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Health Education Research Advance Access published online on June 10, 2008
Health Education Research, doi:10.1093/her/cyn027
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Increasing fruit and vegetable intake among children: comparing long-term effects of a free distribution and a multicomponent program

E. Reinaerts1,*, R. Crutzen2, M. Candel3, N. K. De Vries4 and J. De Nooijer1

1 Department of Health Education and Promotion, Nutrition and Toxicology Research Institute Maastricht, Universiteit Maastricht, 6200 MD Maastricht, The Netherlands
2 Department of Health Education and Promotion
3 Department of Methodology and Statistics, Care And Public Health Research Institute, Universiteit Maastricht, 6200 MD Maastricht, The Netherlands
4 Department of Health Education and Promotion, Nutrition and Toxicology Research Institute Maastricht, Care And Public Health Research Institute, Universiteit Maastricht, 6200 MD Maastricht, The Netherlands

Correspondence to: * Correspondence to: E. Reinaerts. E-mail: evelien.reinaerts{at}gvo.unimaas.nl

The aim of this study was to evaluate and compare the effectiveness of two primary school-based interventions on children’s fruit and vegetable (F&V) consumption on the long term (2 years after the start of the interventions). Six primary schools were recruited and randomly assigned to (i) a daily free distribution program for the whole school or (ii) a multicomponent program consisting of a classroom curriculum and parental involvement (without free F&V), and six schools served as controls. Follow-up measurements were conducted at the end of the intervention (Follow-up I) and 1 year later (Follow-up II). Random coefficient analyses for longitudinal data showed that the effects of both interventions did not differ between the two follow-up measurements. The results showed similar effects for the free distribution program and the multicomponent program in increasing children’s fruit consumption over time (respectively, 7.2 and 15.2 g day–1). The distribution program also increased children’s vegetable consumption over time (3.25 g day–1), even after repeating the analyses using a pessimistic scenario. Despite the large dropout and its consequences for generalizability of our results, the distribution program is considered as the preferred intervention of the two, and implementation on a larger scale should be investigated.

Received on May 29, 2007; accepted on March 31, 2008


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