Abstract
Purpose
The main objective of the PROFRUVE study was to evaluate the effectiveness of a TPB-based intervention program at increasing fruit and vegetable (FV) consumption in schoolchildren aged 7–10.
Methods
Eight eligible classrooms were randomly assigned to the intervention (classrooms n = 4; children n = 90) or control group (classrooms n = 4; children n = 95). The intervention group received 14 sessions of 1 h during an academic year (from October to June) but the control group did not. Sessions were based on the Theory of Planned Behavior (TPB) and focused on modifying FV intake. FV consumption was evaluated before, shortly after and 1 year after intervention ended using validated 7-day food records.
Results
FV intake increased significantly in the intervention group (+ 0.45 servings/day; 95% CI 0.17–0.74; p = 0.001) but not in the control group (+ 0.01 servings/day; 95% CI −0.20–0.22; p = 0.409) shortly after the intervention. Long-term measurement showed that 1 year after intervention finished, the intervention group maintained the effect (+ 0.52 servings/day from baseline; 95% CI 0.22–0.78; p = 0.003). Linear mixed model also showed that nested groups by classrooms differ from intervention and control groups regarding FV intake change (p = 0.002). Multiple linear regression showed that receiving the intervention (B = 0.345, p = 0.045) and FV baseline intake (B = − 0.383, p = 0.000) were associated with FV intake change after adjusting the model by age, gender and family social economic status (SES) (R2 = 0.196).
Conclusions
The intervention program based on TPB seemed to be moderately effective in increasing FV intake and successful in maintaining the effect of the reached increase. Moreover, baseline FV intake determined the effect size of the intervention.
Trial Registration
This study was registered at ClinicalTrials.gov. Identifier: NCT03400891. Data registered 17/01/2018.
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Acknowledgements
The authors wish to thank Slow Food Araba, “5 al día” Association, Ausolan and Tamar for their collaboration in the study. We also thank pre-graduate students for their collaboration in the design of the material. Moreover, our special thanks go to schoolteachers and directors.
Funding
This study was supported by the Government of the Basque Country (IT572/13), CIBERobn (Centro de Investigación Biomédica en Red, ISCIII), University of the Basque Country and City Council of Vitoria-Gasteiz (Programa de Fomento del Consumo de Fruta y Verdura en la Población Infantil de Vitoria-Gasteiz FASE II US14/15). Arrizabalaga-Lopez M is a PhD fellowship holder from the University of the Basque Country UPV/EHU.
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
Ethics approval
The study was approved by the Ethic Committee of the University of the Basque Country UPV/EHU (CEISH/262/2014/RODRIGUEZRIVERA). Parents or legal guardians, school directors and teachers completed a written consent form before the study commences.
Protocol
The study protocol was published elsewhere: https://doi.org/10.1186/s12889-018-5748-3 [21].
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Arrizabalaga-López, M., Rada-Fernández de Jáuregui, D., Portillo, M.P. et al. A theory-based randomized controlled trial in promoting fruit and vegetable intake among schoolchildren: PROFRUVE study. Eur J Nutr 59, 3517–3526 (2020). https://doi.org/10.1007/s00394-020-02185-5
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DOI: https://doi.org/10.1007/s00394-020-02185-5