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J Nutr Educ Behav. 2014 Nov-Dec;46(6):506-46. doi: 10.1016/j.jneb.2014.05.012. Epub 2014 Nov 7.

Influence of behavioral theory on fruit and vegetable intervention effectiveness among children: a meta-analysis.

Author information

1
US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX. Electronic address: cdiep@bcm.edu.
2
US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
3
US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX; Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.

Abstract

OBJECTIVE:

To test the hypotheses that interventions clearly based on theory, multiple theories, or a formal intervention planning process will be more effective in changing fruit and vegetable consumption among children than interventions with no behavioral theoretical foundation.

DESIGN:

Systematic review and meta-analysis.

SETTING:

Identification of articles in PubMed, PsycInfo, Medline, Cochrane Collaborative database, and existing literature reviews and meta-analyses.

PARTICIPANTS:

Children aged 2-18 years.

INTERVENTIONS:

Change in fruit and/or vegetable consumption in dietary change interventions.

METHODS:

Meta-analysis, meta-regression analysis, and summary reporting for articles.

CONCLUSIONS AND IMPLICATIONS:

Predicating an intervention on behavioral theory had a small to moderate enhancement (P < .001) of outcome effectiveness. Differences in mean Hedges' g effect sizes between theory and non-theory interventions were 0.232 for fruit, 0.043 for vegetables, and 0.333 for fruit and vegetables combined. There was mixed support, however, for enhanced dietary change with multiple theories or a formal planning process. After controlling for study quality, theory use was related only to vegetable consumption (β = 0.373; P < .001). More research is needed on theory's influences on dietary behaviors to guide future interventions among children. More research is also needed to identify what may be effective practical- or experience-based procedures that complement theory, to incorporate into interventions.

KEYWORDS:

children; dietary change; meta-analysis; theory

PMID:
25457730
DOI:
10.1016/j.jneb.2014.05.012
[Indexed for MEDLINE]

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