The Impact of Combining Nutrition Education with Active Choice on the Fruit and Vegetable Consumption Among Second Grade Students

Daily intake of fruits and vegetables provides the basis for healthy nutrition. Yet low consumption of fruits and vegetables (FV) persists among school-aged children. Framed by the Social Cognitive Theory, this study aimed to determine the effectiveness of nutrition lessons combined with an active choice intervention on children's FV consumption. Using a quasi-experimental design, 89 second graders were assigned to groups. Students in the experimental group (n=46) received four nutrition lessons combined with nine active choice sessions, while those in the control group (n=43) received active choice sessions only. Responses to pre- and post-intervention surveys that inquired FV knowledge and consumption were compared within and between groups using independent and paired t-tests. Empowered by improved knowledge, self-efficacy and the positive environment created through nutrition lessons and active choice, the experimental group showed improvement in consumption behavior compared to the control group at post-intervention: bringing FV to school and finish eating (69.7 vs. 51.2, p=.05 for fruits; 43.5 vs. 39.5, p=.41 for vegetables); like choosing FV (84.8 vs. 65.1, p=.01); like to eat more FV (80.4 vs. 62.8, p=.16); FV are healthy (100 vs. 95.3, p=.14). The magnitude of improvement is small yet consistent in every aspect of outcome measures. Combining nutrition education with the active choice component showed potential for a larger impact on behavior change among study participants. Parental support and community involvement could enhance the effectiveness of nutrition education in schools.