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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

The role of curriculum dose for the promotion of fruit and vegetable intake among adolescents: results from the Boost intervention

Authors: Thea Suldrup Jørgensen, Mette Rasmussen, Anne Kristine Aarestrup, Annette Kjær Ersbøll, Sanne Ellegaard Jørgensen, Elizabeth Goodman, Trine Pagh Pedersen, Pernille Due, Rikke Krølner

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Multi-component interventions combining educational and environmental strategies have proved effective in increasing children and adolescents’ fruit and vegetable intake. However such interventions are complex and difficult to implement and several studies report poor implementation. There is a need for knowledge on the role of dose for behaviour change and for assessment of intervention dose to avoid conclusions that intervention components which are not implemented are ineffective. This study aimed to examine 1) the association between dose of a class curriculum and adolescents’ fruit and vegetable intake in a school-based multi-component intervention, 2) if gender and socioeconomic position modify this association.

Methods

We carried out secondary analysis of data from intervention schools in the cluster-randomized Boost study targeting 13-year-olds’ fruit and vegetable intake. Teacher- and student data on curriculum dose delivered and received were aggregated to the school-level and class-level (only possible for student data). We analysed the association between curriculum dose and students’ (n 995) self-reported fruit and vegetable intake (24-h recall questionnaire) after finalization of the intervention using multi-level analyses. Potential moderation was examined by analyses stratified by gender and socioeconomic position.

Results

Average dose received at class-level was significantly associated with students’ fruit and vegetable intake (10 g (CI: 0.06, 20.33) per curricular activity received). In stratified analyses the association remained significant among boys only (14 g (CI: 2.84, 26.76) per curricular activity received). The average dose delivered and received at the school-level was not significantly associated with students’ intake.

Conclusions

We found a dose—response relationship between number of curricular activities received and adolescents’ fruit and vegetable intake. The results indicate that curriculum dose received only mattered for promotion of fruit and vegetable intake among boys. Future studies should explore this gender difference in larger samples to guide the planning of school-based curricular interventions with regards to the optimal number of curricular activities required to promote behavioural change in subgroups with low fruit and vegetable intake at baseline.

Trial registration

Current Controlled Trials ISRCTN11666034.
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Metadata
Title
The role of curriculum dose for the promotion of fruit and vegetable intake among adolescents: results from the Boost intervention
Authors
Thea Suldrup Jørgensen
Mette Rasmussen
Anne Kristine Aarestrup
Annette Kjær Ersbøll
Sanne Ellegaard Jørgensen
Elizabeth Goodman
Trine Pagh Pedersen
Pernille Due
Rikke Krølner
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1840-0

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