The overall objectives of this proposed four-year project are: 1) to develop a multi-component intervention strategy, using schools as the channel and children and their families as the target population for an intervention that uses the """"""""5-a-Day"""""""" message, to increase the consumption of fruits and vegetables among 4th grade students; and 2) to evaluate the effectiveness of this strategy using 24 grade schools in the greater Birmingham area in a randomized, controlled design using schools as the unit of randomization and analysis. Our proposed primary outcome measures will be dietary behavior of 36 randomly-selected children per school (for a total of 864 children in the 24 schools) at baseline and then at one- and two-year follow-up evaluations on measures of: 1) 24- hour dietary recalls; and 2) direct observations of children's food consumption during the school lunch period. Secondary outcome measures for these same children and their parents will include: children's diet- related knowledge, intention and perceived self-efficacy to make dietary changes; dietary behavior of parents based on a food frequency questionnaire; and parents' knowledge, intentions and perceived self- efficacy for dietary change. Demographic data will also be collected, and process data will be collected to monitor treatment implementation. Phase I (months 1-17) will involve: 1) the development of intervention components and measurement techniques, 2) formative evaluation and pilot- testing, 3) training of intervention and school personnel, and 4) baseline data collection. Phase II (months 18-26) will involve the randomization of schools to either the treatment or no-treatment control group and implementation of the intervention at treatment schools. During Phase III (months 27-38), no intervention will occur, but outcome data will be collected. Phase IV (months 39-48) will involve final data collection, final data entry and preparation of the final report along with manuscripts. We will also provide the intervention to the schools and children in the no-treatment control group.
