P25 Fruit and Vegetable Intake, Intention, and Healthy Food Choice Self-Efficacy Among Second and Third Grade EFNEP Youth in Guam


      To examine the effectiveness of the Health Kids Club (HKC) curriculum on fruit and vegetable (FV) intake and dietary behaviors among the Expanded Food and Nutrition Education Program (EFNEP) youth participants in Guam.

      Use of Theory or Research

      Guam EFNEP implements the HKC curriculum and applies the Experiential Learning Model; therefore, the constructs of the Social Cognitive Theory is the framework to evaluate this study's objective.

      Target Audience

      Study participants were Guam EFNEP youth in grades 3-5 (N = 2,569) during 2015-2019 from different community-based sites throughout Guam. Majority of youth were Asian and/or Native Hawaiian or Other Pacific Islander race and males (53%).

      Program Description

      The HKC curriculum consists of 6 interactive lessons on food safety, diet quality, portion control, and moving more and each has 2 activities. A lesson is added to gather exit data and celebrate program completion.

      Evaluation Methods

      Only data from youth who self-reported dietary behaviors using the nutrition education survey at entry and exit were analyzed (N = 1,714). Surveys consisted of 14 total questions for both periods 2015-2017 (n = 776) and 2017-2019 (n = 938). A paired t test and Wilcoxon signed rank test were performed to determine program effectiveness. Questions from each survey period were selected to examine FV intake, FV intention, and healthy food choice (HFC) self-efficacy behavior categories.


      Youth reported a significantly higher exit score for all behavior categories in both study periods. In 2015-2017, the mean increase in FV intake, FV intention, and HFC self-efficacy scores at exit were 0.45 (95% CI: 0.35-0.55), 0.18 (95% CI: 0.10-0.27), and 0.55 (95% CI: 0.45-0.65), respectively. In 2017-2019, the mean increase in FV intake and HFC self-efficacy scores at exit were 0.20 (95% CI: 0.05-0.35) and 0.37 (95% CI: 0.29-0.45), respectively, and a statistically significant median increase in FV intention score, z = 2.27, P = 0.023.


      Guam EFNEP youth curriculum is effective in improving children's FV intake, FV intention, and HFC self-efficacy.
      Funding None.

      Appendix. Supplementary data