Improving low fruit and vegetable intake in children: Findings from a system dynamics, community group model building study

PLoS One. 2019 Aug 15;14(8):e0221107. doi: 10.1371/journal.pone.0221107. eCollection 2019.

Abstract

Many children globally do not meet government guidelines for daily fruit and vegetable intake, and in New Zealand, adherence to the vegetable intake recommendation is declining. This study aimed to identify systemic barriers to children meeting fruit and vegetable (FV) guidelines and generate sustainable actions within a local community to improve children's FV intake. A qualitative system dynamics method of community group model building was used. The research team partnered with Healthy Families Waitākere, a Ministry of Health funded prevention initiative, to recruit 17 participants (including students, parents, teachers, community leaders, local retailers and health promoters) from a low-income, ethnically-diverse community in West Auckland, New Zealand. Three group model building workshops were held during which a systems map was created and used to identify actions by considering causal pathways and reinforcing loops in the system. Barriers to children's FV intake identified by participants were the saturation of fast-food outlets in the community and ubiquitous marketing of these products, the high cost of fresh produce compared to fast food, and parents having little time for food preparation plus declining cooking skills and knowledge. Several actions to improve children's FV intake by improving the local food environment were identified, which will be co-designed further and tested by a collaborative group involving community leaders. This project highlights the effectiveness of group model building for engaging a local community in systems change to improve child nutrition, and supplies a blueprint for future qualitative system dynamics research.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Eating*
  • Fast Foods
  • Feeding Behavior*
  • Female
  • Fruit*
  • Health Promotion*
  • Humans
  • Male
  • New Zealand
  • Parents
  • Poverty*
  • Vegetables*

Grants and funding

This research was funded by a Health Research Council Explorer Grant 16/656 (PI: WW and BS, with salary support provided for SG and SH, and DR contracted to provide systems dynamics training and workshop facilitation). AR-D was supported by a Faculty of Medical and Health Sciences Summer Scholarship, University of Auckland. Healthy Families Waitākere is funded by the Ministry of Health and is based with Sport Waitākere as the lead provider. Sport Waitākere employs KA, DAR, ME, and ZS. None of the funders had any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.