Project FIT: A school, community and social marketing intervention improves healthy eating among low-income elementary school children

Alaimo et al. found taste tests and nutrition education associated with increases in fruit consumption, but not vegetables or other meal components.

“Alaimo and colleagues examined taste tests and nutrition education using digital imagery in six elementary schools in Michigan and found increases in fruit consumption, but not in consumption of vegetables or other meal components [73].”

Seventeen of the included studies were assessed as high risk of detection bias.

“Seventeen of the included studies were assessed as high risk [26, 28, 37, 41, 43, 44, 46–49, 52, 54–56, 58, 66, 67] and seven studies were assessed as low risk of detection bias [27, 42, 51, 53, 60, 62, 63].”

Among studies reporting other continuous implementation outcomes (e.g., quantity of physical activity lessons), findings were mixed.

“Among studies reporting other continuous implementation outcomes (e.g., quantity of physical activity lessons), findings were mixed [43, 44, 46, 48, 49, 59, 64, 66].”

It was unclear in the remaining five nonrandomized studies whether confounders had been sufficiently adjusted for.

“Of the seven nonrandomized studies, three were considered as high risk of confounding [26, 52, 59], while it was unclear in the remaining five studies whether confounders had been sufficiently adjusted for [39, 43, 57, 61, 67].”

Just 5 of the 30 studies included in this review examined the impact of implementation occurring "at scale," defined as 50 or more schools.

“just 5 of the 30 studies included in this review (including three targeting implementation of nutrition interventions) examined the impact of implementation occurring “at scale,” defined as 50 or more schools [37, 43, 52, 56, 73].”