Education About Fruit and Vegetable Consumption Includes Listening to the Children

Background: Diets high in fruit and vegetables (F&V) are associated with a lower risk of obesity, diabetes, cancer, and cardiovascular disease (CDC, 2008; Do et al., 2011). However, only 30-40% of children age 4-8 consume four servings of F&V and only 14% consume the recommended five servings a day (Guenther et al., 2006: USDA, 2007). School health education studies involving school aged children ( >5 years) have reported that positive and negative outcome messages can influence a child’s consumption of F&V’s with positive outcome messages having the most significant mediating effect (Reynolds et al. 2004). Similar studies are limited for preschool aged (< 5 years) children. The current study was designed to explore what preschool children hear and remember about fruit and vegetable messages.

Methods: School lunch-time F&V consumption of preschool children (n=201) was recorded over five days. Children (n=192) were individually interviewed about their knowledge, preference, and perceptions of fruits and vegetables using a picture card sort and open ended questions. Social Cognitive Theory (SCT) was utilized to categorize F&V messages conveyed by children. Descriptive statistics, Pearson’s correlation and one-way ANOVA were used for analysis.

Results: Preschool children convey a variety of information associated with F&V consumption that fits under SCT constructs. Positive outcome expectancies (POE), negative outcome expectancies (NOE), and prompts were most frequently stated. POEs were accompanied with a direct benefit valued by the child. Boys received negative reinforcements more than girls. Significant differences were observed based on socioeconomic status.

Conclusions and Implications: How parents, teachers, and health education professionals convey information about F&V’s can have an influence on children’s perceptions and preference. Parent modeling, availability/ accessibility and preference have typically been the default determinants of F&V consumption for young children (age) (Rasmussen et al. 2006). However, preschool children (aged 4) in this study demonstrated an understanding of positive outcome expectancies by placing a direct value on the outcome stated. While preschool children (aged 4) have limited cognitive skills compared with school aged children, their understanding and insight into valued outcomes of consuming F&V may be more apparent than previously researched. Hence, assessing preschool children’s perceptions first, then tailoring health education messages according to why a child values a specific outcome from eating F&Vs may produce benefits in addition to known determinants of F&V consumption.