Effects of Experiential Learning on Vegetable Intake in Preschool Children

The aim of this study is to test the efficacy of providing experience of a target novel vegetable within the context of an interactive story time to increase intake of the target novel vegetable in preschool aged children (aged 2-5 years). In particular, the study will assess whether these strategies are effective to encourage intake of an unfamiliar vegetable in children who are fussy eaters.

There are two manipulations in this study - the provision of a story which features either a target vegetable (celeriac) or a control vegetable (carrot) and the presence of experiential learning (smelling, touching, looking at the vegetable) with either the target vegetable or the control vegetable.

Baseline consumption and familiarity of the target veg will be assessed for all children, before the intervention. The intervention consists of two familiarization trials, and 2-weeks of access to a story book featuring vegetables. Following the final familiarization trial, consumption and familiarity will be assessed again. Each familiarization trial consists of a story in class, and depending on condition, an experiential learning episode in class. During the 2 week interval between familiarization sessions nurseries will be requested to ready the story book 5 times in the preschool room (at times convenient to them).

Participants will be cluster randomized into 4 groups (2X2 between subjects design): 1) target vegetable narrative, 2) target vegetable narrative + experiential, 3) control vegetable narrative 4) control vegetable narrative + experiential

Child's food fussiness data will be collected by parents using the Food Fussiness sub scale of the Child Eating Behaviour Questionnaire. Their usual consumption of the target vegetable will also be measured using parent report.

Nursery staff will be requested to provide feedback to evaluate intervention feasibility, barriers and efficacy.

It is predicted that children's intake of the novel vegetable will vary by intervention. The primary hypothesis to be tested is that providing experience of a target novel vegetable within the context of an interactive story time will encourage preschoolers to taste, try and eat the target vegetable.

• Narrative (Behavioral): Children will be read a story book featuring vegetables for a minimum of 7 times (including twice during the familiarization phase).
• Experiential (Behavioral): Children will receive hands on experience with the vegetable. They will get to listen, see, feel, touch and smell the actual vegetable during the two familiarization phases.

Primary outcomes

• Change in intake of the target vegetable [Change in intake of the target vegetable from Baseline to day 14]: Intake of the novel vegetable will be measured at baseline (day 1) and post intervention (day 14). Intake of the novel vegetable will be measured individually and objectively using weight in grams. Change in intake will be calculated by subtraction of baseline intake from post intervention intake.

Secondary outcomes

• Knowledge of the target vegetable [Knowledge of the target vegetable at day 14 (post intervention)]: Children's knowledge of the target vegetable will be assessed at baseline (day 1) and post intervention (day 14). Children will be asked to name the photo card featuring the target vegetable.

Sex: All, ages: 2 Years to 5 Years, accepts healthy volunteers

Inclusion Criteria:

* 2 to 5 years old
* Attends nursery on selected test day

Exclusion Criteria:

* Relevant food allergy (celeriac / celery)
* Medical condition which would prevent them from eating the test vegetable

• Results publication: Nekitsing C, Blundell-Birtill P, Cockroft JE, Fildes A, Hetherington MM. Increasing Intake of an Unfamiliar Vegetable in Preschool Children Through Learning Using Storybooks and Sensory Play: A Cluster Randomized Trial. J Acad Nutr Diet. 2019 Dec;119(12):2014-2027. doi: 10.1016/j.jand.2019.05.017. Epub 2019 Aug 1. PMID 31378648
• Results publication: Nekitsing C, Blundell-Birtill P, Cockroft JE, Hetherington MM. Taste Exposure Increases Intake and Nutrition Education Increases Willingness to Try an Unfamiliar Vegetable in Preschool Children: A Cluster Randomized Trial. J Acad Nutr Diet. 2019 Dec;119(12):2004-2013. doi: 10.1016/j.jand.2019.05.012. Epub 2019 Aug 1. PMID 31378647

• Chandani Nekitsing, MSc, Principal investigator, University of Leeds