Feasibility and Acceptability of Brighter Bites: A Food Co-Op in Schools to Increase Access, Continuity and Education of Fruits and Vegetables Among Low-Income Populations.

ABSTRACT

Intake of fruits and vegetables (F&V) continues to be low in children in the United States. The purpose of this study was to conduct a pilot feasibility evaluation of Brighter Bites, a school-based food co-op to provide access to fresh F&V and nutrition education to low-income children and their families. Brighter Bites is a 16-week school-based food co-op consisting of (1) Weekly distribution of 50-60 servings of fresh F&V; (2) Weekly bilingual parent handouts and recipe demonstrations; and (3) implementing CATCH, a coordinated school health program in schools. Brighter Bites was pilot tested using a pre-post evaluation design in one charter school in Houston, TX, USA (n = 57 3rd grade parent-child dyads; 94.1 % Hispanic, 91 % low-income). Evaluation, at baseline, midpoint, and post-intervention, included self-reported child and parent surveys on psychosocial factors, dietary habits and mealtime practices. Pearson's Chi square test, Fisher's exact-test or paired t test were used to determine changes pre- to post-intervention (at p < 0.05). Process data using parent surveys, teacher surveys, attendance logs, and produce cost data were used to determine feasibility and acceptability of program. Participants received on average 61 servings of F&V weekly for 16 weeks at the cost of $4.31/family/week. Results showed significant increases in child reported self-efficacy, outcome expectations and attitudes towards consuming F&V (p < 0.05). We found significant increases in child exposure to F&V and child preference of various F&V from baseline to post-intervention (p < 0.05). Parent surveys showed significant improvements in mealtime practices at home decrease in children eating while watching TV, increase in eating dinner with the family, less fast food, less sugary drinks with meals, more children asking for F&V as snacks. Process data showed 98 % retention rate and high parent acceptability of program components. Brighter Bites is a promising strategy to increase F&V access and education in low-income populations using existing infrastructure of schools and food banks.