University of Wisconsin-Eau Claire Measuring the Impact of Group Incentives on Aggregate Fruit and...

University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire

Measuring the Impact of Group Incentives on Aggregate Fruit and Vegetable Consumption for

Lunch in Two Wisconsin Elementary Schools

Student Researchers

Tiffany Christner, Nicholas Douglass, Mitchell Fischer, Jisu Kim, Aaron Lickel, Jonathan Pumper & Lucy Ramquist

Faculty Mentors

Eric Jamelske

Sydney Chinchanachokchai


OverviewOverview

Motivation and Previous Research

Study Design FV Consumption Measurement Phases of Study Demographic Summary Preliminary Results

Conclusions and Future Work Questions and Discussion

MotivationMotivation Inadequate FV consumption (not 5-9 a day) Lots of less healthy alternatives

Rising rates of childhood and adult obesity Significant health care concern, annual costs in the BILLIONS of $


FFVP in Elementary Schools (Jamelske, Bica, Lagoria 2009-10)– Bring FV from home for snack on non-FFVP days, toys and encouragement

After School Program (Jamelske 2012-13)– Eat FV for snack/dinner, chance to win $15-20 prizes weekly, encouragement

Elementary School Lunch FV Consumption (Just & Price 2013)– Small monetary incentives increase fraction of children eating FV by 80%

Elementary School Lunch FV Intake (Wengreen et al. 2013)– Incentives increase F/V intake increased by 0.53 cups per day

Red Pepper Strips Individual Meetings (Wardle et al. 2003)– Exposure and reward raise short term consumption and preferences

Using Incentives to Increase FV IntakeUsing Incentives to Increase FV Intake


Study DesignStudy Design Two Wisconsin elementary schools

Self-serve salad bar at lunch

Children must take two items

Three lunch periods, 2 grades each period

Three observation days each week (M W F)


Study DesignStudy Design

Table set up at waste disposal area

All children drop tray on table upon leaving

Researchers separate FV waste into bus trays by item

After all lunch periods, waste is weighed for each FV item


FV MeasuresFV Measures

All amounts weighed using digital scale (pounds)

Pounds to ounces (multiply by 16)

Ounces per lunch served (divide by lunches served)

Initial FV available for serving Leftover FV not served/taken FV waste, taken but not eaten

Initial – Waste – Leftover = Consumption

Aggregate measure of FV (daily)


Three Phases of StudyThree Phases of Study Initial baseline, 3 days

–No intervention, just measuring

Announcements, encouragement and incentives, 6 days–Prizes if aggregate FV consumption increases

Return to baseline, 3 days

Administrator and teacher survey after all phases of study–Participation, engagement, encouragement, enthusiasm


Announcements/Encouragement & IncentivesAnnouncements/Encouragement & Incentives Announcements and Encouragement

–Daily morning announcement over PA system (general, principal)–Daily classroom announcement before lunch (specific, teachers)–Letter sent home to parents–Posters and encouragement in cafeteria

Incentives–All students and staff receive free bowling or roller skating passes–Chance to win $20 Walmart gift card (two each grade, 12 total in each school)–Plaque of recognition for school office

School IN = 424

F & R = 47.2%

School IN = 424

F & R = 47.2%

School IIN = 406

F & R = 63.1%

School IIN = 406

F & R = 63.1%


PreliminaryResults

PreliminaryResults


Salad Bar FV OfferingsSalad Bar FV Offerings

Generally same in both schools and repeated through study phases

Apple Slices, Diced Peaches, Red Grapes, Diced Pears, Kiwi Halves, Fruit Cocktail, Pineapple Chunks, Cooked Apples, Banana

Baby Carrots, Green Salad, Cherry Tomatoes, Cooked Carrots

Baseline 1: mean = 277, std dev = 2.1

Incentives: mean = 271, std dev = 4.8

Baseline 2: mean =261, std dev = 34.4

# of Lunches Served

Baseline 1: mean = 303, std dev = 13.3

Incentives: mean = 293, std dev = 31.6# of Lunches Served

Translate Ounces into 1/2 Cup ServingsPer Lunch Served

Translate Ounces into 1/2 Cup ServingsPer Lunch Served

Ounces per ½ cup vary by FV item Minimum of 0.8 oz. per ½ cup for salad Maximum of 4 oz. per ½ cup for peaches and pears

Total FV Consumption During Initial Baseline and Incentives Phases

Total FV Consumption During Initial Baseline and Incentives Phases


Re-CapRe-Cap Combined FV intake of School II > School I at initial baseline (fruit)

–2.97 > 2.32–FFVP influence, lower socioeconomic status – just hungrier

F intake > V intake at both schools at initial baseline

–School I: 1.80 > 0.52–School II: 2.55 > 0.43

Combined FV intake increased at both schools during incentives phase

–School I: 3.17 > 2.32 (36.6%, p=0.09)–School II: 3.24 > 2.97 (9.0%, p=0.66)


Re-CapRe-Cap School I larger absolute increase and percentage increase in F intake compared

to V during incentives phase

–Fruit ↑ 0.69 (38.2%) Vegetable ↑ 0.16 (30.9%)

School II larger absolute increase in F intake and larger percentage increase in V intake during incentives phase

–Fruit ↑ 0.16 (6.3%) Vegetable ↑ 0.10 (25.3%)

School I sustained combined FV increase through return to baseline phase

–2.94 > 2.32 (p=0.46)


ConclusionsConclusions Group Level Incentives Matter!

Evidence that children can be influenced to eat more FV

Aggregate level data allow for more students in study

Aggregate level data allow for more accurate measuring

Aggregate level data do not allow for individual level analysis

Very likely some children increased intake, others did not

Gains are small in terms of increased servings of FV, but not trivial


ConclusionsConclusions Results are suggestive, but do not confirm a causal effect

Several minor challenges conducting this study

Food service staff Menu items, food quality School schedules Teacher and administration participation/cooperation

Data have some variability for specific FV items over the study FV intake can vary for a number of reasons on any given day


Future WorkFuture Work

More detailed analysis of individual FV items

More accurate translation to serving size

Analyze FV intake given other lunch items served

Teacher surveys reporting level of encouragement

Analyze changes in food waste


Future WorkFuture Work

Return in spring to measure FV consumption again

Present, write and publish

Work with schools and food service staff to develop next study

Different incentives, longer observation phases

Marketing and promotions, nutrition education


Questions & DiscussionQuestions & Discussion


AppendixAppendix


Administration ResponsibilitiesAdministration Responsibilities

Coordinate and encourage teacher participation

Distribute teacher participation survey after data collection

Complete administrator participation survey after data collection

Read school-wide announcement below over PA system each day during incentive period

Provide school-level student demographic data

Distribute rewards/prizes to students if FV intake increases


Teacher ResponsibilitiesTeacher Responsibilities

Read classroom announcement right before lunch each day during incentive period

Continue encouraging students to eat more FV after incentive period

Report any morning snacks served in classroom on observation days

Complete teacher participation survey after data collection


Food Service Staff ResponsibilitiesFood Service Staff Responsibilities

Serve FV items as planned on menu on observation days

Provide weight measurements of initial amounts of FV available for serving on observation days

Assist in weighing left over FV not served on observation days

Share any other valuable information with researchers

School-Wide Morning AnnouncementSchool-Wide Morning Announcement

Our school is participating in a project to increase your fruit and vegetable consumption.

Researchers have measured the amount of fruit and vegetables that you have been eating during school lunch over the last several days.

During the next two weeks they will continue measuring how much fruit and vegetables you eat during school lunch.

If the total group level amount of fruit and vegetables we eat as a school increases over this period then we will win some very nice prizes.

This project is called EATING FRUITS & VEGGIES MORE MATTERS.

Let’s take advantage of this chance to win some prizes and improve our health by eating MORE FV.

Classroom Pre-Lunch AnnouncementClassroom Pre-Lunch Announcement

Eating fruit and vegetables is an important part of a healthy diet, but most children do not eat enough fruit and vegetables.

We are being encouraged to eat more FV as part of a research project called EATING FRUITS & VEGGIES MORE MATTERS.

As a school, if we increase our total group level fruit and vegetable consumption compared to what we normally eat then we will win some very nice prizes.

If we meet this goal as a school two students in every grade (including 2 students in our grade) will be selected in a random raffle drawing to win a $20 Walmart Gift Card.

In addition, if we meet this goal of increased FV consumption every student in the school (including all of you) will receive one free family pass for all members of a family to roller skate during open skate hours at Vision–Quest in Menomonie.

Also, our school will receive a plaque to display in the main office in recognition of achieving the goal of eating more fruit and vegetables.

Remember, no matter how many FV you currently eat, EATING MORE FRUITS & VEGGIES is good for you.

Let’s take advantage of this chance to win some prizes and improve our health by eating MORE FRUITS & VEGGIES during school lunch.

School I FV ConsumptionSchool I FV Consumption

School II FV ConsumptionSchool II FV Consumption

University of Wisconsin-Eau Claire Measuring the Impact of Group Incentives on Aggregate Fruit and...

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