Improving fruit and vegetable intake among Norwegian first graders through reinforcement, modelling, and peer advice: A feasibility study

Abstract

Background: According to the national dietary survey Ungkost 3, Norwegian children’s fruit and vegetable consumption is low. Several interventions have been implemented to increase consumption, but the effects have been modest. With promising effects from several western countries, the Food Dudes Programme has shown that reinforcement and role modelling can be efficient approaches to increasing children’s fruit and vegetable consumption. Objective: The main aim was to assess the feasibility of a reinforcement-, peer advice-, and modelling-based school intervention among Norwegian first graders. The secondary aim was to evaluate the preliminary outcomes of the intervention. Method: Six first grades from four schools in the Akershus County (Norway) were recruited. The intervention used a multiple baseline design and ran over six weeks. The behavioural change components used were a token economy, teacher modelling, and peer advice. To answer the study objectives, a mixed methods approach including a questionnaire, observation, and weighted registration was used. Results: In total, 99% of the pupils consented to participate in the study, and none of the pupils withdrew during the intervention. The teachers reported that the children understood and enjoyed the programme. Furthermore, most teachers reported that the token economy and peer advice were feasible and that the education material was satisfactory, although some improvements were suggested. The eligibility criteria, the suggested reinforcers, and the teacher modelling were found to be not feasible. Furthermore, the preliminary effects were not consistent across groups. Conclusion: In its current state, the intervention is considered not feasible, nor is it believed to produce the desired effects. Further improvements are needed for the intervention to be considered feasible, especially regarding the choice of reinforcers and teacher modelling.