title: Evaluating changeability to improve fruit and vegetable intake among school aged children.
abstract: BACKGROUND
  The purposes of this paper are two fold. First, to describe an approach used to identify fruits and vegetables to target for a child focused dietary change intervention. Second, to evaluate the concept of fruit and vegetable changeability and feasibility of applying it in a community setting.
  
  
  METHODS
  Steps for identifying changeable fruits and vegetables include (1) identifying a dietary database (2) defining geographic and (3) personal demographics that characterize the food environment and (4) determining which fruits and vegetables are likely to improve during an intervention. The validity of these methods are evaluated for credibility using data collected from quasi-experimental, controlled design among 7-9 year old children (n = 304) participating in a tutoring or mentoring program in St. Louis, MO. Using a 28-item food frequency questionnaire, parents were asked to recall for their child how often foods were eaten the past 7 days. This questionnaire was repeated eight months later (response rate 84%). T-test analyses are used to determine mean serving differences from baseline to post test.
  
  
  RESULTS
  The mean serving differences from baseline to post test were significant for moderately eaten fruits (p < .001), however, not for vegetables (p = .312). Among the intervention group, significantly more children ate grapes (p < .001), peaches (p = .022), cantaloupe (p < .001), and spinach (p = .044) at post testing - all identified as changeable with information tailored to participants.
  
  
  CONCLUSIONS
  Data driven, food focused interventions directed at a priority population are feasible and practical. An empirical evaluation of the assumptions associated with these methods supports this novel approach. However, results may indicate that these methods may be more relevant to fruits than vegetables. This process can be applied to diverse populations for many dietary outcomes. Intervention strategies that target only those changeable fruits and vegetables are innovative and warrant further study.
authors.affiliation: Department of Health Promotion & Education, University of Utah, Salt Lake City, UT, USA. susie.nanney@hsc.utah.edu
authors.forename: Marilyn S
authors.initials: MS
authors.lastname: Nanney
authors.forename: Debra
authors.initials: D
authors.lastname: Haire-Joshu
authors.forename: Michael
authors.initials: M
authors.lastname: Elliott
authors.forename: Kimberly
authors.initials: K
authors.lastname: Hessler
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
mesh_terms: D001521:Behavior Therapy; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D004032:Diet; D015930:Diet Records; D005518:Food Preferences; D005638:Fruit; D006801:Humans; D018673:Nutrition Policy; D012424:Rural Population; D011795:Surveys and Questionnaires; D014505:Urban Population; D014675:Vegetables