title: Process evaluation of a cluster randomised controlled trial of a school-based fruit and vegetable intervention: Project Tomato.
abstract: OBJECTIVE
  The present analysis evaluates the overall appreciation and implementation of an intervention, Project Tomato, designed to maintain fruit and vegetable intake in children aged 8-9 years.
  
  
  METHODS
  A random sample of fifty-four English primary schools (658 children) were randomised to either the intervention group or the control. The intervention group received a multi-component programme delivered in school by teachers and items sent home for parents/children. Dietary measurements were collected at baseline and follow-up. The intervention participants completed questionnaires on the intervention materials, to identify implementation and appreciation of the intervention, and other environmental mechanisms.
  
  
  METHODS
  Fifty-four primary schools were randomly selected, with twenty-seven schools allocated to the intervention group.
  
  
  METHODS
  A total of 311 children received the intervention.
  
  
  RESULTS
  Implementation of the intervention was low, 21·3 % of school items and 56·0 % of home items were implemented. The intervention materials were well received by teachers, parents and children. Other mechanisms that may affect fruit and vegetable intake were explored. Children who ate their main meal with their parents 3-7 nights/week on average consumed 37·6 (95 % CI 9·8, 65·4) g more fruit and vegetables than children who ate with their parents 0-2 times/week.
  
  
  CONCLUSIONS
  Implementation of the trial components was poor. However, the results identified the importance of parental environment and mealtime structure on children's fruit and vegetable intake.
authors.affiliation: Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, UK. m.s.christian@leeds.ac.uk
authors.forename: Meaghan S
authors.initials: MS
authors.lastname: Christian
authors.forename: Charlotte E L
authors.initials: CE
authors.lastname: Evans
authors.forename: Joan K
authors.initials: JK
authors.lastname: Ransley
authors.forename: Darren C
authors.initials: DC
authors.lastname: Greenwood
authors.forename: James D
authors.initials: JD
authors.lastname: Thomas
authors.forename: Janet E
authors.initials: JE
authors.lastname: Cade
mesh_terms: D002648:Child; D004032:Diet / Q000592:standards*; D002149:Energy Intake; D004739:England; D005247:Feeding Behavior; D005260:Female; D005522:Food Services; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D010290:Parents; D012572:School Health Services; D011795:Surveys and Questionnaires; D014675:Vegetables