FS-101

The California Plate Method Education Intervention to Increase Fruit and Vegetable Consumption in Low-Income Individuals and Families

Margaret Johns, Patricia Crawford
University of California Cooperative Extension
 
Nutrition, Family and Consumer Science Advisors with the University of California Cooperative Extension Programs administer federally funded nutrition education programs designed to improve healthy eating behaviors in low-income individuals and families. Increasing fruit and vegetable consumption is often perceived as not possible by clientele due to accessibility barriers and perceived cost. Over the past two years, California’s Cooperative Extension nutrition education programs, FSNEP and EFNEP, have been adapting a new shared curriculum to provide essential information for low-income Californians. To augment this curriculum, NFCS advisors planned a brief supplement that would focus on adding a visual to enhance the material.  Advisors identified the Plate Method, previously used primarily in diabetes control education, as a potentially effective way of enhancing the EFNEP/FSNEP nutrition education curriculum. The method uses a simple graphic of a dinner plate with portions of different foods placed on it to help promote a variety of foods and appropriate portions of different foods. The new method termed The California Plate pilot study was coordinated with the roll out of the new EFNEP curriculum.  Advisors developed the California Plate intervention curriculum that included posters, hand outs, a puzzle magnet, and activities to reinforce nutrition messages, helping participants understand the importance of increasing consumption of fruits and vegetables by trying to have half of their plate full of fruits and vegetables at each meal. A Visually Enhanced Food Behavior Checklist was used to collect data on fruit and vegetable consumption. Both the EFNEP control and intervention curricula consisted of 5 classes; topics covered included physical activity, fruits and vegetables, calcium and consumption of low-fat dairy, protein, and grains. Results from the 24-hour recall showed that both groups (control and intervention) increased their fruit consumption. However, while participants in the control group increased their vegetable consumption, participants receiving the Plate curriculum actually reported a small, but statistically significant decrease in their consumption of vegetables. Analysis of the results from the Visually Enhanced Food Behavior Checklist also showed both groups improved their consumption of fruits and vegetables. Using ANCOVA controlling for group (intervention and control) and baseline, two behaviors improved more with the Plate method compared to the standard curriculum.  Participants in the Plate classes rated their diets as more healthy and reported larger increases in reading nutrition labels than participants in the control classes. Further study with larger sample sizes is needed to properly test this intervention tool and assess the feasibility of this intervention tool to increase fruit and vegetable consumption.