title: Small prizes increased healthful school lunch selection in a Midwestern school district.
abstract: As obesity has become a pressing health issue for American children, greater attention has been focused on how schools can be used to improve how students eat. Previously, we piloted the use of small prizes in an elementary school cafeteria to improve healthful food selection. We hoped to increase healthful food selection in all the elementary schools of a small school district participating in the United States Department of Agriculture Lunch Program by offering prizes to children who selected a Power Plate (PP), which consisted of an entrée with whole grains, a fruit, a vegetable, and plain low-fat milk. In this study, the PP program was introduced to 3 schools sequentially over an academic year. During the kickoff week, green, smiley-faced emoticons were placed by preferred foods, and children were given a prize daily if they chose a PP on that day. After the first week, students were given a sticker or temporary tattoo 2 days a week if they selected a PP. Combining data from the 3 schools in the program, students increased PP selection from 4.5% at baseline to 49.4% (p < 0.0001) during an intervention period of 2.5 school weeks. The school with the longest intervention period, 6 months, showed a PP selection increase of from 3.9% to 26.4% (p < 0.0001). In conclusion, giving small prizes as rewards dramatically improves short-term healthful food selection in elementary school children.
authors.affiliation: a The Center for Better Health and Nutrition, Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Siegel
authors.affiliation: a The Center for Better Health and Nutrition, Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Mary Kate
authors.initials: MK
authors.lastname: Lockhart
authors.affiliation: a The Center for Better Health and Nutrition, Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Allison S
authors.initials: AS
authors.lastname: Barnes
authors.affiliation: b Norwood City School District, Norwood, OH 45212, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hiller
authors.affiliation: b Norwood City School District, Norwood, OH 45212, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Kipp
authors.affiliation: b Norwood City School District, Norwood, OH 45212, USA.
authors.forename: Debora L
authors.initials: DL
authors.lastname: Robison
authors.affiliation: c James M. Anderson Center for Clinical Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Samantha C
authors.initials: SC
authors.lastname: Ellsworth
authors.affiliation: a The Center for Better Health and Nutrition, Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Hudgens
mesh_terms: D000818:Animals; D002648:Child; D002755:Choice Behavior; D000072001:Diet, Healthy; D005260:Female; D005518:Food Preferences; D005522:Food Services; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D062409:Lunch; D008297:Male; D008892:Milk; D012201:Reward; D012574:Schools; D012959:Socioeconomic Factors; D013334:Students; D014481:United States; D014675:Vegetables; D000067348:Whole Grains
keywords: cafeteria; cafétéria; obesity; obésité; pediatrics; petits cadeaux; pédiatrie; school; small prizes; école