title: Feasibility and Acceptability of Brighter Bites: A Food Co-Op in Schools to Increase Access, Continuity and Education of Fruits and Vegetables Among Low-Income Populations.
abstract: Intake of fruits and vegetables (F&V) continues to be low in children in the United States. The purpose of this study was to conduct a pilot feasibility evaluation of Brighter Bites, a school-based food co-op to provide access to fresh F&V and nutrition education to low-income children and their families. Brighter Bites is a 16-week school-based food co-op consisting of: (1) Weekly distribution of 50-60 servings of fresh F&V; (2) Weekly bilingual parent handouts and recipe demonstrations; and (3) implementing CATCH, a coordinated school health program in schools. Brighter Bites was pilot tested using a pre-post evaluation design in one charter school in Houston, TX, USA (n = 57 3rd grade parent-child dyads; 94.1 % Hispanic, 91 % low-income). Evaluation, at baseline, midpoint, and post-intervention, included self-reported child and parent surveys on psychosocial factors, dietary habits and mealtime practices. Pearson's Chi square test, Fisher's exact-test or paired t test were used to determine changes pre- to post-intervention (at p < 0.05). Process data using parent surveys, teacher surveys, attendance logs, and produce cost data were used to determine feasibility and acceptability of program. Participants received on average 61 servings of F&V weekly for 16 weeks at the cost of $4.31/family/week. Results showed significant increases in child reported self-efficacy, outcome expectations and attitudes towards consuming F&V (p < 0.05). We found significant increases in child exposure to F&V and child preference of various F&V from baseline to post-intervention (p < 0.05). Parent surveys showed significant improvements in mealtime practices at home: decrease in children eating while watching TV, increase in eating dinner with the family, less fast food, less sugary drinks with meals, more children asking for F&V as snacks. Process data showed 98 % retention rate and high parent acceptability of program components. Brighter Bites is a promising strategy to increase F&V access and education in low-income populations using existing infrastructure of schools and food banks.
authors.affiliation: Michael and Susan Dell Center for Healthy Living, The University of Texas School of Public Health, 7000 Fannin St., Houston, TX, 77030, USA, Shreela.V.Sharma@uth.tmc.edu.
authors.forename: Shreela
authors.initials: S
authors.lastname: Sharma
authors.forename: Lisa
authors.initials: L
authors.lastname: Helfman
authors.forename: Katherine
authors.initials: K
authors.lastname: Albus
authors.forename: Mike
authors.initials: M
authors.lastname: Pomeroy
authors.forename: Ru-Jye
authors.initials: RJ
authors.lastname: Chuang
authors.forename: Christine
authors.initials: C
authors.lastname: Markham
mesh_terms: D000886:Anthropometry; D002648:Child; D003258:Consumer Behavior; D055927:Cookbooks as Topic; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D005638:Fruit / Q000191:economics / Q000600:supply & distribution*; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D010290:Parents / Q000193:education*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D010865:Pilot Projects; D011204:Poverty Areas; D015995:Prevalence; D015397:Program Evaluation; D012572:School Health Services / Q000458:organization & administration* / Q000592:standards; D013781:Texas / Q000453:epidemiology; D014481:United States; D014675:Vegetables / Q000191:economics / Q000600:supply & distribution*