title: Parental involvement and association with adolescents' fruit and vegetable intake at follow-up: Process evaluation results from the multi-component school-based Boost intervention.
abstract: Based on the assumption of parental influence on adolescent behavior, multicomponent school-based dietary interventions often include a parental component. The effect of this intervention component is seldom reported and the evidence is inconsistent. We conducted a systematic process evaluation of the parental component and examined whether the leveal of parental involvement in a large multi-component intervention: the Boost study was associated with adolescents' fruit and vegetable (FV) intake at follow-up.
  
  
  
  The Boost study was targeting FV intake among 1,175 Danish 7thgraders (≈13- year-olds) in the school year 2010/11. The study included a school component: free FV in class and curricular activities; a local community component: fact sheets for sports- and youth clubs; and a parental component: presentation of Boost at a parent-school meeting, 6 newsletters to parents, 3 guided student-parent curricular activities, and a student-parent Boost event.
  
  
  
  Students whose parent replied to the follow-up survey (n = 347).
  
  
  
  Questionnaire data from students, parents and teachers at 20 intervention schools. Process evaluation measures: dose delivered, dose received, appreciation and level of parental involvement. Parental involvement was trichotomized into: low/no (0-2 points), medium (3 points) and high (4-6 points). The association between level of parental involvement and self-reported FV intake (24-h recall), was analyzed using multilevel regression analyses.
  
  
  
  The Boost study was presented at a parent-school meeting at all intervention schools. The dose delivered was low to moderate for the three other parental elements. Most parents appreciated the intervention and talked with their child about Boost (83.5 %). High, medium and low parental involvement was found among 30.5 %, 29.6 % and 39.4 % of the students respectively. Parental involvement was highest among women. More men agreed that the parental newsletters provided new information. Students with a medium and high level of parental involvement ate 47.5 and 95.2 g more FV per day compared to students with low level/no parental involvement (p = 0.02).
  
  
  
  Students with a high level of parental involvement ate significantly more FV at follow-up compared to students with a low level/no parental involvement. Parental involvement in interventions may improve adolescents' FV intake if challenges of implementation can be overcome.
  
  
  
  ISRCTN11666034 . Registered 06/01/2012. Retrospectively registered.
authors: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark. saej@niph.dk.
authors: Sanne Ellegård
authors: SE
authors: Jørgensen
authors: Council on Health and Disease Prevention, Kristianiagade 12, 2100, Copenhagen Ø, Denmark.
authors: Thea Suldrup
authors: TS
authors: Jørgensen
authors: Intersectoral Research Unit for Health Services, The Capital Region of Denmark, Bispebjerg Hospital, 23 Bispebjerg Bakke, 2400, Copenhagen NV, Denmark.
authors: Anne Kristine
authors: AK
authors: Aarestrup
authors: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark.
authors: Pernille
authors: P
authors: Due
authors: National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2., 1353, Copenhagen K, Denmark.
authors: Rikke
authors: R
authors: Krølner
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001294:Attitude to Health; D003718:Denmark; D004032:Diet / Q000592:standards*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010290:Parents; D015397:Program Evaluation; D012111:Residence Characteristics; D012572:School Health Services; D012574:Schools; D057566:Self Report; D013334:Students; D011795:Surveys and Questionnaires; D014675:Vegetables
keywords: Adolescents; Fruit and vegetable intake; Parental involvement; Process evaluation; School intervention