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      Fuel for Fun: a cluster-randomized controlled study of cooking skills, eating behaviors, and physical activity of 4th graders and their families

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          Abstract

          Background

          Childhood obesity remains a serious concern in the United States and in many other countries. Direct experience preparing and tasting healthful foods and increasing activity during the school day are promising prevention approaches. Engaging parents and families remains an important challenge. Fuel for Fun: Cooking with Kids Plus Parents and Play is a multi-component school- and family-based intervention for 4th graders and their families intended to promote positive food and activity environments, policies and behaviors at the individual, family and school levels. This paper describes the design and evaluation plan.

          Methods/Design

          Four cohorts of 4th-graders and their parents from 8 schools in 2 districts in the same Northern Colorado region are participating in a 4-arm cluster randomized controlled trial. Theory-based Fuel for Fun consists of 5 components delivered over 1 school year: 1) Cooking with Kids - Colorado; an experiential classroom-based cooking and tasting curriculum, 2) Cafeteria Connections; cafeteria-based reinforcements of classroom food experiences using behavioral economic strategies, 3) SPARK active recess; a playground intervention to engage children in moderate to vigorous activity, 4) Fuel for Fun Family; multi-element supports targeting parents to reinforce the 3 school-based components at home, and 5) About Eating; an online interactive program for parents addressing constructs of eating competence and food resource management. Outcomes include child and parent measures of fruit and vegetable preferences and intake, cooking, physical activity, sedentary behaviors and attitudes. School level data assess lunch plate waste and physical activity at recess. In-depth diet and accelerometry assessments are collected with a subsample of parent-child dyads. Data are collected at baseline, immediately post-intervention at 7 months, and at 12 month follow-up. We anticipate recruiting 1320–1584 children and their parents over the length of the project.

          Discussion

          The Fuel for Fun study design allows for impact assessment of school-, family- and online parent-based intervention components separately and in combination. Study strengths include use of theory- and evidence-based programs, valid child and parent self-report instruments, and objective measures of food, cooking, and physical activity behaviors at the individual, family and school levels. Parent involvement and engagement is examined through multiple strategies.

          Trial registration

          Clinicaltrials.gov registration number NCT02491294. Registered 7 July, 2015.

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          Most cited references 49

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          Validation of the GENEA Accelerometer.

          The study aims were: 1) to assess the technical reliability and validity of the GENEA using a mechanical shaker; 2) to perform a GENEA value calibration to develop thresholds for sedentary and light-, moderate-, and vigorous-intensity physical activity; and 3) to compare the intensity classification of the GENEA with two widely used accelerometers. A total of 47 GENEA accelerometers were attached to a shaker and vertically accelerated, generating 15 conditions of varying acceleration and/or frequency. Reliability was calculated using SD and intrainstrument and interinstrument coefficients of variation, whereas validity was assessed using Pearson correlation with the shaker acceleration as the criterion. Next, 60 adults wore a GENEA on each wrist and on the waist (alongside an ActiGraph and RT3 accelerometer) while completing 10-12 activity tasks. A portable metabolic gas analyzer provided the criterion measure of physical activity. Analyses involved the use of Pearson correlations to establish criterion and concurrent validity and receiver operating characteristic curves to establish intensity cut points. The GENEA demonstrated excellent technical reliability (CVintra = 1.4%, CVinter = 2.1%) and validity (r = 0.98, P < 0.001) using the mechanical shaker. The GENEA demonstrated excellent criterion validity using VO2 as the criterion (left wrist, r = 0.86; right wrist, r = 0.83; waist, r = 0.87), on par with the waist-worn ActiGraph and RT3. The GENEA demonstrated excellent concurrent validity compared with the ActiGraph (r = 0.92) and the RT3 (r = 0.97). The waist-worn GENEA had the greatest classification accuracy (area under the receiver operating characteristic curve (AUC) = 0.95), followed by the left (AUC = 0.93) and then the right wrist (AUC = 0.90). The accuracy of the waist-worn GENEA was virtually identical with that of the ActiGraph (AUC = 0.94) and RT3 (AUC = 0.95). The GENEA is a reliable and valid measurement tool capable of classifying the intensity of physical activity in adults.
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            Revisiting a neglected construct: parenting styles in a child-feeding context.

            The extent to which general parenting represents feeding styles in ethnically diverse populations is not well documented. Existing measures of child feeding have focused almost exclusively on specific behaviors of European-American parents. A valid and reliable instrument was developed to identify feeding styles in parents of low-income minority preschoolers. Two hundred thirty-one parents (130 Hispanic; 101 African-American) completed questionnaires on feeding practices and parenting styles. Based on self-reported feeding behavior, parents were assigned to four feeding styles (authoritarian, n=84; authoritative, n=34; indulgent, n=80; and uninvolved, n=33). Convergent validity was evaluated by relating feeding styles to independent measures of general parenting and authoritarian feeding practices. Authoritarian feeding styles were associated with higher levels of general parental control and authoritarian feeding practices. Alternatively, authoritative feeding styles were associated with higher levels of general parental responsiveness. Among the two permissive feeding styles, Hispanic parents were more likely to be indulgent, whereas African-American parents were more likely to be uninvolved. Further, differences were found among the feeding styles on an independent measure of child's body mass index.
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              Determinants of fruit and vegetable consumption among 6-12-year-old children and effective interventions to increase consumption.

              To review the current literature about potential determinants of fruit and vegetable intakes and effective intervention strategies to increase the consumption of fruits and vegetables among 6-12-year-old children. A structured review of literature located in PubMed and Psychinfo electronic literature databases. Of all determinants, the availability and accessibility of fruit and vegetables and taste preferences were most consistently and most positively related to consumption. There was some evidence that parental fruit and vegetable intakes, knowledge of intake recommendations and skills had a positive association with children's intakes, whereas television viewing, exposure to television advertisement, and having a snack bar at school were associated with lower intakes of fruit and vegetables. Multi-component school-based interventions that combined classroom curriculum, parent and food service components showed the greatest promise for fruit and vegetable promotion among children. School fruit and vegetable subscription programmes, scout-based interventions, and fruit and vegetables education via computer multi-media channels also appear promising. Interventions should improve the availability and accessibility of fruit and vegetables to children, and should aim to improve their taste preferences for them. Such interventions should be of a multi-component nature, school-based or use other social channels and may include multi-media channels.
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                Author and article information

                Contributors
                Leslie.Cunningham-Sabo@Colostate.Edu
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                26 May 2016
                26 May 2016
                2016
                : 16
                Affiliations
                [ ]Department of Food Science and Human Nutrition, Colorado State University, 234 Gifford Building, Fort Collins, Colorado 80523-1571 USA
                [ ]Wegmans School of Nutrition and Health, Rochester Institute of Technology, Rochester, New York 14623 USA
                [ ]Department of Food Science and Human Nutrition, Colorado State University, 1571 Campus Delivery, Fort Collins, Colorado 80523-1571 USA
                [ ]Nike, Inc., Beaverton, Oregon 97005 USA
                [ ]Aims Community College, 5401 W 20th, Greeley, Colorado 80634 USA
                [ ]Department of Public Health Studies, University of Hawaii at Manoa, 1960 East-west Road, Honolulu, Hawaii 96822 USA
                [ ]Department of Biology, Colorado State University, 1878 Campus Delivery, Fort Collins, Colorado 80523-1878 USA
                [ ]Department of Marketing, Colorado State University, 1278 Campus Delivery, Fort Collins, Colorado 80523-1278 USA
                Article
                3118
                10.1186/s12889-016-3118-6
                4882848
                27230565
                © Cunningham-Sabo. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100005825, National Institute of Food and Agriculture;
                Award ID: 2012-68001-19603
                Award Recipient :
                Categories
                Study Protocol
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                © The Author(s) 2016

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