Promoting vegetable acceptance in toddlers using a contingency management program: A cluster randomised trial

Area of Science:

• Pediatric Nutrition
• Behavioral Psychology
• Food Acceptance

Background:

• Children's acceptance of novel foods is often achieved through repeated exposure.
• Contingency management programs, combining exposure with rewards, may enhance food acceptance.
• Understanding effective strategies for increasing vegetable consumption in toddlers is crucial.

Purpose of the Study:

• To investigate the effectiveness of a contingency management program (The Vegetable Box) in toddlers.
• To determine if repeated vegetable taste exposure with contingent non-food rewards increases vegetable recognition and willingness to try.
• To compare outcomes between groups receiving exposure/reward, exposure/no reward, and no exposure/no reward.

Main Methods:

• A 3-month intervention involving 598 toddlers (1-4 years old) across 26 Dutch day-care centres.
• Random assignment to three conditions: exposure/reward, exposure/no reward, or no exposure/no reward.
• Assessment of vegetable recognition and willingness to try vegetables before and after the intervention using standardized tests.

Main Results:

• Vegetable recognition significantly increased in both the 'exposure/reward' and 'exposure/no reward' groups compared to the control group.
• Willingness to try vegetables significantly increased only in the 'exposure/reward' group.
• Contingent rewards were particularly effective in increasing children's willingness to taste and consume vegetables.

Conclusions:

• Offering vegetables in day-care settings improves toddlers' vegetable identification skills.
• Contingent rewards are essential for enhancing children's willingness to try and consume vegetables.
• Reward-based programs are a potent strategy for increasing vegetable acceptance in young children.