Page 24 - Delaware Medical Journal - November 2016
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Dependent Measure
approximately 1⁄2” cubed-sized piece of food placed in the mouth by hand or by utensil and swallowed, without any of the item expelled or spit out.
Procedure
All foods used in this study were approved and provided by the after-school program. Snack items the students could access included a variety of whole fruits and vegetables, yogurt, applesauce, cheese sandwiches, granola bars, and 1.5- to 2-ounce bags of pretzels, popcorn, Cheez-Its®, or Chex Mix®. Cups of water were also available. We had three phases in implementing the phases. Each session took approximately 15 minutes to complete.
During traditional baseline students were instructed to follow their typical routine by going to the kitchen to retrieve their snack and then return to the classroom with their selection to eat together as a group. Whole fruits and vegetables were available during this phase. Individual bites of fruits or vegetables were recorded.
available during traditional baseline were peeled and cut into approximately half-inch-cubed pieces and presented on shared plates placed in the middle of a large table that the students shared during their snack time. Students were instructed to follow their typical routine by going to the kitchen to retrieve their snack and then return to the classroom with their snack selection to eat together as a group. Individual bites of fruits or vegetables were recorded.
During intervention, students were taught the Good Nutrition Game and played the game during their typical snack time using
Good Nutrition Game.
The treatment package included three components: teaching the Good Nutrition Game, playing the Good Nutrition Game, and providing visual and descriptive verbal performance feedback and praise.
The researcher explained that during snack periods in the next couple of weeks they would play a game and that the winning team would be able to choose a prize from a selection of items including stickers and small toys. The researcher then described each of the rules of the Good Nutrition Game using a poster with a list of the game rules. The game rules poster was also used to review the rules before each game and was displayed in a location that was visible to all students during the game.
Before each game, the researcher randomly assigned each of the students from the classroom to one of two teams. Students were not required to sit with their teammates. New teams were created prior to each session. A large scoreboard was placed at the front of the classroom in a location that was visible to all students so that they could monitor their progress during the game. A timer was set for 15 minutes, and the students were invited to start. During the game, one point was rewarded to each team contingent upon one of their teammates eating a bite of fruit or vegetables. The students were permitted to consume as much as they wanted and were also permitted to tell the scorekeeper that they had taken a bite. No individual data were recorded on the visible classroom scoreboard; only aggregate team totals were displayed.
At the end of the game, the points for each for the teams were tallied, and a winning team was announced. The researcher encouraged the “Good game.” Members of the winning team were then invited to choose a small prize. All of the students were reminded that they would have the opportunity to play again the following day.
In addition to the scoreboard, the researcher, along with the teacher and assistants, provided descriptive verbal performance feedback and praise to each of the students throughout the game, contingent on eating bites of fruits and vegetables. While they were not explicitly instructed to do so, the students reinforced the behavior other. The protocol and the principles of the Good Behavior Game/ Good Nutrition Game are designed to encourage these behaviors.
Treatment Fidelity
Prior to the study, the researcher reviewed the protocol, procedural
teachers, and staff and answered any questions. Prior to each session the researcher reviewed the checklist, gathered necessary materials, and prepared foods accordingly. Fidelity was 100 percent.
LESSONS LEARNED
however, only the individual data from each of the four consented participants (two from each classroom) were collected and are presented here according to the IRB requirements. During each session, individual bites of fruit, individual bites of vegetables were recorded for each of these four participants. It was also observed that these participants continued to select and consume a non- nutritious snack each day throughout the study. Figure 1 shows the total number of bites of both fruits and vegetables that were consumed per consented participant per session.
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Del Med J | November 2016 | Vol. 88 | No. 11
