title: School-based internet-tailored fruit and vegetable education combined with brief counselling increases children's awareness of intake levels.
abstract: OBJECTIVE
  Children's fruit/vegetable intake is still below recommended levels. This study applied Internet-tailored advice for schoolchildren and Internet-supported brief dietary counselling (with child and parent) within preventive health care to promote fruit/vegetable intake.
  
  
  METHODS
  The study involved 30 seventh-grade classes (16 in the intervention group and 14 in the control group) with a total of 675 children aged 9-12 years, of whom 495 were allowed to participate.
  
  
  METHODS
  A cluster-randomised baseline-post-test experimental design was applied. During school hours, all children completed Internet-administered questionnaires on fruit/vegetable intake and related determinants. Children in the intervention group received immediate online individually tailored nutrition feedback. For each child in the intervention group, a nurse received information concerning the assessment of fruit/vegetable intake via the Internet to support a 5 min counselling protocol to promote fruit/vegetable intake. Children completed a similar post-test questionnaire 3 months after the first assessment. Intention-to-treat analyses were conducted using multilevel regression analyses.
  
  
  RESULTS
  A total of 486 children (98% of 495) participated (263 in the intervention group, 223 in the control group); 240 child-parent couples in the intervention group attended the counselling. Awareness of inadequate fruit intake (odds ratio (OR) = 3.0; 95% confidence interval (CI) = 1.8-5.3) and knowledge of recommended vegetable intake levels (OR = 2.7; 95% CI = 1.8-4.1) were significantly more likely at post-test in the intervention group than in the control group. No significant effects were found on intake or other determinants.
  
  
  CONCLUSIONS
  A compact, integrated two-component intervention can induce positive changes in knowledge and awareness of intake levels of fruit/vegetables among schoolchildren. To induce changes in intake levels, more comprehensive interventions may be needed.
authors.affiliation: Department of Public Health, Erasmus MC-University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.
authors.forename: Resiti T
authors.initials: RT
authors.lastname: Mangunkusumo
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
authors.forename: Johan
authors.initials: J
authors.lastname: van der Lei
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
mesh_terms: D001364:Awareness; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D016000:Cluster Analysis; D016001:Confidence Intervals; D003376:Counseling; D005260:Female; D005638:Fruit; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D020407:Internet; D008297:Male; D018673:Nutrition Policy; D016017:Odds Ratio; D011795:Surveys and Questionnaires; D014675:Vegetables