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University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Measuring the Impact of Group Incentives on Aggregate Fruit and Vegetable Consumption for
Lunch in Two Wisconsin Elementary Schools
Student Researchers
Tiffany Christner, Nicholas Douglass, Mitchell Fischer, Jisu Kim, Aaron Lickel, Jonathan Pumper & Lucy Ramquist
Faculty Mentors
Eric Jamelske
Sydney Chinchanachokchai
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
OverviewOverview
Motivation and Previous Research
Study Design FV Consumption Measurement Phases of Study Demographic Summary Preliminary Results
Conclusions and Future Work Questions and Discussion
MotivationMotivation Inadequate FV consumption (not 5-9 a day) Lots of less healthy alternatives
Rising rates of childhood and adult obesity Significant health care concern, annual costs in the BILLIONS of $
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
FFVP in Elementary Schools (Jamelske, Bica, Lagoria 2009-10)– Bring FV from home for snack on non-FFVP days, toys and encouragement
After School Program (Jamelske 2012-13)– Eat FV for snack/dinner, chance to win $15-20 prizes weekly, encouragement
Elementary School Lunch FV Consumption (Just & Price 2013)– Small monetary incentives increase fraction of children eating FV by 80%
Elementary School Lunch FV Intake (Wengreen et al. 2013)– Incentives increase F/V intake increased by 0.53 cups per day
Red Pepper Strips Individual Meetings (Wardle et al. 2003)– Exposure and reward raise short term consumption and preferences
Using Incentives to Increase FV IntakeUsing Incentives to Increase FV Intake
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Study DesignStudy Design Two Wisconsin elementary schools
Self-serve salad bar at lunch
Children must take two items
Three lunch periods, 2 grades each period
Three observation days each week (M W F)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Study DesignStudy Design
Table set up at waste disposal area
All children drop tray on table upon leaving
Researchers separate FV waste into bus trays by item
After all lunch periods, waste is weighed for each FV item
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
FV MeasuresFV Measures
All amounts weighed using digital scale (pounds)
Pounds to ounces (multiply by 16)
Ounces per lunch served (divide by lunches served)
Initial FV available for serving Leftover FV not served/taken FV waste, taken but not eaten
Initial – Waste – Leftover = Consumption
Aggregate measure of FV (daily)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Three Phases of StudyThree Phases of Study Initial baseline, 3 days
–No intervention, just measuring
Announcements, encouragement and incentives, 6 days–Prizes if aggregate FV consumption increases
Return to baseline, 3 days
Administrator and teacher survey after all phases of study–Participation, engagement, encouragement, enthusiasm
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Announcements/Encouragement & IncentivesAnnouncements/Encouragement & Incentives Announcements and Encouragement
–Daily morning announcement over PA system (general, principal)–Daily classroom announcement before lunch (specific, teachers)–Letter sent home to parents–Posters and encouragement in cafeteria
Incentives–All students and staff receive free bowling or roller skating passes–Chance to win $20 Walmart gift card (two each grade, 12 total in each school)–Plaque of recognition for school office
School IN = 424
F & R = 47.2%
School IN = 424
F & R = 47.2%
School IIN = 406
F & R = 63.1%
School IIN = 406
F & R = 63.1%
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
PreliminaryResults
PreliminaryResults
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Salad Bar FV OfferingsSalad Bar FV Offerings
Generally same in both schools and repeated through study phases
Apple Slices, Diced Peaches, Red Grapes, Diced Pears, Kiwi Halves, Fruit Cocktail, Pineapple Chunks, Cooked Apples, Banana
Baby Carrots, Green Salad, Cherry Tomatoes, Cooked Carrots
Baseline 1: mean = 277, std dev = 2.1
Incentives: mean = 271, std dev = 4.8
Baseline 2: mean =261, std dev = 34.4
# of Lunches Served
Baseline 1: mean = 303, std dev = 13.3
Incentives: mean = 293, std dev = 31.6# of Lunches Served
Translate Ounces into 1/2 Cup ServingsPer Lunch Served
Translate Ounces into 1/2 Cup ServingsPer Lunch Served
Ounces per ½ cup vary by FV item Minimum of 0.8 oz. per ½ cup for salad Maximum of 4 oz. per ½ cup for peaches and pears
Total FV Consumption During Initial Baseline and Incentives Phases
Total FV Consumption During Initial Baseline and Incentives Phases
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Re-CapRe-Cap Combined FV intake of School II > School I at initial baseline (fruit)
–2.97 > 2.32–FFVP influence, lower socioeconomic status – just hungrier
F intake > V intake at both schools at initial baseline
–School I: 1.80 > 0.52–School II: 2.55 > 0.43
Combined FV intake increased at both schools during incentives phase
–School I: 3.17 > 2.32 (36.6%, p=0.09)–School II: 3.24 > 2.97 (9.0%, p=0.66)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Re-CapRe-Cap School I larger absolute increase and percentage increase in F intake compared
to V during incentives phase
–Fruit ↑ 0.69 (38.2%) Vegetable ↑ 0.16 (30.9%)
School II larger absolute increase in F intake and larger percentage increase in V intake during incentives phase
–Fruit ↑ 0.16 (6.3%) Vegetable ↑ 0.10 (25.3%)
School I sustained combined FV increase through return to baseline phase
–2.94 > 2.32 (p=0.46)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionsConclusions Group Level Incentives Matter!
Evidence that children can be influenced to eat more FV
Aggregate level data allow for more students in study
Aggregate level data allow for more accurate measuring
Aggregate level data do not allow for individual level analysis
Very likely some children increased intake, others did not
Gains are small in terms of increased servings of FV, but not trivial
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionsConclusions Results are suggestive, but do not confirm a causal effect
Several minor challenges conducting this study
Food service staff Menu items, food quality School schedules Teacher and administration participation/cooperation
Data have some variability for specific FV items over the study FV intake can vary for a number of reasons on any given day
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Future WorkFuture Work
More detailed analysis of individual FV items
More accurate translation to serving size
Analyze FV intake given other lunch items served
Teacher surveys reporting level of encouragement
Analyze changes in food waste
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Future WorkFuture Work
Return in spring to measure FV consumption again
Present, write and publish
Work with schools and food service staff to develop next study
Different incentives, longer observation phases
Marketing and promotions, nutrition education
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Questions & DiscussionQuestions & Discussion
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
AppendixAppendix
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Administration ResponsibilitiesAdministration Responsibilities
Coordinate and encourage teacher participation
Distribute teacher participation survey after data collection
Complete administrator participation survey after data collection
Read school-wide announcement below over PA system each day during incentive period
Provide school-level student demographic data
Distribute rewards/prizes to students if FV intake increases
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Teacher ResponsibilitiesTeacher Responsibilities
Read classroom announcement right before lunch each day during incentive period
Continue encouraging students to eat more FV after incentive period
Report any morning snacks served in classroom on observation days
Complete teacher participation survey after data collection
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Food Service Staff ResponsibilitiesFood Service Staff Responsibilities
Serve FV items as planned on menu on observation days
Provide weight measurements of initial amounts of FV available for serving on observation days
Assist in weighing left over FV not served on observation days
Share any other valuable information with researchers
School-Wide Morning AnnouncementSchool-Wide Morning Announcement
Our school is participating in a project to increase your fruit and vegetable consumption.
Researchers have measured the amount of fruit and vegetables that you have been eating during school lunch over the last several days.
During the next two weeks they will continue measuring how much fruit and vegetables you eat during school lunch.
If the total group level amount of fruit and vegetables we eat as a school increases over this period then we will win some very nice prizes.
This project is called EATING FRUITS & VEGGIES MORE MATTERS.
Let’s take advantage of this chance to win some prizes and improve our health by eating MORE FV.
Classroom Pre-Lunch AnnouncementClassroom Pre-Lunch Announcement
Eating fruit and vegetables is an important part of a healthy diet, but most children do not eat enough fruit and vegetables.
We are being encouraged to eat more FV as part of a research project called EATING FRUITS & VEGGIES MORE MATTERS.
As a school, if we increase our total group level fruit and vegetable consumption compared to what we normally eat then we will win some very nice prizes.
If we meet this goal as a school two students in every grade (including 2 students in our grade) will be selected in a random raffle drawing to win a $20 Walmart Gift Card.
In addition, if we meet this goal of increased FV consumption every student in the school (including all of you) will receive one free family pass for all members of a family to roller skate during open skate hours at Vision–Quest in Menomonie.
Also, our school will receive a plaque to display in the main office in recognition of achieving the goal of eating more fruit and vegetables.
Remember, no matter how many FV you currently eat, EATING MORE FRUITS & VEGGIES is good for you.
Let’s take advantage of this chance to win some prizes and improve our health by eating MORE FRUITS & VEGGIES during school lunch.
School I FV ConsumptionSchool I FV Consumption
School II FV ConsumptionSchool II FV Consumption