Preschool children and fruits and vegetables: What they know, what messages can we give?

Introduction: When encouraging healthy eating, best practices recommend mealtime discussion focus on taste, texture, color, nutritional benefits and portion size.  Prompting (e.g. eat your vegetables) is discouraged and counterproductive.  Positive outcome expectancies that associate value (e.g., liking) with an outcome (e.g. getting strong) are ideal. The study purpose was to assess what messages preschool children hear related to encouraging fruit and vegetable consumption (FVC) and their understanding of messages.  Methods: Children (n=192) were individually interviewed using a play based picture card game.  Children were cued with knowledge and preference questions followed by open-ended questions about messages they hear.  Messages were coded using Social Cognitive Theory constructs.  Descriptive statics were calculated, the independent samples t-test assessed differences based on income.  Pearson’s correlation was done to explore relationships between variables.  Results:  Over half (54%) the children stated a positive outcome expectancy.  Many children associated specific activities they liked doing with an outcome.  Messages stated increased with increasing income.  Positive outcome messages were stated more with higher knowledge scores.  Fruit and vegetable dislikes increased with higher reporting of negative outcome expectancies.  Paradoxically, like ratings increased with more negative reinforcements and with decreased income.  Discussion: Assessing preschool children and developing a tailored message intervention requires thoughtful consideration for cognitive abilities and the environment the child knows.  Health messaging interventions following best practices may not initially work if a child is used to a different a style of motivation.