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Health Education & Behavior
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5-a-Day Power Plus: Process Evaluation of a Multicomponent Elementary School Program to Increase Fruit and Vegetable Consumption

Mary Story, PhD, RD

Division of Epidemiology, School of Public Health, Minneapolis, Minnesotastory{at}epivax.epi.umn.edu

Rita Warren Mays, MS, RD, LN

Donald B. Bishop, PhD

Center for Health Promotion, Minnesota Department of Health, St. Paul

Cheryl L. Perry, PhD

Division of Epidemiology, School of Public Health, Minneapolis, Minnesota

Gretchen Taylor, MPH, RD

Center for Health Promotion, Minnesota Department of Health, St. Paul

Mary Smyth, MS

Division of Epidemiology, School of Public Health, Minneapolis, Minnesota

Clifton Gray, PhD

Center for Health Promotion, Minnesota Department of Health, St. Paul

The 5-a-Day Power Plus program targeted multiethnic fourth- and fifth-grade students in 10 intervention and 10 control urban elementary schools in St. Paul, Minnesota, to increase fruit and vegetable consumption. The intervention included behavioral curricula in classrooms, parental involvement, school food service changes, and food industry support. Process evaluation was conducted by using surveys and classroom and lunchroom observations to assess the characteristics of teachers and food service staff, the degree the intervention was implemented as intended, and external factors that may have affected the program results. Results showed high levels of participation, dose, and fidelity for all of the intervention components, with the exception of parental involvement. The process evaluation findings help explain why the increase in fruit and vegetable consumption occurred mostly at school lunch and not at home. Future intervention research should focus on creating new and potent strategies for parental involvement and for increasing the appeal and availability of vegetables.

Health Education & Behavior, Vol. 27, No. 2, 187-200 (2000)
DOI: 10.1177/109019810002700205
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