Transcript The Food Dudes Healthy Eating Programme

The Food Dudes Healthy Eating Programme
Presented by Dr Sally Pears
Changing children’s eating habits for life
Overview
- The Food Dudes programme: background & behavioural principles.
- Programme impact: children’s F&V and ‘unhealthy’ snack consumption data.
- DVD of a school in Wolverhampton before & after Food Dudes.
- Take-up of the programme and awards.
Changing children’s eating habits for life
Behavioural Goal:
To increase consumption of fruit and
vegetables in primary school children
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Changing children’s eating habits for life
Why Increase Fruit and Vegetable Intake?
• Recommended daily intake = 5 portions a day (400g)
• 70 % of adults in the UK fail to meet this target (2006)
• Average British daily intake = 250g
• Worldwide obesity crisis
• We must change eating habits
Changing children’s eating habits for life
Health Benefits of Fruit and Vegetables
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Help prevent obesity
Protect against many cancers
Reduce the risk of coronary heart disease
Help prevent diabetes
Protect against asthma
Keep skin, teeth and hair healthy
Changing children’s eating habits for life
Traditional Approach: Health Education
• Changes knowledge, beliefs and attitudes but not
actual eating habits/behaviour.
• Changing F&V consumption is key!
Changing children’s eating habits for life
The Food Dudes Programme
• Designed by psychologists, based on behavioural
principles and theory.
• Brings about major and long-lasting change
Changing children’s eating habits for life
The Food Dudes 3 Rs
• Role Modelling
help to establish and maintain behaviour
• Rewards (extrinsic)
• Repeated Tasting – intrinsic rewards in eating F&V
Changing children’s eating habits for life
The Food Dudes 3 Rs
• Role Modelling
• Rewards
• Repeated Tasting
Changing children’s eating habits for life
Role-modelling
Role-Modelling is more effective when:
- The model is of similar age or slightly older than the observer.
- The model is liked or admired by the observer.
- The model’s behaviour is rewarded.
- The observer’s imitation of the model is rewarded.
- Multiple models are presented.
The Food Dudes
Rewards
- Rewards should be potent.
- Need to be tied to the Food Dudes system.
- Reward delivery should be given very soon after the desired behaviour.
- Instructions (to children) should clearly specify the reward contingency.
- Children’s actual consumption of F&V should be rewarded (rather than
verbal statements of what they eat or prefer).
Repeated Tasting
- Repeated tastings (10-15) of a particular food generates liking.
- A biological / physiological phenomenon.
- Well-researched (though only for a limited range of foods).
Phase 1 (16 days)
- Each day children given a portion of fruit and a portion of veg.
- DVD episodes and letters from the “Food Dudes” – role-models for children to imitate.
- Children who eat a portion of fruit AND veg (repeated tasting) are given a small reward.
- A ‘Home Pack’ encourages children to eat more f&v at home.
Phase 1 (16 days)
Days 1-4: Children earn a reward by tasting both their fruit and vegetable.
Days 5-16: Children earn a reward by eating a portion of their fruit and a portion of
their veg.
A portion is roughly the amount that fits into the child’s
cupped hand
Changing children’s eating habits for life
Phase 2 (ongoing)
- Focus shifts to F&V eaten at school lunchtime.
Day 17:
- Reward given for home consumption during Phase 1.
- Homepack 2 (letter and F&V boxes).
Ongoing:
- Children receive handstamps for eating F&V at lunchtime.
- Teachers record progress on a classroom Wallchart.
- Rewards given when children achieve targets on the Wallchart.
Changing children’s eating habits for life
Why Does Food Dudes Work?
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The DVD episodes and rewards encourage children to taste fruit and vegetables
repeatedly.
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Children discover the intrinsically rewarding properties of these foods and develop a
taste for them.
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Children come to see themselves as fruit and vegetable eaters and are proud of it.
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The Programme creates a culture, both at school and at home, that strongly supports the
eating of fruit and vegetables.
Results
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Large increases in consumption
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Greatest increases in consumption shown by those children who are the ‘poorest
eaters’.
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Increases in consumption are long-lasting.
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Increases extend across a wide range of fruit and vegetable varieties.
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The Programme works for all children aged 4-11yrs old.
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The effects generalise across contexts, ie. School to home.
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The Programme is equally effective for boy and girls.
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Effects are highly reliable, regardless of school location and social deprivation.
Changing children’s eating habits for life
London Schools
Poorest Eaters
Food Dudes School
Control School
68
70
Fruit
Vegetables
60
50
% consumed
48
48
43
40
30
20
10
11
7
4
2
5
7
7
4
0
Before
After
16 Days
After
4 Months
Before
After
16 Days
After
4 Months
Before
After
16 Days
After
4 Months
Before
After
16 Days
After
4 Months
NB. Average daily portion weight presented = 83g of fruit or 60g of vegetables
Horne et al. (2004) Increasing children's fruit and vegetable consumption: a peer-modelling and rewards-based intervention.
Eur. J. Clin. Nutr. 58, p1649-1660.
Food Dudes in Ireland
2004
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After seeing the overwhelmingly positive results of experimental evaluations of the Food
Dudes programme in England and Wales, the Irish Government decided to run an
experimental evaluation of the programme in schools in Ireland.
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Ireland has no school meal system – effectiveness of Food Dudes would be dependent
on parents providing F&V in children’s lunchboxes!
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The results of the evaluation were as strong as those of previous studies, with the
programme resulting not only in large increases in children’s consumption of F&V but
also in parental provision of F&V in children’s lunchboxes.
Changing children’s eating habits for life
Ireland Experimental Evaluation
Fruit and Vegetable PROVISION
(in packed lunches)
140
Fruit and Vegetable CONSUMPTION
(from packed lunches)
Before
131
100
80
100
68
63
63
60
40
grammes consumed
grammes provided
After 12 months
90
120
80
93
70
60
50
49
42
40
34
30
20
20
10
0
0
Food Dudes
School
Control
School
Food Dudes
School
Control
School
Horne et al. (2009) Increasing parental provision and children's consumption of lunchbox fruit and vegetables in Ireland: the Food
Dudes intervention. Eur. J. Clin. Nutr. 63, p613-618.
Food Dudes in Ireland continued…
2005
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The Irish Government, with support from the European Union and Industry, launched a
pilot roll-out of the programme in 150 primary schools in Ireland.
2006
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In recognition of its success after one year, the programme was awarded a World Health
Organization Best Practice Award.
2007
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Based on the pilot roll-out’s success, the Irish Government made the Food Dudes
programme available to every primary school in Ireland (3,300 schools over 7 years) on a
budget of 28 million euro. To date 200,000 children have participated in the programme.
Changing children’s eating habits for life
Food Dudes in Wolverhampton
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In 2009 a 3 year roll-out of the programme began in Wolverhampton, funded
by Wolverhampton City PCT.
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6 of the 10 schools that received the programme in 2009 were chosen as
Experimental Schools to evaluate the impact of the Programme.
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A24 hour food diary (DIET24) recorded fruit, vegetable and snack consumption
at different eating occasions throughout the day, both at home and at school.
Changing children’s eating habits for life
Wolverhampton Evaluation: Results 1
Daily Fruit & Veg Consumption (at Home and School)
Whole School
Poorest Eaters
(<2portions per day)
*
2.0
Portions Consumed
1.6
Fruit
1.92
*
*
1.61
1.37
1.30
*
1.10
1.2
0.87
0.8
0.41
0.4
0.24
0.0
PRE POST
PRE POST
PRE POST
PRE POST
Vegetables
Wolverhampton Evaluation: Results 2
Unhealthy Snack Consumption (in School)
0.9
Portions Consumed
0.8
0.79
*
20% reduction
0.7
0.63
0.6
• As F&V consumption increased,
‘unhealthy’ snack food
consumption decreased.
• Suggests that F&V displaced other
snack food in children’s diets.
0.5
0.4
0.3
PRE
POST
Wolverhampton DVD
Award Winning Programme
• 1998: Caroline Walker Trust - changing children’s diets
• 2006: World Health Organisation - combating obesity
• 2009: Social Marketing Centre - Showcase Award
• 2010: Chief Medical Officer’s Public Health Awards – Gold Medal
Take Up
Ireland
2007 -2012: National Roll-out to all primary schools (3,300 schools; 450,000 children).
England- (SFT; DoH; HDC; Worshipful Company of Fruiterers)
2009-2011: Wolverhampton regional roll-out to 84 schools, 20,000 children.
2009-2010: Bedfordshire pilot roll-outs to 13 schools.
2010-2012: Coventry: roll-out to 30 schools, 9,000 children.
Other regions are also interested in piloting the scheme.
Worldwide
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Pilot projects in Sicily, California (US) and Utah (US).
Interest expressed from Australia, Mauritius, Brazil and Greecr.
Some testimonials from parents……
“I think that the Food Dudes Programme is an excellent initiative. It appears to stop children
saying, "I don't like" various fruit/veg when they haven't even tried it.”
“Food Dudes should be introduced into every Primary School.”
“The children ate more fruit and veg and asked for less chocolate and crisps!”
“I found I was buying more fruit than usual.”
“I think it was beneficial, it has helped and encouraged all the family to eat healthy. My son
is trying to encourage other family members to eat healthy.”
Changing children’s eating habits for life
Contacts:
 Email: [email protected]
 Fax: +44 (0)1248 382599
 Write to: Bangor Food and Activity Research Unit,
School of Psychology, Bangor University, Gwynedd, UK, LL57 2AS.
Food Dudes Co-ordinator (Pauline Kelly)
 Email: [email protected] Tel: +44 (0)1248 388534
Food Dudes Strategy and Business Development (Tracey Anthony)
Email: [email protected] Tel: +44 (0)1248 383479
www.fooddudes.co.uk
Changing children’s eating habits for life