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A Cluster Randomized Controlled Trial of a Home-Delivered Food Box on Children's Diet Quality in the Chickasaw Nation
Insights
The Packed Promise intervention improved children's fruit, vegetable, and whole grain intake. This child nutrition program showed small but significant dietary improvements for low-income families.
Area of Science:
- Pediatric Nutrition
- Public Health Interventions
- Dietary Quality Assessment
Background:
- Poor diet quality in children negatively impacts health, development, and academic success.
- Child nutrition assistance programs are crucial for enhancing children's diets.
Purpose of the Study:
- To evaluate the Packed Promise intervention's effect on the diet quality of low-income children.
- To assess changes in fruit, vegetable, and whole grain consumption.
Main Methods:
- A cluster randomized controlled trial involving 40 school districts and 4,750 households.
- Home-delivered food boxes and fruit/vegetable vouchers were provided to intervention households.
- Dietary intake was assessed using a screener questionnaire at baseline and follow-up.
Main Results:
- Children in the intervention group showed significantly higher daily consumption of fruits and vegetables (2.35 vs. 2.25 cup equivalents, P < 0.001).
- Mean daily whole grain consumption also increased significantly in the intervention group (0.73 vs. 0.67 ounce equivalents, P < 0.001).
- Other measured outcomes, including added sugar intake and food shopping habits, did not show statistically significant differences.
Conclusions:
- The Packed Promise intervention resulted in modest but statistically significant improvements in children's fruit, vegetable, and whole grain intake.
- Factors such as household participation levels may influence the intervention's impact size.
Background:
Poor diet quality among children can lead to poor health, development, and academic achievement. Child nutrition assistance programs aim to improve diet quality among children.
Objective:
This study tested the impact of the Packed Promise intervention on diet quality among low-income children in Chickasaw Nation territory.
Design:
This study was a cluster randomized controlled trial of 40 school districts and 4,750 eligible, consented households within treatment and control districts.
Participants/Setting:
Household data were collected at baseline (n = 2,859) and follow-up (n = 2,852) in 12 rural Oklahoma counties.
Intervention:
Packed Promise treatment households chose from 5 types of home-delivered food boxes that contained nutritious foods ($38 food value) and a $15 check for purchasing fruits and vegetables.
Main Outcome Measures:
Key outcomes included children's daily consumed amounts of fruits and vegetables, whole grains, and added sugars collected by a dietary screener questionnaire. Other outcomes included food shopping frequency, type of grocery store used, distance traveled from home to grocery stores, and the number of weekly family dinners. All outcomes in this article are secondary to the study's primary outcome-food insecurity among children.
Statistical Analyses Performed:
Differences between the treatment and control groups were estimated by a regression model controlling for baseline characteristics and population-based average portion sizes.
Results:
Children's mean daily consumption of fruits and vegetables combined was about 2.35-cup equivalents in the treatment group and 2.25-cup equivalents in the control group (P < 0.001). Mean consumption of whole grains was 0.73-ounce equivalents in the treatment group compared with 0.67-ounce equivalents in the control group (P < 0.001). Other outcomes were not statistically significant.
Conclusion:
Packed Promise led to significant but small improvements in children's daily consumption of fruits and vegetables and whole grains. Several factors, including household participation levels in Packed Promise, may have moderated the size of impacts.
Funding/Support:
This article is published as part of a supplement supported by the US Department of Agriculture, Food and Nutrition Service.
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