Nudges using Inexpensive Toys and Stickers Proven Effective in Promoting Selection and Consumption of Fruits and Vegetables (F/V) in Elementary School Lunchrooms

 

Increasing selection and consumption of healthy foods among children has proven challenging to improve in schools.  Children often do not select these items as they may be perceived as “boring” or not visually appealing.  To encourage healthy eating, the National School Lunch Program ensures that fruits and vegetables are available and accessible to students.  Despite implementation of this program, healthy selection and consumption of these foods are not always realized.

Researchers developed an inexpensive intervention to encourage the consumption of fruits and vegetables in two select schools by using methods commonly seen within food markets.  As current marketing strategies for the children’s food industry commonly include the use of characters on cereal boxes or toys in a McDonald’s Happy Meal; success in these markets suggest a correlation between use of marketing and food consumption.  In addition, utilizing these methods to provide a fun and reward-oriented environment for selecting and consuming fruits and vegetables, has potential to change the food choices of students to promote healthful eating.  Researchers for this study coordinated with lunchroom staff with prior approval of the school board to implement the intervention including the following:

1. Placing small stickers depicting superheroes, cartoon characters, monsters, etc. on fruit and vegetable containers in a food safe manner
2. Rewarding students with a token that could be exchanged for an inexpensive toy such as wristbands, jumping frogs, etc. for a finished serving of fruits and vegetables daily during the intervention period.

In School 1 (School 2), students’ trays were observed for 13 days (7 days) during the baseline period, followed by 10 days (7 days) during intervention, and 7 days (5 days) in post intervention period.  By collecting data in all stages, researchers could determine if a change in fruits and vegetables was observed and if the change was sustained.  Two measures of selection and two measures of consumption were studied based on plate waste data as seen below.

Selection:

1. Frequency for which the student selected and consumed at least one serving of F/V
2. Frequency for which the student selected, but did not consume at least one serving of F/V

 

Consumption:

1. Servings of F/V consumed by each student in increments of half servings
2. Frequency at which the student ate at least one serving of F/V

An increase in fruit and vegetable consumption were observed in schools 1 and 2 (25% and 47%, respectively) from baseline to intervention.  Additionally, from baseline to post-intervention there was a 20% and 23% increase, respectively. Increases were observed consistently across all grade levels (grades 1 through 5).  Hence, consumption of healthy foods increased while maintaining the children’s freedom of choice. Conserving choice in this context has been found to increase satisfaction. Results suggest that inexpensive marketing towards healthy food choices can be successful in encouraging healthy eating among school children.  There are other ideas to improve healthy food choices which can be found at http://ben.cornell.edu/.

Contributors

Janani Rajbhandari-Thapa, Ph.D, Department of Health Policy and Management in the College of Public Health, University of Georgia

Conrad Lyford, Ph.D, Department of Agricultural and Applied Economics, Texas Tech University