title: Feeding Strategies Derived from Behavioral Economics and Psychology Can Increase Vegetable Intake in Children as Part of a Home-Based Intervention: Results of a Pilot Study.
abstract: BACKGROUND
  Behavioral economics and psychology have been applied to altering food choice, but most studies have not measured food intake under free-living conditions.
  
  
  OBJECTIVE
  To test the effects of a strategy that pairs positive stimuli (ie, stickers and cartoon packaging) with vegetables and presents them as the default snack.
  
  
  METHODS
  A randomized controlled trial was conducted with children who reported consumption of fewer than two servings of vegetables daily. Children (aged 3 to 5 years) in both control (n=12) and treatment (n=12) groups received a week's supply of plainly packaged (ie, generic) vegetables, presented by parents as a free choice with an alternative snack (granola bar), during baseline (Week 1) and follow-up (Week 4). During Weeks 2 and 3, the control group continued to receive generic packages of vegetables presented as a free choice, but the treatment group received vegetables packaged in containers with favorite cartoon characters and stickers inside, presented by parents as the default choice. Children in the treatment group were allowed to opt out of the vegetables and request the granola bar after an imposed 5-minute wait.
  
  
  METHODS
  General Linear Model repeated measures analysis of variance was conducted to compare vegetable and granola bar intake between control and treatment groups across the 4-week study. Both within- and between-subjects models were tested.
  
  
  RESULTS
  A time×treatment interaction on vegetable intake was significant. The treatment group increased vegetable intake from baseline to Week 2 relative to control (P<0.01), but the effects were not sustained at Week 4 when the treatment was removed. Granola bar intake decreased in the treatment group at Week 2 (P≤0.001) and Week 3 (P≤0.005) relative to baseline.
  
  
  CONCLUSIONS
  Parents were able to administer feeding practices derived from behavioral economics and psychology in the home to increase children's vegetable intake and decrease intake of a high-energy-density snack. Additional studies are needed to test the long-term sustainability of these practices.
authors.forename: Terri L
authors.initials: TL
authors.lastname: Cravener
authors.forename: Haley
authors.initials: H
authors.lastname: Schlechter
authors.forename: Katharine L
authors.initials: KL
authors.lastname: Loeb
authors.forename: Cynthia
authors.initials: C
authors.lastname: Radnitz
authors.forename: Marlene
authors.initials: M
authors.lastname: Schwartz
authors.forename: Nancy
authors.initials: N
authors.lastname: Zucker
authors.forename: Stacey
authors.initials: S
authors.lastname: Finkelstein
authors.forename: Y Claire
authors.initials: YC
authors.lastname: Wang
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Rolls
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Keller
mesh_terms: D015992:Body Mass Index; D002675:Child, Preschool; D002755:Choice Behavior; D060909:Economics, Behavioral; D002149:Energy Intake; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005518:Food Preferences / Q000523:psychology; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010865:Pilot Projects; D062410:Snacks; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014675:Vegetables
keywords: Behavioral economics; Children; Defaults; Vegetable intake