Poor diet quality in children contributes to obesity, chronic disease, and diminished quality of life. Many efforts have focused on foods provided in schools. But elementary school children regularly bring snacks and lunches. Little attention has been directed toward improving the nutrient profiles of foods brought from home. The proposed intervention, The GREEN (Growing Right: Eating Eco-friendly and Nutritious) Project takes advantage of a natural synergy between healthy eating and eco-friendly behaviors to address the quality of foods brought to school from home. Our novel, school-based communications campaign will combine messages about the nutritional and eco-friendly qualities of foods. Our target population is third and fourth graders and their caregivers in Eastern Massachusetts. Our central hypothesis is that at the end of one school year, children who receive a campaign with combined healthy eating and eco-friendly messages will show greater improvement in diet quality and eco-friendliness of snacks and lunches brought from home than those who receive healthy eating communications alone or those in a control group. The theory-based multi-channel communications campaign will be developed on the basis of qualitative research with the target population. For the campaign, schools will be randomized to three conditions to receive: (1) healthy eating and eco-friendly messages;(2) healthy eating only messages;or (3) delayed healthy eating eco-friendly messages after serving as controls. The primary outcome is change in the number of servings of fruits and vegetables brought to school. Secondary outcomes will include changes in the quantity of sugar-sweetened beverages and processed, energy-dense foods, as well as the weight of trash associated with foods brought from home. Baseline and outcome assessments of these outcomes will be made using digital photography. After the GREEN Project has been implemented, the RE-AIM framework will be used to make revisions to the intervention which will then be disseminated to the delayed intervention group. This design will provide an opportunity to test the feasibility of replication. If successful, this novel approach, taking advantage of the synergy between healthy eating and eco-friendly messages, could be extended to elementary schools across the US and adapted to other populations. In addition, the strategy might be extended to other behaviors affecting personal health that can be tied to eco-friendly behaviors.

Public Health Relevance

Poor diet quality in children in the United States contributes to obesity, chronic disease, and diminished quality of life. Our innovative school-based nutrition communication campaign, which combines the synergies of healthy eating and eco-friendly behaviors addresses the quality of foods third and fourth graders bring to school from home. If successful, the communication strategy we will employ will contribute to improving dietary quality among school-children, thus improving their quality of life.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Research Project (R01)
Project #
Application #
Study Section
Community-Level Health Promotion Study Section (CLHP)
Program Officer
Haverkos, Lynne
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Tufts University
Other Domestic Higher Education
United States
Zip Code
Goldberg, Jeanne P; Folta, Sara C; Eliasziw, Misha et al. (2015) Great Taste, Less Waste: a cluster-randomized trial using a communications campaign to improve the quality of foods brought from home to school by elementary school children. Prev Med 74:103-10
Hubbard, Kristie L; Must, Aviva; Eliasziw, Misha et al. (2014) What's in children's backpacks: foods brought from home. J Acad Nutr Diet 114:1424-31