| Health disparities persist in the United States despite numerous policies, interventions, and programs to address the issue. Rural children are at a higher risk for poor health outcomes because of their geographic location, household income, and/or parent education. Incidence of childhood obesity and Type 2 diabetes are directly related to food access and eating behaviors, including vegetable and sugary beverage consumption. In North Carolina in 2011, 74% of children age 0-17 did not consume the recommended daily serving of vegetables, and at least 67.7% of all NC children age 0-17 consumed one or more sugary beverages per day.;Families and school nutrition services (SNS) are key to shaping elementary school children's eating behaviors, but few published studies have successfully leveraged the strengths of both entities in a coordinated fashion to meaningfully impact child eating behavior. A few interventions have tried to improve urban child eating behavior with mixed success, but barriers in rural settings, which include limited time, transportation, parent education, and funding, make replication of other interventions in rural settings difficult.;To overcome these barriers, we developed a theory- and technology-based nutrition intervention delivered by SNS that targets parents of 4th and 5th grade children. Our objective was to improve child and parent self-efficacy for vegetable consumption by engaging families through a blend of new technologies (text messages and social media).;We employed a mixed-methods community-engagement approach to iteratively develop the program with families from a public charter school serving primarily low-income rural NC children. Program development included in-depth interviews, focus groups, surveys, and a two-week test. The resulting product was tested in a twelve-week randomized delayed intervention control pilot to determine whether the technology program enhanced the impact of the original school-based intervention. Change in child self-efficacy for vegetable consumption was not statistically significant between groups (p=0.407, CI[-12.2,5.20]), but intervention parents increased self-efficacy for vegetable consumption (p=0.000, CI[4.64,14.1]) and proxy efficacy for vegetable consumption (p=0.069, CI[-0.10,2.64]) compared to parents randomized to the control. Parents, children and school staff were enthusiastic about the program; a larger trial should be conducted to better understand FE2 effects. |
