Table 3 Overview of intervention setting, programme activities, determinants, and theory-based methods in the Boost study
School class Educational strategy | Pupil work book/teacher manual to monthlyguided classroom activities to be integrated in different school subjects. Main activities: Computer tailoring, statistics on FV intake in school class, how much is a portion?, introduction to the five basic tastes, taste testing of FV, FV research & conference, analysis of commercial for unhealthy food, development of commercial for FV, barriers for eating FV in social situations, FV & the body, FV & the family. | 2 assignments per month (September-May). Certain assignments are compulsory | D: Awareness of own FV intake, knowledge of recommended intake levels, taste preferences, media influence, peer influence, social skills, short term outcome expectations, family influence. P: to modify predisposing factors which hinders or facilitates motivation for change (e.g. knowledge, awareness, attitude, perceptions); to improve children's FV preparation skills; to make children aware of what influences their FV preferences; to enable children to obtain FV in different situations and develop skills to ask for FV in a variety of settings; to make children aware of the importance of FV intake for health and well-being. | Behavioural experiments, skills training, role play, modelling, social comparisons, barrier identification, relapse prevention, consciousness raising, and information processing. |
School class and home Educational strategy | Boost computer tailoring. Separate tests for fruit and vegetable intake. Tailored feedback. | September (in class), December (at home) and May (in class) | D: Awareness; taste preferences, situational norms. P: to increase children's awareness of recommended intake and own intake; to change children's perceptions of appropriate time, settings and occasions for eating FV; to change taste preferences; to collect process data on use of FV programme. | Self-monitoring of behaviour and feedback, reinforcement, consciousness raising, and taste acquisition theory. |
School class Educational strategy | Script for FV project week/pupil workbook. Day 1: Set FV goals or make day meal plan with FV, day 2: examine access to FV at home and in local area, day 3: Visit supermarket and make a dish with V, day 4: Boost journalist for a day (interview peers about eating habits), and day 5: Self-evaluation of meeting FV goals/meal plan and school event with parents in the evening. | One week e.g. in October/November. Two days of the programme are compulsory for schools | D: Self-efficacy, situational norms, perceived FV availability, shopping skills, FV preparation skills, parental- and peer influence. P: to modify predisposing factors which hinders or facilitates motivation for change (e.g. knowledge, awareness, attitude, perceptions); to improve children's skills. | Specific goal setting, review of behavioural goals, planning, social comparisons, skills training, information seeking of FV access. |
School Educational Strategy (training of staff) | One-day-workshop for year 7 teachers: 1. Information on rationale for Boost and intervention components. 2. How to integrate FV in schools (FV breaks and hands-on teaching). 3. Cooking activities with cook. 4. Teacher feedback on 1st draft of Boost educational material. | Before intervention start (April 2010) | D: Knowledge, attitude, skills for preparing FV snacks. P: to establish motivation and create a receptive environment; to ensure the programme is feasible and acceptable to the teachers and do not increase their workload; to provide inspiration for FV breaks; to facilitate teacher network. Formative research: teacher feedback on preliminary drafts of educational material. | Skills training, prompt identification as role model and social support. Social comparisons. Reinforcement. |
School class Educational strategy | 3 competitions for pupils from intervention schools based on curricular activities (Prize: money for school class): 1) Best FV commercial or FV research poster, 2) best map of access to FV in local area, 3) nomination of 3 favourite FVs and 3 least favourite FVs. Boost posters for school and classrooms of year 7 pupils. | Distributed in January 2011 (Spring term). Deadlines: Feb/March and April/May2011 | D: Attitude. P: to enthuse children to stay motivated; to create sustained project support. Midterm reminder of curricular component. | Reinforcement, cues/reminders. |
School/home Educational and environmental strategy | Parent-school meeting: information on Boost/launch of the intervention. | Visit by Boost project group in August/September 2010 | D: Parental support, parental knowledge, parental attitude. P: to inform parents about the intervention; to establish motivation and create a receptive environment; to make parents understand the value/benefits of the intervention; to create parental support towards intervention goals; to create awareness about recommended intake levels for 13- year-olds and actual intake levels among Danish teenagers. To prompt parents to support their children in eating more FV. | Prompt social support, and consciousness raising. |
School/home Educational and environmental strategy | Parent event as part of project week | One day during project week e.g. in October or November | D: Social norms, social support. P: to create parental support. | Prompt social support |
Home Educational and environmental strategy | Guided pupil-parent activities as part of pupil workbook: examine access to FV at home, examine parents' and siblings' FV taste preferences and monitor parents' intake of FV during one week. | 2 assignments during September-June | D: Home availability, family taste preferences, family FV intake, awareness. P: to make children aware of what influences their FV preferences, to prompt children to find FV at home; to make parents aware of own behaviour. | Prompt social support, consciousness raising, environmental change. |
Home Educational and environmental strategy | Parental newsletters: FV snacks, FV throughout the day, FV & sport, barriers for serving FV, acquired taste & taste prejudices, tips to continuance of FV school programmes after funding exceeds, preservation and storage of FV, saving time and money when shopping FV, recipes on quick simplemeals with FV. | 6 issues: October, November, January, Marts, April, May | D: Parental facilitation, parental knowledge, attitude, modelling, situational norms, accessibility, perceived parental barriers (perceived affordability, satiety value, preparation methods, time), modelling. P: to make parents aware of own behaviour and act as role models by eating FV with children; to prompt parents to increase availability/accessibility to FV at home; to prompt parents to make FV easy accessible (ready-to-eat) for their children; to prompt parents to provide their children with FV to bring to school. | Prompt identification as role model, social support, barrier identification, and environmental change. |
Local community/school Educational strategy | Guided pupil visits in grocery stores in school neighbourhood (pupil workbook). | One day during project week e.g. in October or November | D: Knowledge, media influence, perceived FVavailability, shopping skills. P: to make children aware of how grocery stores try to influence what people purchase, to modify predisposing factors which hinder or facilitate motivation for change (e.g. knowledge, awareness, attitude, perceptions) as well as skills for shopping FV. | Prompt barrier identification, skills training |
Local community/school Educational strategy | Create a map on where to find FV in school neighbourhood (pupil workbook). | One day during project week e.g. in October or November | D: Perceived FV availability, skills. P: to modify predisposing factors which hinder or facilitate motivation for change (perceptions); to make children identify different places where they can get FV. | Prompt barrier identification |
Local community: sports clubs Educational and environmental strategy | Facts sheets to coaches and managers of sport clubs: 1) How to increase children's access to FV during sport (e.g. during practices, competitions, all- day events), 2) to teach children the importance of healthy food when being physical active and 3) to be aware of the coach's status as a role model for eating behaviours. | January (to be implemented in the spring term) | D: Availability, social support, modelling, attitude. P: to increase children's access to FV in leisure time, to encourage sports coaches to be role models. | Provide information about behaviour- health link. Facilitation. Prompt identification as role model, social support, and environmental change |
Local community: youth clubs Educational and environmental strategy | Facts sheets to managers of youth clubs: 1) Tips to increase children's access to FV in leisure time (e.g. offering FV snacks, providing recipes with FV), and 2) to teach children the importance of healthy food. | January (to be implemented in the spring term) | D: Availability, social support, knowledge, attitude. P: to increase children's access to FV in leisure time. | Provide information about behaviour- health link. Facilitation. Prompt social support and environmental change |
Local community/home/leisure time: Educational and environmental strategy | Newsletter to parents: tips on healthy, nutritious snacks and beverages for sporty teenagers. Information about recommendations. | January 2011 | D: Home facilitated leisure time availability, parental support, parental knowledge, situational norms, and accessibility. P: to prompt parents to provide their children with FV to bring to leisure time activities; to make FV a natural part of leisure time activities. | Provide information about behaviour- health link. Prompt social support and environmental change. Facilitation. Mobilising social networks. |
Local community: Educational and environmental strategy | Boost poster for local providers of FV and participating sports- and youth clubs. | Distributed in January 2011 (Spring term) | D: Attitude, norms, awareness. P: to create project support; to promote social responsibility image of involved partners. Midterm reminder. | Cues/reminders |