A mobile texting pilot proj

1. TEXT4TOTS
A program to increase fruit and vegetable intake in children
ages 2 - 5
Lalaine Ricardo and Saara Taylor

2. HEALTH GOAL
• To increase fruit and vegetable intake, and reduce
overweight and obesity among toddlers ages 2 -5
• PRIMARY TARGET AUDIENCE
• Parents of children age 2 – 5 in the Northern Virginia area
• SECONDARY TARGET AUDIENCE
• The toddler age children who attend day care, kindergarten or stay at
home

3. OBJECTIVES
• Behavioral Objective (Social Cognitive theory)
• To increase the fruit & vegetable intake in toddler age children of
our target audience by 50% by the end of the 3-month
intervention
• Communication Objectives
• By the end of the 3-month intervention, more than 50% of
parents of toddler-age children will report having increased their
knowledge of the importance of F & V intake [Expectations]
• At the end of our campaign, parents will be able to name at least
two ways to add F & V to their child’s meals and snacks from a
list of 5 [Behavioral capability]
• At the end of our campaign, 50% of our target will report having
increased confidence that their kids are eating the recommended
daily amount of F & V [Self-efficacy]

4. PARTICIPANTS
• n = 11 parents
• 9 female
• 4 work outside of home
• 1 works at home
• 4 stay at home
• 2 male
• 1 works outside of home
• 1 stay-at-home dad

5. SAMPLE MESSAGES
• Increase knowledge
• “A medium apple counts as 1 cup of fruit, hitting your
child's fruit goal for the day. Apples are a good source of
immune-boosting vitamin C.”
• Behavioral capacity
• “Try this recipe for a fruit smoothie - use nonfat vanilla
yogurt, 100% orange juice & banana as a base, then add
other fresh or frozen fruit.“
• Self-efficacy
• “Kids learn from watching you. Eat fruits & veggies and they
will too. Text us — what is your favorite fruit or veggie?”

6. SAM SCORE
Readability: Between 6th and
7th grade

7. EVALUATION
• Baseline survey
• 6 out of 11 participants responded
• What is most difficult about ensuring your child has
enough F & V each day?
• “Making it more appealing to them”
• “Time at night — we both work full time so preparing meals is
tough”
• “Keeping track”
• “Child eats lots of fruits but only selected veggies”
• “Being compared to other parents who let their kids eat junk”
• “Keeping it from going bad”

8. EVALUATION
• Final survey
• 7 out of 11 responded
• 57% increased their purchase & preparation of F & V in the past
week
• 57% think the messages were effective in reminding them about
their child’s F & V intake
• 57% were satisfied that texts messages helped them improved
their family’s health; 28.6% were very satisfied ; 14% was
dissatisfied
• 72% read all text messages; 14% read 4-6 messages; 14% read 0-3
• 71% said their knowledge of F & V importance stayed the same
• 43% said their confidence in giving their child the recommended
amount of F & V increased

9. INTERACTION
• Asked participants two questions
• How many servings did your child have yesterday?
• 3 responses
• Reinforcement message: Great job!
• What are your favorite fruits and vegetables?
• 3 responses

10. PROPOSED FINAL PRODUCT
• More tailored messages, based on response in
baseline survey
• Participants in general already were hitting the
recommended targets for F & V for their children
• Would specifically tailor messages for parents depending on
age of child
• Better schedule time and frequency of messages according
to participant’s preferences
• Would target separately working parents and stay-at-home
parents

11. REFERENCES
Haapala, et al. (2009). Weight loss by mobile phone: a 1-year
effectiveness study. Public Health Nutrition, 12(12):
2382-2391.
Kahlor, et al. (2011). Ensuring Children Eat a Healthy Diet: A
Theory-Driven Focus Group Study to Inform Communication
Aimed at Parents. Journal of Pediatric Nursing 26: 13–24.
Norman, et al. (2007). A Review of eHealth Interventions for
Physical Activity and Dietary Behavior Change. American
Journal of Preventative Medicine. 33:336-345.
Patrick, et al. (2009). A text message-based intervention for
weight loss: randomized controlled trial. Journal of Medical
Internet Research 11(1):e1.
Peng, W. (2009). Design and evaluation of a computer game to
promote a healthy diet for young adults. Health