Movimiento Saludable MOVS Project: Impact On Fruit And Vegetable Intake Using Reflectance Spectroscopy And Relationship With Behavioral Theory Predictors

Background. Movimiento Saludable (MOVS), a component of Ciudadanos Comprometidos con la Paz (CCOMPAZ) in Ciudad Juarez, MX is an after-school lifestyle program that was implemented at five schools during 2016 - 2017. The purpose of the MOVS program is to prevent chronic diseases such as obesity and diabetes in children. The MOVS curriculum includes two components: a) physical conditioning through dance, body expression, and free play, and b) nutrition education and healthy meals to increase fruit and vegetable (F/V) intake. The Paso del Norte Institute for Healthy Living (IHL) at UTEP collected the data to conduct an evaluation of the program. Aims & Objectives. The objective of this study was to conduct a secondary data analysis to assess a relationship between F/V intake and self-efficacy, outcome expectations, and social norms related to F/V intake in children who participated in the MOVS program. The specific aims of this study were to: 1) determine if the MOVS program changes F/V intake, 2) test if specific behavioral theory predictors correlate with F/V intake, and 3) determine which behavioral theory predictors influence F/V intake the most. The hypotheses are based on relationships between F/V intake and behavioral predictors at baseline and the relationships between changes in F/V intake (from baseline to follow-up) and changes in behavioral predictors Baseline: H1a. F/V self-efficacy correlates with F/V intake; H2a. Outcome expectations for F/V correlate with F/V intake; H3a. Social Norms for F/V intake correlate with F/V intake. Change from baseline to follow-up: H1b. Change in F/V self-efficacy correlates with change in F/V intake; H2b. Change in outcome expectations for F/V correlate with change in F/V intake; H3b. change in social norms for F/V intake correlate with change in F/V intake; H4b. Children participating in the MOVS program will increase F/V intake. Methods. A total of 296 students were enrolled in the MOVS program (5-15 y). The dataset for this secondary data analysis included 185 children at baseline and 75 at follow-up. The variables selected from the parent dataset for analysis were: reflectance spectroscopy score, a biomarker of F/V intake, as well as self-efficacy, social norms, and outcome expectations for F/V (self-reported survey). Paired sample t-tests were used to analyze differences in pre-post assessment for F/V intake. Pearson correlations were run to determine the relationship between behavioral theory predictors and F/V intake at baseline and with change from baseline to follow-up. A linear regression using variable selection method was used to determine which behavioral theory predictor (self-efficacy, outcome expectations, social norms) is most influential in F/V intake. Results: F/V intake increased from baseline to follow-up (mean ± SD: 98.9±19.0 vs. 104.7±22.6, t=2.2, df 74, p=0.03; H4b). There were no significant correlations for any of the relationships tested at baseline: F/V intake at baseline was not correlated with self-efficacy (H1a), outcome expectations (H2a), or social norms (H3a) at baseline. There was a negative correlation between change in outcome expectations for F/V with change in F/V intake for children �12 years old (r=-0.487, p-value= 0.02). There was a positive correlation between change in social norms for F/V intake with change in F/V intake (r=0.270, p-value= 0.02). There was no correlation between change in F/V self-efficacy with change in F/V intake. The most influential predictor in changing F/V intake was social norms (Coef= 17.626, Sdt. Error= 9.191, t=1.918, Pr(\u3e|t|) = 0.064) Conclusion: Results indicate a moderate impact of MOVS on F/V intake and some indication that the behavioral theory predictor of social norms can influence F/V intake. Social norms and outcome expectations may contribute to an overall context that promotes certain eating behaviors and can change F/V intake