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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #338448
Title: Motivational theater to increase consumption of vegetable dishes by preschool children

Author
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item LOPEZ, SANDRA - Children'S Nutrition Research Center (CNRC)
item LIU, YAN - Children'S Nutrition Research Center (CNRC)
item SAAB, RABAB - Children'S Nutrition Research Center (CNRC)
item REIHER, ROBERT - Innertainment

Submitted to: International Journal of Behavioral Nutrition and Physical Activity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/23/2017
Publication Date: 2/7/2017
Citation: Nicklas, T.A., Lopez, S.M., Liu, Y., Saab, R., Reiher, R. 2017. Motivational theater to increase consumption of vegetable dishes by preschool children. International Journal of Behavioral Nutrition and Physical Activity. doi:10.1186/s12966-017-0468-0.

Interpretive Summary: Children's food preferences and practices are initiated early in life (e.g. 2- to 5-year-olds). Seventy-five percent of young children consumed less than the recommended levels for vegetables, with median intakes less than one cup per day. French fries constituted about 23% of all vegetables consumed. Many preschool children are reluctant not only to eat vegetables, but even to taste vegetables, which is reflected in the very low intake of vegetables observed in preschoolers. The goal of this study was to test the feasibility of an innovative theater approach (puppet show) to increase the consumption of vegetable dishes in two low-income minority groups, African-American (AA) and Hispanic-American (HA) preschool children attending Head Start. Children in the intervention group significantly increased consumption of vegetable dishes from baseline to follow-up compared to the control group. At follow-up, the intervention group continued to have significantly higher intake of vegetable dishes compared to the control group. Using theory-based motivational theater with multiple exposures and related activities may be an effective behavioral intervention to increase consumption of vegetable dishes by preschool children that can be easily disseminated to a large sample.

Technical Abstract: 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.