Influence of Cultural Immersion on Willingness to Try Fruits and Vegetables Among Children in Guam: the Traditions Study

NCT02457234 | Completed

• 1 other identifier: CHRS #14-55
• Study Type: interventional
• Target: 104
• Locations: 0 countries
• Sites: N/A

Brief Summary

The purpose of the Traditions study was to examine the influence of cultural immersion on willingness to try fruits and vegetables among children, 3-12 y, in Guam. The primary objective of this study was to examine willingness to try fruits and vegetables and fruit and vegetable intake among children attending three existing summer camp programs: a cultural immersion camp, a university day camp, and a recreational sports camp. The primary hypothesis was that children attending the cultural immersion camp would have higher willingness to try fruits and vegetables (WillTry score) and a higher intake of fruits and vegetables compared to children attending both, the university day camp and recreational sports camp, without cultural immersion. A pre-post, quasi-experimental design was used to evaluate 3 summer camps with different exposure levels of cultural immersion. High, moderate, and zero (cultural) exposure was provided by a cultural immersion camp (CIC), a university-based day camp (UDC), and a recreational sports camp (RSC), respectively. CIC delivered 4 culturally adapted nutrition lessons within the context of Chamorro cultural traditions as part of the cultural immersion camp activities. The UDC delivered the same lessons within a physiology framework. The RSC was without nutrition lessons and cultural immersion. Children 3-12 years old registered in any of the three summer camp programs were eligible to participate. Data collection was primarily administered at two assessment periods: before (± 2 weeks) and after (± 1 week) each summer camp program. Children's willingness to try fruits and vegetables, the primary outcome, was assessed with the interview-administered Adapted WillTry tool. The secondary outcome was fruit and vegetable intake as servings/day in the CIC to UDC only. Fruit and vegetable intake was assessed using the mobile food record (mFR), which is an app running on an iPod Touch based on the technology assisted dietary assessment (TADA) protocols. Outcomes examined Adapted WillTry post-scores for local novel and local common fruits and vegetables and fruit and vegetable servings/day using multivariate regression models adjusting for the relevant pre-score, sex, age, ethnicity, dose, BMI percentile, and parent's cultural affiliation. Therefore, additional measures like sociodemographic information, anthropometry (i.e. heights and weights), and parent's cultural affiliation were collected to account for potential confounders.

Conditions

Food Preferences

Keywords

fruits and vegetables; cultural immersion

Outcome Measures

Primary Outcomes (1)

• Willingness to try local fruits and vegetables measured by the Adapted WillTry tool.

  The Adapted WillTry tool measures children's willingness to try FV and was previously validated for children 3-11 years old in Guam. The Adapted WillTry has 3 distinct scales of FV: local novel, local common, and imported. The scores for each scale ranged from 1 to 3, i.e., least to most willing to try. The Adapted WillTry administration and scoring methods have been described previously.

  4 weeks

Secondary Outcomes (1)

• Fruit and vegetable intake measured using the mobile food record

  4 weeks

Study Arms (3)

Cultural Immersion Children's Day Camp

EXPERIMENTAL

Participants in this group received four culturally adapted nutrition lessons within a cultural immersion context as part of the camp program.

Behavioral: Cultural immersion

University Children's Day Camp

ACTIVE COMPARATOR

Participants in this group received four culturally adapted nutrition lessons in addition to camp activities that did not include cultural immersion.

Behavioral: Cultural immersion

Recreational Children's Sports Day Camp

NO INTERVENTION

Participants in this group participated in existing camp activities that were exclusively physical activity.

Interventions

Cultural immersion BEHAVIORAL

The primary intervention was the cultural immersion within CIC. Unique to the Traditions study were culturally-adapted nutrition lessons incorporated into CIC and UDC. CIC had a high cultural dose as the Traditions lessons were implemented within the cultural immersion context of the camp. The UDC had moderate cultural dose from the Traditions lessons only. RSC was without cultural immersion and Traditions lessons or had zero cultural dose.

Also known as: Culturally adapted nutrition lessons

Cultural Immersion Children's Day Camp; University Children's Day Camp

Eligibility Criteria

• Age: 3 Years - 12 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• Summer camps over 4 weeks serving children 3-12 years old in Guam

You may not qualify if:

• Summer camps shorter or greater than 4 weeks serving children older than 12 years old in Guam

Sponsors & Collaborators

• University of Guam: lead
• University of Hawaii: collaborator

Related Publications (7)

• Blanchette L, Brug J. Determinants of fruit and vegetable consumption among 6-12-year-old children and effective interventions to increase consumption. J Hum Nutr Diet. 2005 Dec;18(6):431-43. doi: 10.1111/j.1365-277X.2005.00648.x.

  PMID: 16351702 BACKGROUND

• Aflague TF, Leon Guerrero RT, Boushey CJ. Adaptation and evaluation of the WillTry tool among children in Guam. Prev Chronic Dis. 2014 Aug 21;11:E142. doi: 10.5888/PCD11.140032.

  PMID: 25144677 BACKGROUND

• Thomson JL, McCabe-Sellers BJ, Strickland E, Lovera D, Nuss HJ, Yadrick K, Duke S, Bogle ML. Development and evaluation of WillTry. An instrument for measuring children's willingness to try fruits and vegetables. Appetite. 2010 Jun;54(3):465-72. doi: 10.1016/j.appet.2010.01.012. Epub 2010 Jan 29.

  PMID: 20116407 BACKGROUND

• Six BL, Schap TE, Zhu FM, Mariappan A, Bosch M, Delp EJ, Ebert DS, Kerr DA, Boushey CJ. Evidence-based development of a mobile telephone food record. J Am Diet Assoc. 2010 Jan;110(1):74-9. doi: 10.1016/j.jada.2009.10.010.

  PMID: 20102830 BACKGROUND

• Daugherty BL, Schap TE, Ettienne-Gittens R, Zhu FM, Bosch M, Delp EJ, Ebert DS, Kerr DA, Boushey CJ. Novel technologies for assessing dietary intake: evaluating the usability of a mobile telephone food record among adults and adolescents. J Med Internet Res. 2012 Apr 13;14(2):e58. doi: 10.2196/jmir.1967.

  PMID: 22504018 BACKGROUND

• Renzaho AM, Swinburn B, Burns C. Maintenance of traditional cultural orientation is associated with lower rates of obesity and sedentary behaviours among African migrant children to Australia. Int J Obes (Lond). 2008 Apr;32(4):594-600. doi: 10.1038/ijo.2008.2. Epub 2008 Feb 5.

  PMID: 18253161 BACKGROUND

• Kuhnlein H, Erasmus B, Creed-Kanashiro H, Englberger L, Okeke C, Turner N, Allen L, Bhattacharjee L. Indigenous peoples' food systems for health: finding interventions that work. Public Health Nutr. 2006 Dec;9(8):1013-9.

  PMID: 17125565 BACKGROUND

MeSH Terms

Conditions

Food Preferences

Condition Hierarchy (Ancestors)

Feeding Behavior; Behavior

Study Officials

• Carol J Boushey, PhD

  University of Hawaii Cancer Research Center

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctoral Candidate - CHL program

Study Record Dates

• First Submitted: May 27, 2015
• First Posted: May 29, 2015
• Study Start: May 1, 2014
• Primary Completion: August 1, 2014
• Study Completion: August 1, 2014
• Last Updated: May 29, 2015

Record last verified: 2015-05