Post on 30-Dec-2015
1999 California Healthy Eating and Exercise Practices Survey:
Programmatic Implications for the
California Children’s
5 a Day–Power Play! Campaign
Authors:
Angie Keihner1, Tanya Garbolino1, Mark Hudes2
1 Public Health Institute, 2 University of California, Berkeley
Diet and Exercise
• Only 1% of children eat a diet consistent with federal nutrition recommendations (1989-1991 CSFII).1
• Fewer than half of California children meet the 60 minute PA recommendation, and 14% get fewer than 30 minutes of PA a day.2
1 Munoz K, et al., Food Intakes of U.S. Children and Adolescents Compared with Recommendations. Pediatrics, 1997. 100(3): p. 323 - 329.
2 California Department of Health Services, 1999 California Children's Healthy Eating and Exercise Practices Survey: Unpublished data. In press: Sacramento, CA.
Trends in the Prevalence of Overweight Among Children and Adolescents in the U.S.
4 4
7
11
15
56
5
11
16
1963-70 1971-74 1976-80 1988-94 1999-000
5
10
15
20Percent of Children and Adolescents, 6-19 Years
Age in Years 6-11 12-19
Sources: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health and Nutrition Examination Survey, Hispanic Health and Nutrition Examination Survey (1982-84), and National Health Examination Survey (1963-65 and 1966-70).
Marketing to Children
• In 1997, U.S. children spent $7.7 billion on foods and beverages– Ranked first among expenditures
– Accounted for one-third of the total $23.4 billion spent
McNeal JU. The kids market: Myths and realities. Ithaca, NY: Paramount Market Publishing, 1999.
The Child Consumer
Median Age
Consumer Behavior
Primary Stores
Primary Products
2 months First store visit Supermarkets
2 yearsFirst in-store gesture/ request
SupermarketsCereals and snacks
3½ years First in-store selections
SupermarketsCereals, toys, and snacks
5½ yearsFirst assisted purchases
Mass discounters
Toys
8 yearsFirst independent purchase
Convenience stores
Snacks
Survey Purpose
• Fills a monitoring gap - no comprehensive statewide surveys on nutrition for 9-11 year-old age group
• Includes dietary and physical activity practices on a typical school day; knowledge, attitudes, beliefs
• Evaluates knowledge and awareness of 5 a Day–Power Play!
Sample Selection and Administration
• Market research panel population• Demographically diverse, English-
speaking sample• Conducted April - June 1999• Parent-assisted 2-day food and physical
activity diary: Mailed, filled out, and returned
• Unassisted telephone survey– 14 minutes, 44 questions
Sampling and Response Rate
• Quota sampling– Demographically reflect California
households with 9-11 year old children – Pool of 2000 qualified households
selected from the market research panel• 814 returned food and activity diary
– 41% response rate• 394 completed telephone interview
– 51% response rate
Paid Advertising and Public Service Announcements (PSA) in 1999
• Commercial– Three Wishes
• FV make you faster, stronger, and learn more
• FV give you power
• 5 a Day is important
• PSA– Shaq’s Secret
• 5 a Day is important
• FV give you power
California Children Aware of 5 a Day-Power Play! Campaign TV Spots, 1999,
by Gender**, Ethnicity*, and Income*
31
1822
48
2024
35
21 21
BoysGirls
WhiteAfrican American
LatinoAsian/Other
$19,999 or less$20,000-$49,999
$50,000 or more0
10
20
30
40
50
Percent of Children
* p<.05; ** p<.01Source: California Department of Health Services, Preliminary data.
California Children Aware of 5 a Day-Power Play! Campaign TV Spots Were More Likely to Know
that 5 or More Servings of Fruits and Vegetables Are Needed for Good Health, 1999
20
27
53
24
47
28
0-2 Servings 3-4 Servings 5+ Servings
Fruits and Vegetables Believed Needed
0
10
20
30
40
50
60
Percent of Children
Aware of 5 a Day-Power Play! Yes No/Don't Know
p<.001Source: California Department of Health Services, Preliminary data.
California Children Aware of 5 a Day-Power Play! Campaign TV Spots Were More Likely to Eat
5 or More Servings of Fruits and Vegetables, 1999
12
26
38
25
5
40 39
17
0 Servings 1-2 Servings 3-4 Servings 5+ Servings
Fruit and Vegetable Intake
0
10
20
30
40
50
60Percent of Children
Aware of 5 a Day-Power Play! Yes No/Don't Know
p<.05Source: California Department of Health Services, Preliminary data.
Who Prepares Meals and Snacks?
Meals and Snacks Who Fixed Them
Breakfast Parent, Child, School
Lunch School, Parent, Child
Dinner Parent
After-school snack Child, Parent
Evening snack Parent, Child
Associations Between Who Makes Meals and Snacks and Fruit and Vegetable Intake, 1999
15
56
21
29
52
7
47
71
0
10
20
30
40
50
60
70
80Percent of Children Who Ate a Serving of Fruit or Vegetable
Who Made Meal/Snack Child Alone
Mom/Dad/Adult
School
** p<.01; *** p<.001Source: California Department of Health Services, Preliminary data.
After-School Snack***
Lunch**Breakfast***
California Children Who Participated in School Meals Were More Likely to Eat 5 or More Servings
of Fruits and Vegetables, 1999
37
23
17 16
0
10
20
30
40
Percent of Children Meeting 5 a Day Goal
Participated in School Meals Yes No
School Breakfast*** School Lunch**
** p<.01; *** p<.001Source: California Department of Health Services, Preliminary data.
California Children's Access to Soda Vending Machines, Candy Vending Machines, and
Fast Food on School Campuses, 1999
24
16
8
0
5
10
15
20
25
30Percent of Children
Source: California Department of Health Services, Preliminary data.
School Cafeteria Serves Fast Food
Vending Machine with Chips and Candy
Vending Machine with Soda
Vending Machines Linked to Vegetable Intake
• Soda vending machines at school – Ate significantly fewer servings of
vegetables (0.7 vs. 1.3 servings, p<.001)
• Vending machines stocked with chips and candy at school– Ate significantly fewer servings of salad
(0.1 vs. 0.3 servings, p<.001)
California Children's Participation in Physical Education by Total Minutes
of Daily Physical Activity, 1999
69 66
93 9691
None 1 or Less Times 2 Times 3-4 Times 5 Times
Physical Education Per Week
0
20
40
60
80
100
Minutes of Physical Activity
Source: California Department of Health Services, Preliminary data.
Physical Education Linked to Daily Physical Activity
• Schools made students exercise (84 vs. 63 minutes of daily PA, p<.01)
• Children who participated in PE 2 or more times per week (22-30 minutes more daily PA, p<.001)
Prioritize Campaign Activities:Food Preparation
Meals and SnacksCampaign Efforts
Should Target
After-school snack Parent, Child
Breakfast Child, Parent
Lunch Parent
• Encourage children to participate in school meal programs
Prioritize Campaign Activities:School Environment
• Address soda vending machines, vending machines stocked with chips and candy, and fast food in schools
• Replace soda, chips, and candy with more nutritious foods– Promote the voluntary adoption of school
nutrition guidelines– Educate legislators
Prioritize Campaign Activities:School Environment
• Encourage schools to enforce existing PE requirement of 200 minutes of PE every 10 days– Promote the voluntary adoption of
school PE guidelines– Educate legislators