Abstract
Objective
To explore the potential of mHealth using smartphones to improve fruit and vegetable
intake in children.
Design
A 10-week randomized control and intervention pilot study.
Setting
Story time sessions at local libraries.
Participants
A convenience sample of 30 parents and children (aged 3–8 years).
Intervention
Delivery of nutrition intervention through the mobile Jump2Health website, Facebook posts, and text messages.
Main Outcome Measures
Electronic food photos of children's meals and snacks, 10-question survey related
to fruit and vegetable consumption, reflectance spectroscopy via Veggie Meter to measure
skin carotenoid levels, body mass index percentiles, and a mobile learning survey.
Analysis
Descriptive statistics and Wilcoxon matched-pairs signed-rank test.
Results
Veggie Meter values for children and parents showed significant week × treatment interactions
in the intervention group compared with the control group for both children (P < .001 and parents (P < .001).
Conclusions and Implications
This pilot study offers a potentially effective program including a mobile Web site,
social media, and test message components to increase fruit and vegetable intake of
young children.
Key Words
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References
- Prevalence of childhood and adult obesity in the United States, 2011-2012.JAMA. 2014; 311: 806-814
- Causes and consequences of childhood obesity.(Accessed April 6, 2018)
- Parents as health promoters: a Theory of Planned Behavior perspective on the prevention of childhood obesity.J Health Commun. 2010; 15: 95-107
- Challenges, alternatives, and educational strategies in reaching limited income audiences.J Ext. 2009; 47: 6RIB2
- Recruitment of minority and underserved populations in the United States: the Centers for Population Health and Health Disparities experience.Contemp Clin Trials. 2008; 29: 847-861
- Enrollment and attendance in a parent training prevention program for conduct problems.Prev Sci. 2011; 12: 126-138
- Parent perspectives on attrition from tertiary care pediatric weight management programs.Clin Pediatr (Phila). 2013; 52: 513-519
- Management issues related to effectively implementing a nutrition education program using peer educators.J Nutr Educ. 2001; 33: 284-292
World Health Organization. eHealth at WHO. http://www.who.int/ehealth/about/en/. Accessed April 6, 2018.
- Parent-focused childhood and adolescent overweight and obesity eHealth interventions: a systematic review and meta-analysis.J Med Internet Res. 2016; 18: e203
File T, Ryan C. Computer and Internet use in the United States: 2013. US Census Bureau. https://www.census.gov/history/pdf/2013computeruse.pdf. Accessed November 30, 2018.
- Jump2Health website for Head Start parents to promote a healthy home environment: results from formative research.J Public Health Res. 2017; 6: 1054
- Qualitative evaluation of the Jump2Health website for parents of preschool children shows behavior changes.Int Q Community Health Educ. 2016; 37: 43-50
- Characteristics associated with older adolescents who have a television in their bedrooms.Pediatrics. 2008; 121: 718-724
- The nutrition needs of low-income families regarding living healthier lifestyles: findings from a qualitative study.J Child Health Care. 2013; 17: 53-61
- Is frequency of shared family meals related to the nutritional health of children and adolescents?.Pediatrics. 2011; 127: e1565-e1574
- Childhood sleep time and long-term risk for obesity: a 32-year prospective birth cohort study.Pediatrics. 2008; 122: 955-960
- Sleep duration and adolescent obesity.Pediatrics. 2013; 131: e1428-e1434
- Recommendations for treatment of child and adolescent overweight and obesity.Pediatrics. 2007; 120: S254-S288
- Overweight among low-income preschool children associated with the consumption of sweet drinks: Missouri, 1999-2002.Pediatrics. 2005; 115: e223-e229
- Guiding family-based obesity prevention efforts in low-income children in the United States. Part I: what determinants do we target?.Int J Child Adolesc Health. 2009; 2: 19-30
National Academies of Sciences, Engineering, and Medicine. Early Childhood Obesity Prevention Policies. http://www.nationalacademies.org/hmd/Reports/2011/Early-Childhood-Obesity-Prevention-Policies.aspx. Accessed August 6, 2018.
- Availability, accessibility, and preferences for fruit, 100% fruit juice, and vegetables influence children's dietary behavior.Health Educ Behav. 2003; 30: 615-626
Epidemiology and Genomics Research Program. Usual dietary intakes: food intakes, U.S. population, 2007-10. Bethesda, MD: National Cancer Institute; 2018.
- Association of picky eating and food neophobia with weight: a systematic review.Child Obes. 2016; 12: 247-262
- Feel your food: the influence of tactile sensitivity on picky eating in children.Appetite. 2015; 84: 7-10
- Social Foundations of Thought and Action: A Social Cognitive Theory.Prentice-Hall, Englewood Cliffs, NJ1986
Facebook. What metrics are available on Page posts? https://www.facebook.com/help/131809553587433?helpref=popular_topics. Accessed August 6, 2018.
Southern M. Facebook to begin measuring post reach based on actual views. https://www.searchenginejournal.com/facebook-begin-measuring-post-reach-based-actual-views/236587/. Accessed August 6, 2018.
Leander M. What is a good Facebook engagement rate? See numbers here. http://www.michaelleander.me/blog/facebook-engagement-rate-benchmark/. Accessed August 6, 2018.
- Innovative techniques for evaluating behavioral nutrition interventions.Adv Nutr. 2017; 8: 113-125
- Skin carotenoids as biomarker for vegetable and fruit intake: validation of the reflection-spectroscopy based “Veggie Meter.”.FASEB J. 2016; 30: 409.3
- A non-invasive assessment of skin carotenoid status through reflection spectroscopy is a feasible, reliable and potentially valid measure of fruit and vegetable consumption in a diverse community sample.Public Health Nutr. 2018; 21: 1664-1670
- Optical assessment of skin carotenoid status as a biomarker of vegetable and fruit intake.Arch Biochem Biophys. 2018; 646: 46-54
- Dermal carotenoid measurements via pressure mediated reflection spectroscopy.J Biophotonics. 2012; 5: 559-570
Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey (NHANES) Anthropometry Procedures Manual. Atlanta, GA: Centers for Disease Control and Prevention; 2007.
Centers for Disease Control and Prevention. BMI percentile calculator for child and teen. https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/tool_for_schools.html. Accessed November 30, 2018.
- Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids.The National Academies Press, Washington, DC2000
- Vegetable behavioral tool demonstrates validity with MyPlate vegetable cups and carotenoid and inflammatory biomarkers.Appetite. 2016; 107: 628-638
- The role and interpretation of pilot studies in clinical research.J Psychiatr Res. 2011; 45: 626-629
- Patterns in children's fruit and vegetable consumption by meal and day of the week.J Am Coll Nutr. 1997; 16: 216-223
National Institutes of Health, National Cancer Institute. Dietary assessment primer: Learn more about day-of-week effect. https://dietassessmentprimer.cancer.gov/learn/day.html. Accessed April 6, 2018.
- Home food environment factors associated with the presence of fruit and vegetables at dinner: a direct observational study.Appetite. 2016; 96: 526-532
- Interventions for increasing fruit and vegetable consumption in children aged five years and under.Cochrane Database Syst Rev. 2018; 1CD008552
- Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies.Int J Behav Nutr Phys Act. 2011; 8: 112
- Interventions for increasing fruit and vegetable consumption in children aged 5 years and under.Cochrane Database Syst Rev. 2012; 11CD008552
- Challenges of accurately measuring and using BMI and other indicators of obesity in children.Pediatrics. 2009; 124: s3-s22
- Child factor in measurement dependability.Am J Hum Biol. 2001; 13: 548-557
- Day-to-day variation in body weights of children.Ann Hum Biol. 1976; 3: 75-76
- Using Facebook in a healthy lifestyle intervention: feasibility and preliminary efficacy.West J Nurs Res. 2018; 40: 1818-1842
- Revising an Extension education website for limited resource audiences using social marketing theory.J Ext. 2011; 49: 1-13
- Facebook: the use of social media to engage parents in a preschool obesity prevention curriculum.J Nutr Educ Behav. 2018; 50 (e1): 4-10
- Are health behavior change interventions that use online social networks effective? A systematic review.J Med Internet Res. 2014; 16: e40
- Developing and evaluating digital interventions to promote behavior change in health and health care: recommendations resulting from an international workshop.J Med Internet Res. 2017; 19: e232
- Feasibility of bidirectional text messages in evaluating a text-based nutrition education program for low-income parents: results from the Text2BHealthy program.Eval Program Plann. 2017; 64: 90-94
- Development and implementation of an interactive text messaging campaign to support behavior change in a childhood obesity randomized controlled trial.J Health Commun. 2015; 20: 843-850
- Content relevance and delivery time of SMS advertising.Int J Mob Commun. 2011; 9: 19-38
- The forgotten parent: fathers’ representation in family interventions to prevent childhood obesity.Prev Med. 2018; 111: 170-176
Article info
Publication history
Published online: January 09, 2019
Accepted:
November 12,
2018
Footnotes
Conflict of Interest Disclosure: The authors have not stated any conflicts of interest.
Identification
Copyright
© 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
