Small Prizes to Improve Food Selection in Inner City Elementary Schools

Robert M. Siegel, Ryan Geoppinger, Megan M. Emerso

Background: Poor food selection in school cafeterias is a risk factor for childhood obesity. Previously, we described a pilot program in which healthful food selection was increased by over 100% in an elementary school cafeteria by offering small prizes if students selected a Power Plate (PP); a fruit, vegetable, plain fat free milk (PFFM) and entree. We now describe this Power Plate Program (PPP) when expanded to 8 inner city elementary schools in Cincinnati, Ohio, US. Methods: A Green smiley-faced emoticons were posted near the 4 PP items. In addition, students ages 5 to 12 were rewarded with a small prize if they selected a PP which consisted of the four healthful foods. Purchase of the healthful foods was determined by cash register receipts over the 2015-16 academic year. Results: Overall, 330,580 lunch purchases were evaluated. Baseline purchase of PFFM was 0.14 per student and increased to 0.23, a 56% increase (p<0.0001). Chocolate milk purchase decreased from 0.72 per student to 0.61 (p<0.0001) and vegetable purchase increased from 1.30 to 1.42 per student (a 9.2% increase, p<0.0001). Fruit purchase, however, decreased from 1.02 to 0.99 per student (a 2.9% decrease, p<0.0001)) and total milk sales decreased from 0.87 to 0.84 per student (a 3.6% decrease, p<0.0001). All changes were significant. Conclusion: Emoticon placement and small prizes as an incentive for healthful food purchase increased PFFM and vegetable purchase but also resulted in a small decrease in fruit and total milk selection by inner city elementary school children.

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