title: Evaluating a school-based fruit and vegetable co-op in low-income children: A quasi-experimental study.
abstract: The purpose of this study was to evaluate the effectiveness of a new school-based food co-op program, Brighter Bites (BB), to increase fruit and vegetable intake, and home nutrition environment among low-income 1st graders and their parents. This was a non-randomized controlled comparative effectiveness trial (2013-2015). Six schools received BB (n=407 parent-child dyads); six comparison schools implemented a coordinated school health program (n=310 parent-child dyads) in Houston, Texas, 2013-2015. Brighter Bites (BB) is a 16-week school-based food co-op comprising weekly distribution of fresh produce (50 servings); nutrition education in schools and for parents; and weekly recipe tastings. Measurements included parent-reported home nutrition environment surveys, and food frequency questionnaires for parent and child. Intervention effects were examined using multivariate analyses. At baseline, the sample was 71% Hispanic, 24% African American; 43% of 1st graders were overweight/obese. Children receiving BB had significant increases in intake of fruit servings (P=0.046), vegetable servings (P=0.049), and decreased intake of added sugars (P=0.014). Among parents, there were significant increases in fruit consumed (P=0.032); vegetable intake increased baseline to midpoint but not post-intervention. Among BB families, there were significant improvements in the home environment including understanding and usage of nutrition facts labels to make food purchases (P<0.05), frequency of cooking (P=0.007), rules and practices regarding eating family meals (P=0.022), serving fruits (P=0.005) and vegetables (P=0.028) at meals, and limiting portion sizes (P=0.016). In conclusion, a school-based food co-op model shows promising results in improving dietary habits and home nutrition environment among low-income families.
authors.affiliation: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, 1200 Pressler, Houston, TX 77030, United States. Electronic address: Shreela.V.Sharma@uth.tmc.edu.
authors.forename: Shreela V
authors.initials: SV
authors.lastname: Sharma
authors.affiliation: Center for Health Promotion and Prevention Research, The University of Texas Health Science Center-School of Public Health, Houston, 7000 Fannin St, Houston, TX 77030, United States. Electronic address: Christine.Markham@uth.tmc.edu.
authors.forename: Christine
authors.initials: C
authors.lastname: Markham
authors.affiliation: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, 1200 Pressler, Houston, TX 77030, United States. Electronic address: Wai.Yee.Chui@uth.tmc.edu.
authors.forename: Joanne
authors.initials: J
authors.lastname: Chow
authors.affiliation: Michael & Susan Dell Center for Healthy Living, The University of Texas School of Public Health, 1616 Guadalupe, Austin, TX 78701, United States. Electronic address: Nalini.Ranjit@uth.tmc.edu.
authors.forename: Nalini
authors.initials: N
authors.lastname: Ranjit
authors.affiliation: Brighter Bites, 505 Portwall St, Houston, TX 77029, United States. Electronic address: Michael.Pomeroy@brighterbites.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Pomeroy
authors.affiliation: Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center-School of Public Health, 1200 Pressler, Houston, TX 77030, United States. Electronic address: Margaret.P.Raber@uth.tmc.edu.
authors.forename: Margaret
authors.initials: M
authors.lastname: Raber
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D005247:Feeding Behavior / Q000208:ethnology*; D005260:Female; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010290:Parents / Q000193:education; D011203:Poverty; D012572:School Health Services; D011795:Surveys and Questionnaires; D013781:Texas; D014675:Vegetables
keywords: Child dietary behaviors; Food co-op; Fruit and vegetable intake; Low-income populations; School-based intervention