The goal of the 5-A-Day POWER PLUS Program is to assess the effects of a school-based intervention for promoting increased consumption of fruits and vegetables among elementary school children to reduce their risk of cancer. The school-based intervention consists of four components: food service environmental changes, classroom curricula, family involvement, and industry and media support. The hypothesis is that the POWER PLUS Program will result in increased consumption of total fruits and vegetables and greater awareness and understanding of the 5-A-Day message. This will bc assessed through a trial in which 34 elementary schools from within one urban school district in Minnesota are randomly assigned to intervention and control conditions. The primary endpoint will be the number of servings of total fruits and vegetables consumed per day, measured in students between the fourth and sixth grades. Specifically, the study will evaluate the hypothesis that children in the intervention schools, in comparison with those in the control schools, will demonstrate at follow-up an average number of total daily fruit and vegetable servings that is at least one serving greater, after adjustment for baseline values. Measurable endpoints include: (1) total dietary fruit and vegetable intake (reflected in 24-hour recall values) that is one serving greater for students in the intervention sites than those in controls; (2) total fruit and vegetable consumption in the school lunch program (reflected in plate waste study values) that is 1/2 serving greater for students in the intervention sites; and (3) awareness and understanding of the 5-A-Day message, related health knowledge, and behavioral skill scores related to fruit and vegetable consumption that are 30% greater in the intervention than control sites, measured by a health behavior questionnaire. A secondary goal of the study will bc to determine whether the family involvement and industry/media components of the intervention can bc successfully integrated with the more conventional POWER PLUS school-based components. Family involvement will be measured through a telephone interview survey. Industry participation will bc measured through products contributed for the intervention such as incentives, public service announcements for use in the schools, and actual fruits and vegetables for consumption in classrooms and at home.
