–1.61) Sample 2: OR 1.48 (1.08–2.03) |
| Castro et al., 2013 | Cohort; 3 years; community; families | 120 (60 families) 6 ± 3.4 years (2–15 years) 49% | Growing healthy kids program: weekly sessions in community garden (staff assisted with garden preparation, planting etc), 7‐week cooking & nutrition workshop (information & resources for healthy food choices), social events for families and garden newsletter. Contact: Weekly | TP: Baseline, 1, 2 & 3 years comp: family gardening participation 45% weekly, 45% 2–3×/month, 7%1/month, 3% no attendance data. CG: none | Survey (parent report): V variety available at home; usual servings consumeday/weekday | Availability: 3.5 ± 2.06 usual intake: 2.1 ± 0.96 | Availability: 7.8 ± 1.80 usual intake: 2.8 ± 1.28 | — | Availability: 4.3 ± 1.82 (123% increase, t = 16.37, df = 47, P < 0.001) Usual intake: 33% increase (t = 3.17, df = 45, P < 0.001) |
| Corsini et al. 2011 | RCT; 2 weeks; home; parents, children | 185 children & caregiver (4–6 years) 59% | 3 groups: EO, exposure + reward (E + R) & control. EO group required parent to present & ask child to taste small piece of target vege daily for 2 weeks. E + R group same as EO procedure + 14‐day sticker reward chart for tasting the vege. Contact: short daily activity | TP: Baseline, post‐I (2 & 4 weeks, & 3 months) Comp: 94% returned exposure diary. 86% offered target V on ≥ 10 occasions. 56% children achieved 10 taste exposures. CG: normal feeding behaviour | Target V: g consumed usual intake: FFQ f/day Variety: number V/week | — | — | — | Target V intake: All increased from baseline (X 2(1) = 22.98,P < 0.001) E + R increased post‐I to 3 months (change 6.47, SE 2.26, P = 0.013) & 4 weeks to 4 months (change 7.23, SE 1.49, P < 0.001) C: increased Post‐I to 3 months (change 3.51, SE1.22, P = 0.012) usual V intake: variety increased with time (F(2,126) = 30.23, P < 0.001) frequency, E + R increased from baseline to 4 weeks (change 0.32, SE0.12, P < 0.5) |
| Davis, 2011 | Pilot cluster RCT; 12 weeks; ASP; childre and, parents | 104 9.8 ± 0.7 years 52% | Cooking /nutrition education, gardening lessons & market garden visits + 60 min parent nutrition & gardening class Contact: 90 min/week | TP: Baseline, 1‐week post‐I Comp: parent component – 25% participation CG: abbreviated delayed intervention after post‐testing of IG. | FFQ (41 items): servings/day (previous day) | I:1.6 ± 1.0 C:1.9 ± 1.3 | I:1.6 ± 1.0 C:1.3 ± 1.0 | ‐ | I v C, P = 0.11 |
| De Bock, 2011 | Cluster RCT; 6 months; pre‐school; children; parents | 377 (18 pre‐schools) 4.26 ± 0.78 years (3–6 years) 53.2% | Nutrition intervention: education on different foods, preparing, cooking, shared meals, parent education (modelling & child nutrition needs), interactive play, active parent participation & peer interaction. FV & water offered every week to increase exposure. Contact: 2 hours/week × 15 nutrition sessions (10 children only, 5 parents only or parent & child) | TP: baseline, 6 & 12 months Comp: not stated CG: waiting list control arm (received the intervention 6 months later). | FFQ: portions/day | 34.6% achieved recommended daily vege intakes | — | — | Intervention effect higher post intervention unadjusted: +0.22 points P < =0.01 Adjusted: +0.15 points, P = 0.027 **a change of 1 point = ~ 1 portion |
| Engels et al. 2005 | Pilot cohort; 12 weeks; ASP; children, parents | 56 children (25 parents) 11.1 ± 1.3 years 32% | Program employed social, cognitive, & behavioural strategies. Content included: dance, sport, fitness & nutrition activities, targeted handouts & poster‐board display, & motivational talk by public figure. Participants required to record daily FV intake & step counts. Contact: 60‐75 min sessions 4 days/week | TP: Pre & post‐I Comp: not stated CG: no Control | FFQ: f/day (converted to 0–10 score) | Green salad (+/− other V): 3.42 ± 1.97; fries/fried potato: 3.60 ± 1.54; boiled/mashed potato: 2.79 ± 1.66 V servings (−salad V/potato): 3.96 ± 1.69 | Green salad (+/‐other V): 4.58 ± 2.80; fries/fried potato: 3.92 ± 2.79; boiled/mashed potato: 3.70 ± 2.33; V servings (−salad V/potato): 4.36 ± 2.20 | — | Green salad (+/−other V): +1.16, P = 0.003 Fries/fried potato: +0.32, P = 0.278 Boiled/mashed potato: +0.91, P = 0.005 V servings (−salad V/potato): +0.4, P = 0.276 |
| Freedman & Nickell, 2010 | Cohort; 3 weeks; Local library; Children (+1 session for parent & child) | 49 11.1 ± 0.03 years (9–14 years) 36% | ‘Snack Smart’ workshops: nutrition education through videos, food prep, tastings, label‐reading, games, creating recipes, handouts, role modelling, goal setting, barriers, home activities, social support networks. Reinforcements used + recipe book & draw prize post‐I. Contact: 6 h total; 3 × 90 min/week after‐school nutrition workshops, 2 × 45 min weekend workshops | TP: Baseline, post‐I, 3–4 months Comp: Not stated CG: children acted as own control | FFQ: f/d (converted to 0–3 score) | — | — | follow‐up ‐ pretest −1.17, P = 0.24 | posttest – pretest: −2.12, P = 0.03 |
| Gholami et al., 2015 | RCT; education leaflet mailed out; Home; Mothers | 155 mothers with daughters aged 6–11 year mothers: 34.13 ± 5.87 years (25–50 year) NA | Theory‐guided instructional leaflet provided to mothers after baseline; included info on consequences of behaviour, WHO healthy eating recommendations, instructions on how to perform behaviour, dietary action planning and coping planning exercises. Contact: Education leaflet mailed out | TP: Baseline, 2 weeks, 3 months Comp: Not stated CG: not stated | Survey: Usual portions/day | I: 2.42 (SD 1.44), C: 2.80 (SD 1.71), (t = 1.54, d = ‐0.24, P = 0.12) | 2 weeks I: 3.09 (SD 1.86), C: 2.53 (SD 1.63), (t = ‐2.07, d = 0.32, P = 0.04) | 3 month I: 3.05 (SD 1.48), C: 2.87 (SD 1.45), t = −0.80, d = 0.12, P = 0.42 | Main effects: time effect P = .03, No treatment effect P = .67. Interaction between time and treatment existed P = 0.02 (I group higher at time 2, not time 3) |
| Haire‐Joshu et al., 2008 | Group randomised nested cohort design; 7 months; home; family | 1306 families with preschool aged child (2–5 years) — | High 5 for Kids: tailored newsletter based on pretest interview, home visits & materials for parent & child. Intervention strategies targeted knowledge, parental modelling, feeding practices, FV availability. Contact: 4 × 60 min home visits + newsletters | TP: baseline, 7 months Comp: Program delivered to 78% intervention families, 84% completed posttest CG: standard program | FFQ (27 items): Servings/day | I: 1.55 C: 1.46 | I: −0.02 C: −0.04 | — | Intervention effect, adjusted 0.06, P = 0.10 |
| Horne et al., 2011 | Randomised cross over trial; 2 phases 30 days each; childcare; children | 20 34 months (24–52 months) 40% | Modelling & rewards intervention: videos screened during intervention featuring animated characters modelling consumption of target food & being rewarded for eating them. Letters from characters read out to reinforce target food, previous days intake and rewards. Rewards given for eating varying amounts of target foods. Contact: not specified | TP: baseline 1, fruit intervention, baseline 2, christmas break, baseline 3, vege intervention, baseline 4, 6 months follow‐up. Comp: not stated CG: no control | Observational record: % consumed | Baseline 1 snacktime: 24.6% lunchtime: 17.9% Baseline 3 snacktime: 28.8% lunchtime: 30% | Post‐I (cf baseline 3 intake) snacktime: 85.5% lunchtime: 76.9% | 6 months (cf baseline 1 intake) snacktime: 85.1% lunchtime: 84.8% | post‐I snack time: +56.7 (t (19) = 7.09; P < 0.001; d = 1.73) lunchtime: + 46.9 (t (19) = 5.98; P < 0.001; d = 1.42) 6 month FU snack time: +60.5 (t (13) = 8.09; P < 0.001; d = 2.59) lunchtime: +66.9 (t (13) = 8.12; P < 0.001; d = 2.68) |
| Horton et al., 2013 | RCT; 4 months; Home; Families | 361 families with ≥ 1 child aged 7–13 years no info | Intervention topics included: family relations/communication/parenting styles, stress & eating, healthy eating & FV, social support. Also included DVD series, goal setting sheets, skill building activities, child‐directed activities & family weekly tasks. Contact: 14 contacts: 11 × home visits, 3 × calls), total 16.5 h. | TP: Baseline, 4 months 6 months Comp: retention rates I: 88%, C:91% CG: delayed treatment intervention | Survey (2Q) Cups/day, Variety in last month (44 items) | — | Adj mean of daily cups of vege consumed: I: 1.19 (SE 0.07), C: 1.05 (SE 0.07) Adj mean of monthly variety of vege: I: 12.0 (SE 0.44), C: 10.8 (SE 0.43) | — | I vs. C post‐I: cups consumed, P = 0.14 variety, P = 0.067 |
| Latif et al., 2011 | Cluster RCT; 9 weeks; community group; children | 473 12.8 ± 1.1 years(10–4 years) 100% | 2 x I groups (dietary or PA based). Dietary I: 5 A Day Badge program ‐ functional knowledge & skills, tastings, recipe booklet. PA I: Fit for Life (FFL) Badge program ‐ sporting activities, ‘drills’ booklet. Internet component: BCTs ‐ goal setting/review/modelling and problem solving Contact: 9 × 55 min/week group sessions (30 min in‐troop activities/25 min internet activities) | TP: Baseline, post‐I, 6 months post‐intervention Comp: not stated CG: — | FFQ: servings/day | I: 0.35 (SD ± 0.32) C: — | I: 0.44 (SD ± 0.36) C — | 6 months Post I I: 0.38 (SD ± 0.36) C — | Post I: +0.09 6 months post I: +0.03 (C group NA) |
| Martinez‐Andrade et al., 2014 | Pilot cluster RCT; 6 weeks; primary care clinic; families | 306(189 completed 3&6 months FU) 40.6 ± 10 months (2–5 years) 52.6% | Intervention group: obesity awareness & prevention workshops. Topics: portion size, healthy eating, label reading, meal planning, PA & sun exposure. Techniques included motivational interviewing, reflexive listening skills, goal setting/review, barriers, activities (games, cooking). Contact: 2 h/week (90 min workshop, 30 min shared food). | TP: Baseline, 3 months, 6 months Comp: 40% compliance to educational sessions. 35% families did not complete 3 months FU. CG: Usual care | FFQ: Servings/week | I: 20.9 (SD ± 15.0) C:20.6 (SD ± 20.1) | 3 month FU I: 20.0 (SD ± 17.1) C:15.1 (SD ± 13.9) | — | 3 months FU I: ‐0.8 (SD ± 0.2) C: ‐5.5 (SD ± 0.2) adj I‐C dif 6.3 (95%CI 1.8,10.8) 6 months FU I: −3.1 (SD ± 0.2) C: ‐5.0 (SD ± 0.2) adj I‐C dif 2.7 (95%CI −1.3, 6.7) |
| Namenek Brouwer & Benjamin Neelon 2013 | Pilot RCT; 4 months; Childcare; Children | 12 (4 childcare centres) 73% aged 3–5 years — | ‘Watch Me Grow’ garden based program: grow a crop/month, weekly class activities (reading, tasting, garden, classroom). Program included a gardener to assist & health educator for menu review. Contact: 4 activities/month (~1/week). Duration not stated. | TP: Baseline, post‐I (5 months) Comp: not stated CG: delayed intervention | Observation record: servings/2 days | Total V: I: 0.8 +/−0.68, C: 0.8+/−00.38 dark V: I: 0.00+/−00.00, C: 0.01+/−00.02 white potatoes: I:0.17+/−00.23, C: 0.22+/−00.39 | Total V: I: 1.05+/−00.67, C: 0.63+/−00.28 dark V: I: 0.07+/−00.13, C: 0.02+/−00.01 white potatoes: I: 0.33+/−00.34, C: 0.00+/−00.00 | — | Total V: I: 0.25 +/−01.1, C: ‐0.18 +/−00.52 dark V: 0.07+/−00.13, C: 0.01+/−00.05 white potatoes: 0.16+/−00.54, C: 0.22+/−00.39 |
| Schwinn et al. 2014 | Cohort; 3 weeks; Internet; Mother daughter dyads | 67 mother daughter dyads 11.85 ± 0.88 years (10–12 years) NA | 3 session web delivered program to develop & maintain healthy relationships, bodies & minds. Topics: communication, family meals, knowledge of drugs, setting rules, food shopping skills, preparing healthy dinners, coping skills. Contact: 3 × 25 min sessions | TP: Baseline, post‐test, 5 months FU Comp: 35/36 in intervention completed all sessions CG: no intervention materials | FFQ (21 items): f/week | 2.28+/−00.9 | 1 week postI:2.38+/−00.81 | 5 months postI 2.41+/−00.99 NS | NS |
| Slusser et al. 2013 | Evaluation pre/post test; 1 School year; After‐school program; staff | 121 from 8 ASP sites (I:4, Ct:4) 6–11 years 43% | Catch Kids Club: 32‐lesson ASP teaching students nutrition & skills to make healthy dietary & PA choices. Intervention sites received staff training in nutrition, child development & PA routines, curriculum resources, mentoring & assistance visits, nutrition education manual, activity box, & snack prep activities. Contact: ‐ | TP: Baseline (Sep), follow‐up at the end of school yr (June). Comp: Not stated CG: No training or support provided | Survey: f (previous day) | I: 0.37 (SD 0.117) C: 0.36 (SD 0.092) | I: 0.37 (SD 0.284) C: 0.46 (SD 0.140) | — | Change score I: 0.00, C: +0.10, P = 0.084 |
| Somerville et al. 2012 | Evaluation with pre/post test; 13 weeks; Community; Children | 40 9 y (6–12 years)‐ | Weekly activities included FV snack preparation, blind tasting, apple stamping, produce Pictionary, & FV bingo. Children encouraged to prepare & consume FV snacks during session & at home. Contact: 1 h/week | TP: Baseline, post‐Is Comp: Not stated CG: No Control | Observation: Servings eaten at snacktime (FV combined) Survey (7 item): usual Servings/day | Usual servings/day 2.17 ± 1.82 | Usual servings/day 3.07 ± 1.87 | — | 0.9, P < 0.05 |
| Tabak et al. 2012 | Pilot RCT; 4 months; Phone + print materials; Parents | 43 families 3.6 ± 0.8 years (2–5 years) 16% | Intervention: 4 tailored monthly newsletters & 2 motivational phone calls. Calls addressed V/food issues from baseline surveys, areas for improvement, encouraged parents to describe successes, use problem solving to overcome barriers, receive support & encouragement. Newsletters addressed: V availability, picky eating, family meals, role modelling, individual feedback, goal setting, recipes, tips, resources and goal tracking. Contact: 4 monthly newsletters & 2 calls | TP: baseline, post‐I (~5 months) Comp: not stated CG: 4 children's books (non‐health/nutrition related) (1/month) | FFQ: servings/day | I: 0.8 (SD 0.4) C: 0.6 (SD 0.4) | — | — | change in mean (P = 0.61 adj) I: +0.1 (SD 0.3) C: +0.0 (SD 0.5) |
| Witt & Dunn 2012 | RCT; 6 weeks; pre‐school; children | 263 from 17 childcare centres 4–5 years 53% | Colour me Healthy: designed for 4–5 years old pre‐schoolers & delivered by pre‐school teachers, provides interactive learning & teacher toolkit (lesson guides, picture cards, posters, music CD, hand stamps, parent newsletters etc). Activities encourage discussion about FV, tasting experiences. Contact: 3 sessions/week, 15‐30 min each | TP: baseline, post‐I, 3 months post‐I Comp: attendance 14.2 ± 4.0/18 lessons; completed take‐home activities 3.4 ± 2.4/6 CG: no treatment | Weighed record: % of 1 Cup serve consumed | I: 37.9% C: 35.6% | I: 62.1% C: 33.2% | I: 71.0% C: 34.0% | Main effect for time (F [2,240] = 21.67, P <0.01) Interaction effect (F [2,240] = 27.65, P < 0.01) I: higher intake post‐I (F [1,120] = 24.14, P = <0.001; d = 0.90) & FU (F [1,120] = 43.41, P = <0.001; d = 1.20) |
| Wolfenden et al. 2014 | RCT; 1 months; phone + materials delivered to homes; Parents & children | 394 parents from 30 pre‐schools 4.3 ± 0.6 years (3–5 years) I:49.0%, C:54.3% | Weekly phone intervention + printed resources relating to healthy eating at home (based on Australian guide to healthy eating – AGHE). Aims: increase FV availability, supportive family routines & parental role modelling & self monitoring & develop contingencies for difficult situations. Contact: 4x30min phone contact + print materials | TP: Baseline, 12 month, 18 month Comp: 87% completed all 4 phone calls, & interviewers covered 97% of key intervention content CG: print material on AGHE only | Survey (CDQ): variety & f on previous d; f/ during previous week; FV combined; servings usually consumed. | serves not measured | V serves: I: 2.95 +/− 0.12 C: 2.47 +/− 0.11 | V serves: I: 2.98 +/− 0.11 C: 2.55 +/− 0.10 | I: sig higher at post‐I & FU, P < 0.01 |
| Wright et al. 2012 | RCT; program: 6 weeks, school/community activities: 4 months; ASP; children & teachers & parents | 251 (I:121, C:130) I: 9.0 ± 1.6 years, C:8.3 ± 1.1 year, (–12 years) I:42%, C:38% | Two components: (1) ‘Kids Nutrition & Fitness‘ (KNF): afterschool family lifestyle program & parental group encouraging healthy lifestyle behaviours, food pyramid, cooking patterns, (2) school & community environmental activities to create/deliver school based policy for physical & dietary change, professional development for teachers, home activities via bimonthly newsletters. Contact: KNF: 6 × 90 min sessions School/Community activities: unclear duration | TP: Baseline, post‐I, 12 months Comp: not stated CG: received general education (standard PA program offered by the school) | Survey (6 item): f/day | I: 1.51 +/− 0.5 C: 1.55 +/− 0.69 | — | — | I: +1.51(−2.11,5.50) C: +0.4 (−1.11,1.9), P = 0.03 |
I = intervention group; CG = control group; TP = timepoint; Comp = compliance – if no information provided in manuscript; V/vege = vegetable; F = fruit; PA = physical activity; f = frequency; NS = not significant; SSB = sugar sweetened beverages; Adj = adjusted; EO = exposure only; and ASP = after school program.
Calculated by ((post intervention intake − baseline intake)/baseline intake × 100) or ((post intervention intake of intervention group − post intervention intake of control group)/post intervention intake of control × 100). This is only calculated for intake date, not for frequency data.