F.D. Almansour

Lunch Is In The Bag: Increasing Fruits, Vegetables, and Whole Grains in Sack Lunches of Preschool-Aged Children

Fruits, vegetables, and whole grains are important sources of nutrients for healthy growth and development of young children. Recent evidence suggests that sack lunches packed by parents for children to consume at child-care centers do not regularly meet the goal of one serving of fruit, vegetables, and whole grains. Lunch Is In The Bag is a child-care center-based nutrition education program targeted at parents of preschool-aged children to increase the number of servings of fruits, vegetables, and whole grains in sack lunches sent from home that was pilot tested in fall 2008. In a quasiexperimental design, six child-care centers were paired by size before being randomly assigned to intervention (n=3) and comparison (n=3) groups. The parents of caregivers with primary responsibility for preparing the sack lunches of the 3- to 5-year-old children attending the centers were enrolled as parent-child dyads. The intervention included parent handouts, classroom activities, education stations, and teacher training. The contents of the lunch sacks for both the intervention group and comparison group were recorded for 3 nonconsecutive days before and immediately after the intervention period to measure the number of servings of fruits, vegetables, and whole grains. A total of 132 parent-child dyads completed the study, 81 in the intervention group and 51 in the comparison group. Direct observation of childrens lunches from the intervention group showed an increase in predicted mean number of servings of vegetables, from 0.41 to 0.65 (P<0.001) and whole grains, from 0.54 to 1.06 (P<0.001). No significant difference was observed in the mean number of servings of fruit. Lunch Is In The Bag, which is designed to fit in the child-care environment and targets parents of 3- to 5-year-old children, is a feasible intervention for improving the nutritional quality of sack lunches.

Unbundling Outcomes of a Multilevel Intervention to Increase Fruit, Vegetables and Whole Grains Parents Pack for Their Preschool Children in Sack Lunches.

Abstract Background: Packing fruit, vegetables and whole grains in preschool childrens sack lunches is a powerful way for parents to teach their children eating habits and food preferences to support a lifetime of good health. A multilevel intervention pilot-tested in childcare settings increased servings of vegetables and whole grains, but the lunches still fell short of the intervention goals. Purpose: Secondary analyses were conducted to identify specific behavior changes underlying achieved increases in servings of vegetables and whole grains. Methods: Food records from direct observation of 769 parent-packed lunches were investigated to unbundle and measure multiple aspects of lunch packing behavior. Changes from baseline to six week follow-up for the intervention (N = 81) and comparison (N = 51) parent-child dyads were evaluated in multilevel modeling. Results: The increase for whole grains was explained by more parents packing whole grain items whereas increase for vegetables was explained by parents packing vegetables on more days. Discussion: Tailored options were identified for further strategies to increase vegetables and whole grains in parentpacked sack lunches. Translation to Health Education Practice: Linking achieved outcomes to specific behaviors can be an aid in assessing needs and designing interventions to maximize the chances for success.

How to help parents pack better preschool sack lunches: Advice from parents for educators

OBJECTIVES This exploratory study obtained parent suggestions about messages and activities to guide parents to pack healthful sack lunches for preschool-aged children. METHODS A facilitator conducted group interviews using a modified nominal group technique with a convenience sample of parents who pack daily lunches for their children. Interviews took place after hours at child care centers in group settings. Investigators reviewed written statements for common themes then calculated frequencies of references to identified themes. RESULTS In total, 31 parents participated in 3 group interviews held at 3 centers. Interest in receiving written information and in activities stimulating parent interaction were dominant themes in 29% of the comments. Workshops and activity stations were suggested in 20% of the comments. Finally, recommendations for support from local supermarkets were present in 10% of the comments. CONCLUSIONS AND IMPLICATIONS Parents provided helpful suggestions that can guide nutrition educators to implement effective program messages and strategies.

Psychosocial outcomes of Lunch is in the Bag, a parent program for packing healthful lunches for preschool children.

OBJECTIVE This pilot study evaluated effects of Lunch is in the Bag on behavioral constructs and their predictive relationship to lunch-packing behaviors of parents of young children. METHODS Six child care centers were pair-matched and randomly assigned to intervention (n = 3) and comparison (n = 3) groups. Parent/child dyads participated. Constructs of knowledge, outcome expectations, perceived control, subjective norms, and intentions were measured by a pre/post questionnaire. Hierarchical linear regression was used, and P < .05 was considered significant. RESULTS There were significant increases in knowledge (P = .01); outcome expectations for whole grains (P < .001); and subjective norms for fruit (P = .002), vegetables (P = .046), and whole grains (P = .02). Perceived control, outcome expectations, and intentions significantly predicted packing vegetables and knowledge predicted whole grains. CONCLUSIONS AND IMPLICATIONS Lunch is in the Bag is a feasible intervention to improve the lunch-packing behaviors of parents of preschool-aged children.

Temperature of Foods Sent by Parents of Preschool-Aged Children

OBJECTIVE: To measure the temperatures of foods in sack lunches of preschool-aged children before consumption at child care centers. METHODS: All parents of 3- to 5-year-old children in full-time child care at 9 central Texas centers were invited to participate in the study. Foods packed by the parents for lunch were individually removed from the sack and immediately measured with noncontact temperature guns 1.5 hours before food was served to the children. Type of food and number of ice packs in the lunch sack were also recorded. Descriptive analyses were conducted by using SPSS 13.0 for Windows. RESULTS: Lunches, with at least 1 perishable item in each, were assessed from 235 parent-child dyads. Approximately 39% (n = 276) of the 705 lunches analyzed had no ice packs, 45.1% (n = 318) had 1 ice pack, and 88.2% (n = 622) of lunches were at ambient temperatures. Only 1.6% (n = 22) of perishable items (n = 1361) were in the safe temperature zone. Even with multiple ice packs, the majority of lunch items (>90%) were at unsafe temperatures. CONCLUSIONS: These results provide initial data on how frequently sack lunches sent by parents of preschool-aged children are kept at unsafe temperatures. Education of parents and the public must be focused on methods of packing lunches that allow the food to remain in the safe temperature zone to prevent foodborne illness.