Characterising the determinants of fruit and vegetable consumption in pre-school children

Abstract

Fruit and vegetable intake in young children in England is low compared with national recommendations. Existing interventions to improve consumption levels have a limited but positive impact. The research reported in this thesis aimed to better understand the determinants of fruit and vegetable consumption in young children, and the way in which these determinants interact. This new information will help inform the development of more effective interventions.

A mixed methods approach was used to explore, and develop a model of, the determinants of fruit and vegetable provision and consumption in pre-school children. A phased approach to the research was used to develop and refine a model of determinants. At each stage, a integrative tool, the Theoretical Domains Framework (TDF), was used to better understand these determinants. The TDF consists of 12 domains which capture a collection of theoretical concepts that characterise barriers and facilitators to a particular behaviour; data was coded to the corresponding TDF domains and added to the model of determinants presented at the end of each phase.

Results indicated that the most influential determinants included: the role of grandparents, parental role modelling (both social influences domain), and parenting style and practices (nature of the behaviours domain). Less influential but nonetheless important determinants included: feedback from the child, support from others (both social influences domain), time, cost, and availability of fruits and vegetables (all environmental context and resources domain).

It is recommended that interventions which aim to improve the fruit and vegetable intake of pre-school children, particularly the intervention techniques and modes of delivery used, are informed by the results of this thesis. This will allow for interventions that are theoretically driven and thus more likely to be effective. It is acknowledged that intervention development should take into account ‘local’ contextual factors and the complex interplay of determinants.