Using mobile technology to impact fruit and vegetable consumption in low-income youth

Abstract

The benefits of fruits and vegetables (FV) include supplying nutrients and fiber to the diet, reducing risk of disease, and assisting in weight maintenance by increasing satiety and decreasing energy density of the diet. FV intake has been inadequate compared to national recommendations across the population and interventions to increase FV intake in pediatric populations have shown mixed results. This study utilized mobile health technology (mHealth, handheld computers) to deliver an Ecological Momentary Intervention (EMI) incorporating behavior change skills (e.g., goal setting, self-monitoring, problem-solving, feedback, and reward) called Growing up Strong (GuS) to increase FV consumption in low-income, ethnic minority children and adolescent girls. Compared to a paper manual control condition, participants randomized to GuS significantly increased their fruit and combined FV, but not vegetable intake from Baseline to end of intervention (Week 4). Follow-up at Week 12 showed that all treatment gains had been lost. Adherence to the electronic program was high, with participants interacting with the program on 81.1% of days and answering 50.4% of the 6 daily program prompts over the 28 days of the intervention. Results indicate an EMI is acceptable to female youth and can help boost FV intake. Creating fun FV intervention programs that can sustain interest for longevity of use might have a greater impact by preventing immediate return to previous intake levels and reinforcing longer-term lifestyle change. Recommendations are provided for integrating FV intervention into larger multiple health behavior change (MHBC) programs to increase impact on weight management and health outcomes.