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A theory-based randomized controlled trial in promoting fruit and vegetable intake among schoolchildren: PROFRUVE study

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Abstract

Purpose

The main objective of the PROFRUVE study was to evaluate the effectiveness of a TPB-based intervention program at increasing fruit and vegetable (FV) consumption in schoolchildren aged 7–10.

Methods

Eight eligible classrooms were randomly assigned to the intervention (classrooms n = 4; children n = 90) or control group (classrooms n = 4; children n = 95). The intervention group received 14 sessions of 1 h during an academic year (from October to June) but the control group did not. Sessions were based on the Theory of Planned Behavior (TPB) and focused on modifying FV intake. FV consumption was evaluated before, shortly after and 1 year after intervention ended using validated 7-day food records.

Results

FV intake increased significantly in the intervention group (+ 0.45 servings/day; 95% CI 0.17–0.74; p = 0.001) but not in the control group (+ 0.01 servings/day; 95% CI −0.20–0.22; p = 0.409) shortly after the intervention. Long-term measurement showed that 1 year after intervention finished, the intervention group maintained the effect (+ 0.52 servings/day from baseline; 95% CI 0.22–0.78; p = 0.003). Linear mixed model also showed that nested groups by classrooms differ from intervention and control groups regarding FV intake change (p = 0.002). Multiple linear regression showed that receiving the intervention (B = 0.345, p = 0.045) and FV baseline intake (B = − 0.383, p = 0.000) were associated with FV intake change after adjusting the model by age, gender and family social economic status (SES) (R2 = 0.196).

Conclusions

The intervention program based on TPB seemed to be moderately effective in increasing FV intake and successful in maintaining the effect of the reached increase. Moreover, baseline FV intake determined the effect size of the intervention.

Trial Registration

This study was registered at ClinicalTrials.gov. Identifier: NCT03400891. Data registered 17/01/2018.

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Acknowledgements

The authors wish to thank Slow Food Araba, “5 al día” Association, Ausolan and Tamar for their collaboration in the study. We also thank pre-graduate students for their collaboration in the design of the material. Moreover, our special thanks go to schoolteachers and directors.

Funding

This study was supported by the Government of the Basque Country (IT572/13), CIBERobn (Centro de Investigación Biomédica en Red, ISCIII), University of the Basque Country and City Council of Vitoria-Gasteiz (Programa de Fomento del Consumo de Fruta y Verdura en la Población Infantil de Vitoria-Gasteiz FASE II US14/15). Arrizabalaga-Lopez M is a PhD fellowship holder from the University of the Basque Country UPV/EHU.

Author information

Authors and Affiliations

  1. Nutrition and Obesity Group, Department of Nutrition and Food Science, Faculty of Pharmacy and Lascaray Research Center, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006, Vitoria-Gasteiz, Spain

    María Arrizabalaga-López, María del Puy Portillo & Víctor Manuel Rodríguez

  2. Department of Preventive Medicine and Public Health, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain

    Diego Rada-Fernández de Jáuregui

  3. CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain

    María del Puy Portillo & Víctor Manuel Rodríguez

  4. Department of Sociology 2, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain

    Jose Ramón Mauleón

  5. Department of Pharmacy and Food Science, Faculty of Pharmacy, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain

    Olaia Martínez & Iñaki Etaio

  6. Sensory Laboratory LASEHU, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain

    Iñaki Etaio

  7. Lactiker Research Group, Lascaray Research Center, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain

    Iñaki Etaio

  8. Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain

    María Tormo-Santamaría & Josep Bernabeu-Maestre

Authors
  1. María Arrizabalaga-López
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  2. Diego Rada-Fernández de Jáuregui
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  3. María del Puy Portillo
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  5. Olaia Martínez
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  6. Iñaki Etaio
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  7. María Tormo-Santamaría
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  8. Josep Bernabeu-Maestre
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  9. Víctor Manuel Rodríguez
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Corresponding author

Correspondence to María Arrizabalaga-López.

Ethics declarations

Conflict of interest:

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval

The study was approved by the Ethic Committee of the University of the Basque Country UPV/EHU (CEISH/262/2014/RODRIGUEZRIVERA). Parents or legal guardians, school directors and teachers completed a written consent form before the study commences.

Protocol

The study protocol was published elsewhere: https://doi.org/10.1186/s12889-018-5748-3 [21].

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Arrizabalaga-López, M., Rada-Fernández de Jáuregui, D., Portillo, M.P. et al. A theory-based randomized controlled trial in promoting fruit and vegetable intake among schoolchildren: PROFRUVE study. Eur J Nutr 59, 3517–3526 (2020). https://doi.org/10.1007/s00394-020-02185-5

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  • DOI: https://doi.org/10.1007/s00394-020-02185-5

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