Implementing a Free School-Based Fruit and Vegetable Programme: Barriers and Facilitators Experienced by Pupils, Teachers and Produce Suppliers in the Boost Study

dc.contributor.utaustinauthorEvans, Alexandraen_US
dc.creatorAarestrup, Anne Kristineen_US
dc.creatorKrolner, Rikkeen_US
dc.creatorJorgensen, Thea Suldrupen_US
dc.creatorEvans, Alexandraen_US
dc.creatorDue, Pernilleen_US
dc.creatorTjornhoj-Thomsen, Tineen_US
dc.description.abstractMulti-component interventions which combine educational and environmental strategies appear to be most effective in increasing fruit and vegetable (FV) intake in adolescents. However, multi-component interventions are complex to implement and often poorly implemented. Identification of barriers and facilitators for implementation is warranted to improve future interventions. This study aimed to explore implementation of two intervention components which addressed availability and accessibility of FV in the multi-component, school-based Boost study which targeted FV intake among Danish 13-year-olds and to identify barriers and facilitators for implementation among pupils, teachers and FV suppliers. Methods: We conducted focus group interviews with 111 13-year-olds and 13 teachers, completed class observations at six schools, and conducted telephone interviews with all involved FV suppliers. Interviews were transcribed, coded and analysed using qualitative analytical procedures. Results: FV suppliers affected the implementation of the FV programme at schools and thereby pupils' intake through their timing of delivery and through the quality, quantity and variety of the delivered FV. Teachers influenced the accessibility and appearance of FV by deciding if and when the pupils could eat FV and whether FV were cut up. Different aspects of time acted as barriers for teachers' implementation of the FV programme: time spent on having a FV break during lessons, time needed to prepare FV and time spent on pupils' misbehaviour and not being able to handle getting FV. Teacher timing of cutting up and serving FV could turn into a barrier for pupils FV intake due to enzymatic browning. The appearance of FV was important for pupils' intake, especially for girls. FV that did not appeal to the pupils e. g. had turned brown after being cut up were thrown around as a part of a game by the pupils, especially boys. Girls appreciated the social dimension of eating FV together to a larger extent than boys. Conclusions: Limited time and pupils' misbehaviour were barriers for teachers' implementation. Establishing FV delivery to schools as a new routine challenged FV suppliers' implementation. Food aesthetics were important for most pupils' FV intake while the social dimension of eating FV together seemed more important to girls than boys.en_US
dc.description.departmentCenter for Health Promotion and Disease Prevention Research in Underserved Populationsen_US
dc.description.sponsorshipUniversity of Southern Denmarken_US
dc.description.sponsorshipEU School Fruit Scheme through the Danish Food Industry Agencyen_US
dc.description.sponsorshipDanish Ministry of Food, Agriculture and Fisheriesen_US
dc.description.sponsorshipMichael & Susan Dell Center of Healthy Living at the University of Texas, School of Public Health in Austin, Texasen_US
dc.identifier.citationAarestrup, Anne K., Rikke Krølner, Thea S. Jørgensen, Alexandra Evans, Pernille Due, and Tine Tjørnhøj-Thomsen. "Implementing a free school-based fruit and vegetable programme: barriers and facilitators experienced by pupils, teachers and produce suppliers in the Boost study." BMC public health, Vol. 14, No. 1 (Feb., 2014): 146.en_US
dc.relation.ispartofserialBMC Public Healthen_US
dc.rightsAdministrative deposit of works to Texas ScholarWorks: This works author(s) is or was a University faculty member, student or staff member; this article is already available through open access or the publisher allows a PDF version of the article to be freely posted online. The library makes the deposit as a matter of fair use (for scholarly, educational, and research purposes), and to preserve the work and further secure public access to the works of the University.en_US
dc.subjectprocess evaluationen_US
dc.subjectfruit and vegetablesen_US
dc.subjectrandomized controlled-trialsen_US
dc.subjectpro childrenen_US
dc.subjectpublic, environmental & occupational healthen_US
dc.titleImplementing a Free School-Based Fruit and Vegetable Programme: Barriers and Facilitators Experienced by Pupils, Teachers and Produce Suppliers in the Boost Studyen_US
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