Pauline J. Horne

Effects of a peer modelling and rewards-based intervention to increase fruit and vegetable consumption in children

Objective: To measure childrens consumption of, and liking for, fruit and vegetables and how these are altered by a peer modelling and rewards-based intervention.Design: In this initial evaluation of the programme, childrens consumption of fruit and vegetables were compared within and across baseline and intervention phases.Setting: Three primary schools in England and Wales.Subjects: In total, 402 children, aged from 4 to 11 y.Interventions: Over 16 days, children watched six video adventures featuring heroic peers (the Food Dudes) who enjoy eating fruit and vegetables, and received small rewards for eating these foods themselves.Main outcome measures: Fruit and vegetable consumption was measured (i) in school at lunchtime and snacktime using a five-point observation scale, with inter-rated reliability and weighed validation tests; and (ii) at home using parental recall. A questionnaire measured childrens liking for fruit and vegetables before and after the intervention.Results: Consumption during the intervention was significantly higher than during baseline at lunchtime and at snacktime (P<0.001 in all instances). Consumption outside school was significantly higher during the intervention on weekdays (P<0.05) but not weekend days. Following the intervention, childrens liking for fruit and vegetables also showed a significant increase (P<0.001).Conclusions: The peer modelling and rewards-based intervention was shown to be effective in bringing about substantial increases in childrens consumption of, and expressed liking for, fruit and vegetables.Sponsorship: Horticultural Development Council, Fresh Produce Consortium, ASDA, Co-operative Group, Safeway, Sainsbury, Somerfield, Tesco and Birds Eye Walls.

Increasing children's fruit and vegetable consumption: a peer-modelling and rewards-based intervention

Objective: To evaluate a peer-modelling and rewards-based intervention designed to increase childrens fruit and vegetable consumption.Design: Over a 5-month period, children in an experimental and a control school were presented with fruit and vegetables at lunchtime. Children aged 5–7 y also received fruit at snacktime (mid-morning). The intervention was implemented in the experimental school and levels of fruit and vegetable consumption were measured at baseline, intervention and at 4-month follow-up.Setting: Two inner-city London primary schools.Subjects: In total, 749 children aged 5–11 y.Intervention: Over 16 days children watched video adventures featuring heroic peers (the Food Dudes) who enjoy eating fruit and vegetables, and received small rewards for eating these foods themselves. After 16 days there were no videos and the rewards became more intermittent.Main outcome measures: Consumption was measured (i) at lunchtime using a five-point observation scale; (ii) at snacktime using a weighed measure; (iii) at home using parental recall.Results: Compared to the control school, lunchtime consumption in the experimental school was substantially higher at intervention and follow-up than baseline (P<0.001), while snacktime consumption was higher at intervention than baseline (P<0.001). The lunchtime data showed particularly large increases among those who initially ate very little. There were also significant increases in fruit and vegetable consumption at home (P<0.05).Conclusions: The intervention was effective in bringing about substantial increases in childrens consumption of fruit and vegetables.Sponsorship: Horticultural Development Council, Fresh Produce Consortium, ASDA, Co-operative Group, Safeway, Sainsbury, Somerfield, Tesco and Birds Eye Walls.

Increasing parental provision and children's consumption of lunchbox fruit and vegetables in Ireland: the Food Dudes intervention.

Background/Objectives:Previous research in the United Kingdom, where there is a school canteen system, has shown that the Food Dudes intervention substantially increases childrens fruit and vegetable consumption. The current study evaluated its effectiveness in Ireland where school meals are not provided and children bring food to school in lunchboxes.Subjects/Methods:Participants were 4- to 11-year-old children attending two primary schools; the schools were randomly assigned to experimental or control conditions (n=228 and 207, respectively). During the 16-day intervention in the experimental school, children watched video adventures featuring the heroic Food Dudes, and received small rewards for eating fruit and vegetables provided. In both schools, parental provision and childrens consumption of fruit and vegetables in the lunchboxes were assessed at baseline and 12-month follow-up (Lunchbox measures). Fruit and vegetables were provided in both schools over an 8-day baseline phase and the 16-day intervention, and childrens consumption was measured (school-provided food measures).Results:Relative to baseline, consumption of the school-provided foods increased during the intervention in the experimental school (P<0.001), whereas in the control school it showed a significant decline. At 12-month follow-up, parents in the experimental school provided and their children consumed significantly more lunchbox fruit, vegetables and juice relative to baseline and to the control school (P<0.001 in all instances).Conclusions:The Food Dudes intervention was effective in changing parental provision and childrens consumption of lunchbox fruit and vegetables in Ireland.

Modifying delusions: the role of empirical testing

Planned empirical testing of beliefs (reality testing) is used in all cognitive therapies and is thought to be the single most effective way to change beliefs. In the present study we first subjected delusions to a period of reality testing, and followed this with a period of conventional verbal challenge. Four people with long-standing delusions took part in a multiple-baseline across-subjects design. Reality testing appeared to be a weak initial intervention, producing temporary or insubstantial effects. These effects were considerably less impressive than those observed when verbal challenge has been used as an opening intervention, and they challenge the assumption that reality testing is the most efficacious way to weaken beliefs. However, by the close of the verbal challenge period, three of the four patients reported substantial reductions in belief conviction, adding further evidence that delusions may be responsive to cognitive therapy.

The way to healthy eating for children

There is widespread concern that children consume too few fruit and vegetables and as a result are likely to incur health problems. This paper outlines a series of studies in which an intervention that combines video‐based peer modelling with rewards has been shown to be very effective in enabling children to eat a variety of fruit and vegetables that previously they rejected. These effects have been very substantial and long lasting. The procedure has been used successfully in children’s own homes and, as this paper shows in particular detail, in school settings.

Effects of rewards, peer-modelling and pedometer targets on children's physical activity: A school-based intervention study

This study evaluated a physical activity intervention for children that comprised peer-modelling, pedometer step goals and tangible rewards. A version of the intervention without the reward component was also tested. Participants (n = 386) were from three primary schools, which were randomly assigned to one of three conditions: (i) full intervention, where children received “Fit ‘n’ Fun Dude” peer-modelling materials and were given daily pedometer goals to receive rewards, (ii) no-rewards intervention, where children received peer-modelling materials and pedometer goals but rewards were not used and (iii) control, where children wore pedometers with no further intervention. Physical activity was measured at baseline, intervention and at the end of a 14-week ‘taper’ phase. During the intervention, the full intervention school showed the largest increase in physical activity relative to baseline (+2456 steps per day, p < 0.001). There was a smaller increase in the no-rewards school (+1033 steps per day, p < 0.03), and no significant change in the control. At the end of the taper phase, physical activity in the no-rewards school continued to increase (+2030 steps per day, p < 0.001) but had returned to baseline in the full intervention school. The intervention that used only peer-modelling and pedometer goals produced better effects over time.

Transfer of function across members of an equivalence class

A child’s presses on response windows behind which stimuli were presented via computer monitor occasionally lit lamps arranged in a column; a present was delivered when all lamps in the column were lit. During the operation of a multiple schedule, the child first learned low rates of pressing in the presence of STAR and high rates in the presence of TREE. Later, in an arbitrary matching task, the child learned to select STAR given wiggly WORM and TREE given BLOCK. When WORM and BLOCK were inserted into the multiple schedule, the low and high rates respectively correlated with STAR and TREE transferred to them. Tests of reflexivity (identity matching) and of symmetry of the arbitrary matching implied that STAR and WORM had become members of one equivalence class, and TREE and BLOCK had become members of another.

Nonverbal behavior correlated with the shaped verbal behavior of children.

Children under 6 years old pressed on response windows behind which stimuli appeared (star or tree). Presses occasionally lit lamps arranged in a column; a present was delivered when all lamps were lit. A random-ratio schedule in the presence of star alternated with a random-interval schedule in the presence of tree. These contingencies usually did not produce respective high and low response rates in the presence of star and tree, but the shaping of verbal behavior (e.g., “press a lot without stopping” or “press and wait”) was sometimes accompanied by corresponding changes in response rate. Verbal shaping was accomplished between schedule components during verbal interactions between the child and a hand-puppet, Garfield the Cat, and used social consequences such as enthusiastic reactions to what the child had said as well as concrete consequences such as delivery of extra presents. Variables that may constrain the shaping of verbal behavior in children seem to include the vocabulary available to the child and the functional properties of that vocabulary; the correlation between rates of pressing and what the child says about them may depend upon such variables.

A home-based intervention to increase physical activity in girls: the Fit ‘n’ Fun Dudes program

There is a strong need to increase physical activity levels and healthy dietary behaviors among children due to rising levels of obesity in many countries worldwide. Following on from previous research on dietary change, the current study evaluated the effects of a home-based physical activity intervention with 32 girls (mean age, 10.6 ± 0.7 years) and their parents. During the 8-day intervention, children were introduced to fictional role models (the “Fit ‘n’ Fun Dudes”) and were given daily pedometer step targets to reach in order to receive small rewards. Pedometer measures were taken from children and parents in the experimental and control groups at baseline, during the intervention, and 12-week follow-up. Children in the experimental group were significantly more active than control children during the intervention on weekdays and weekend days (both p p

Operant Conditioning The Hiatus between Theory and Practice in Clinical Psychology

The application of operant conditioning principles, characterized variously as behavior modification or applied behavior analysis, has become widespread in clinical psychology. A central theoretical assumption underlying this approach is that operant principles, originally derived from the study of animals in controlled experimental settings, have general applicability, governing not only the behavior of animals but also that of humans. In their early work, Skinner and others showed that animal behavior was an orderly function of contingencies of reinforcement so that any particular performance, on a schedule of reinforcement for instance, could be analyzed within the framework of the “three-term contingency,” that is, the relationship between responses, reinforcers, and discriminative stimuli. The response was usually the operation of some mechanical device like a lever; the reinforcer was typically food, and discriminative stimuli were environmental events, such as the illumination of colored lights. All of these variables were publicly observable events. The creation of explanatory fictions, “events taking place somewhere else, at some other level of observation” (Skinner, 1950), was eschewed.