Harvest for Healthy Kids Pilot Study: Associations between Exposure to a Farm-to-Preschool Intervention and Willingness to Try and Liking of Target Fruits and Vegetables among Low-Income Children in Head Start.

BACKGROUND: Most US children do not meet recommendations for daily fruit and vegetable intake. OBJECTIVE: Our aim was to evaluate the hypothesis that at post-intervention, children exposed to the Harvest for Healthy Kids pilot study will have greater willingness to try and liking of target foods vs children in the comparison group, controlling for baseline differences. DESIGN: We conducted a quasi-experimental pilot study with comparison, low-intervention, and high-intervention groups. Pre- and post-intervention survey data were collected. PARTICIPANTS/SETTING: The intervention period was October 2012 to May 2013. The analysis sample was 226 children within the higher-level unit sample of five participating Head Start centers (Portland, OR); 231 children dropped out of or enrolled in Head Start mid-year, were absent during or refused to participate in the assessments, or were missing covariates. INTERVENTION: The comparison group received no intervention components; the low-intervention group received foodservice modifications; the high-intervention group received foodservice modifications and nutrition education. MAIN OUTCOME MEASURES: Willingness to try and liking of target foods were tested and analyzed as binary variables. STATISTICAL ANALYSES PERFORMED: McNemar's tests were used to assess differences between pre- and post-intervention scores by intervention group. Fixed slope, random intercept multilevel logistic models were used to assess associations between intervention group and post-intervention scores controlling for covariates, adjusting for baseline values, and accounting for center level clustering. RESULTS: The difference between pre- and post-intervention willingness to try and liking of target foods was statistically significant for a variety of foods; for example, 44.2% of children liked rutabaga pre-intervention compared with 78.1% post-intervention (P=0.004). Multilevel modeling indicated similar associations. CONCLUSIONS: The Harvest for Healthy Kids pilot study suggests a positive association between the intervention and willingness to try and liking for target foods among study participants. Additional research is needed to assess the impact of the program on fruit and vegetable intake.

A community-based participatory research approach to developing the Harvest for Healthy Kids curriculum.

BACKGROUND: A diet rich in fruits and vegetables is associated with reduced risk of diet-related chronic diseases. However, fewer than half of children in the United States consume the recommended amount. OBJECTIVES: This article describes the community-based participatory research (CBPR) process used to develop the Harvest for Healthy Kids curriculum. METHODS: Harvest for Healthy Kids is a intervention research project designed to increase access to and intake of fruits and vegetables among preschoolers enrolled in Head Start. The curriculum is composed of eight kits, each focusing on a different fruit or vegetable. RESULTS: The Harvest for Healthy Kids curriculum was developed through an iterative process in which Head Start teachers were highly involved. The final product reflects the teachers' experiences using the curriculum and their suggestions for improving. CONCLUSIONS: The CBPR process used to develop the Harvest for Healthy Kids curriculum led to a product that is grounded in theory and practice.