Action schools! BC - healthy eating: Effects of a whole-school model to modifying eating behaviours of elementary school children

The rate of obesity and associated risk factors in Canadian youth is increasing at an alarming rate. Nutrition plays an important role in weight maintenance. This study reports the effectiveness of Action Schools! BC - Healthy Eating, a school-based fruit and vegetable (FV) intervention, in effecting change in: 1) students' intake of FV, 2) students' knowledge, attitudes and perceptions regarding FV, and 3) students' willingness to try new FV. Five schools that represented geographic, socio-economic and size variation were recruited as Action Schools! BC - Healthy Eating intervention schools. A second set of five schools were selected as matched healthy eating usual practice schools. Student outcomes were measured at baseline and at 12-week follow-up using self-report questionnaires. Classroom logs and progress reports were used to assess implementation dose and fidelity. The intervention included school-wide activities based on individualized Action Plans addressing goals across six Action Zones. Significant differences were found between conditions over time while controlling for baseline levels. Fruit servings, FV servings, FV variety, and percent of FV tried from a fixed list increased in intervention schools. Teachers implemented a mean of 64% of requested classroom dose, and school Action Teams implemented activities across 80% of the whole-school model. A whole-school framework can impact FV intake, but results were modest due to implementation issues. Further implementation and evaluation are necessary to fully understand the effectiveness of this initiative