title: Influence of behavioral theory on fruit and vegetable intervention effectiveness among children: a meta-analysis.
abstract: OBJECTIVE
  To test the hypotheses that interventions clearly based on theory, multiple theories, or a formal intervention planning process will be more effective in changing fruit and vegetable consumption among children than interventions with no behavioral theoretical foundation.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Identification of articles in PubMed, PsycInfo, Medline, Cochrane Collaborative database, and existing literature reviews and meta-analyses.
  
  
  METHODS
  Children aged 2-18 years.
  
  
  METHODS
  Change in fruit and/or vegetable consumption in dietary change interventions.
  
  
  METHODS
  Meta-analysis, meta-regression analysis, and summary reporting for articles.
  
  
  CONCLUSIONS
  Predicating an intervention on behavioral theory had a small to moderate enhancement (P < .001) of outcome effectiveness. Differences in mean Hedges' g effect sizes between theory and non-theory interventions were 0.232 for fruit, 0.043 for vegetables, and 0.333 for fruit and vegetables combined. There was mixed support, however, for enhanced dietary change with multiple theories or a formal planning process. After controlling for study quality, theory use was related only to vegetable consumption (β = 0.373; P < .001). More research is needed on theory's influences on dietary behaviors to guide future interventions among children. More research is also needed to identify what may be effective practical- or experience-based procedures that complement theory, to incorporate into interventions.
authors.affiliation: US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX. Electronic address: cdiep@bcm.edu.
authors.forename: Cassandra S
authors.initials: CS
authors.lastname: Diep
authors.affiliation: US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Tzu-An
authors.initials: TA
authors.lastname: Chen
authors.affiliation: US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Vanessa F
authors.initials: VF
authors.lastname: Davies
authors.affiliation: US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Janice C
authors.initials: JC
authors.lastname: Baranowski
authors.affiliation: US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Tom
authors.initials: T
authors.lastname: Baranowski
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D017195:Adolescent Nutritional Physiological Phenomena; D032763:Behavior Control; D001521:Behavior Therapy; D002648:Child; D002652:Child Behavior; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D005638:Fruit; D006801:Humans; D018673:Nutrition Policy; D010349:Patient Compliance; D014675:Vegetables
keywords: children; dietary change; meta-analysis; theory