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Title: The effectiveness of asking behaviors among 9-11 year-old children in increasing home availability and children's intake of fruit and vegetables: Results from the Squire's Quest II self-regulation game intervention

Author
item DESMET, ANN - Ghent University
item LIU, YAN - Children'S Nutrition Research Center (CNRC)
item DE BOURDEAUDHUIJ, ILSE - Ghent University
item BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC)
item Thompson, Deborah - Debbe

Submitted to: International Journal of Behavioral Nutrition and Physical Activity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/7/2017
Publication Date: 4/21/2017
Publication URL: https://handle.nal.usda.gov/10113/5678148
Citation: DeSmet, A., Liu, Y., De Bourdeaudhuij, I., Baranowski, T., Thompson, D. 2017. The effectiveness of asking behaviors among 9-11 year-old children in increasing home availability and children's intake of fruit and vegetables: Results from the Squire's Quest II self-regulation game intervention. International Journal of Behavioral Nutrition and Physical Activity. 14:51.

Interpretive Summary: Children do not consume adequate amounts of fruits and vegetables. A home environment that supports and promotes fruits and vegetable consumption is desirable. Teaching children asking behaviors (i.e., how to successfully ask parents or caregivers) to increase home availability of fruits and vegetables may be an important way to enhance the home environment and increase fruit and vegetable consumption. This research demonstrated that at baseline, child asking behaviors predicted home availability. The Squire's Quest! II intervention increased child asking behaviors, fruit and vegetable availability, and consumption. Increased asking behaviors did not predict increases in home availability, and increases in neither asking behaviors nor the home environment were associated with increases in fruit and vegetable consumption. The home environment is an important component of helping children engage in healthy behaviors, such as eating more fruits and vegetables. Additional research is needed to identify ways in which children can influence their home environment to support and reinforce positive behavior change.

Technical Abstract: Home environment has an important influence on children's fruit and vegetable (FV) consumption, but children may in turn also impact their home FV environment, e.g. by asking for FV. The Squire's Quest II serious game intervention aimed to increase asking behaviors to improve home FV availability and children's FV intake. This study's aims were to assess: 1) did asking behaviors at baseline predict home FV availability at baseline (T0) (RQ1); 2) were asking behaviors and home FV availability influenced by the intervention (RQ2); 3) did increases in asking behaviors predict increased home FV availability (RQ3); and 4) did increases in asking behaviors and increases in home FV availability mediate increases in FV intake among children (RQ4)? This is a secondary analysis of a study using a randomized controlled trial, with 4 groups (each n=100 child–parent dyads). All groups were analyzed together for this paper since groups did not vary on components relevant to our analysis. All children and parents (n=400 dyads) received a self-regulation serious game intervention and parent material. The intervention ran for three months. Measurements were taken at baseline, immediately after intervention and at 3-month follow-up. Asking behavior and home FV availability were measured using questionnaires; child FV intake was measured using 24-h dietary recalls. ANCOVA methods (research question 1), linear mixed-effect models (research question 2), and Structural Equation Modeling (research questions 3 and 4) were used. Baseline child asking behaviors predicted baseline home FV availability. The intervention increased child asking behaviors and home FV availability. Increases in child asking behaviors, however, did not predict increased home FV availability. Increased child asking behaviors and home FV availability also did not mediate the increases in child FV intake. Children influence their home FV environment through their asking behaviors, which can be enhanced via a serious game intervention. The obtained increases in asking behavior were, however, insufficient to affect home FV availability or intake. Other factors, such as child preferences, sample characteristics, intervention duration and parental direct involvement may play a role and warrant examination in future research.