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We developed, pilot-tested, and field-applied a stages of change questionnaire regarding fruit and vegetable (FV) consumption among fourth- and fifth-grade students.The design included cross-sectional assessment of internal consistency and construct validity, and 2-week and 7-week longitudinal assessment of test-retest reliability. Subjects included 134 students from one school for pilot-testing and 252 from two schools for field application. Thirty-two questions from McConnaughy et al's stages of change questionnaire were adapted and pilot-tested; minor revisions were made for field application. Statistical analyses included principal components analysis to identify subscales; cluster analysis to identify subgroups within students; Cronbach's alpha coefficient to assess internal consistencies; Pearson product-moment correlations to assess test-retest reliabilities; and oneway ANOVA's by FV stages of change clusters with actual FV consumption, FV self-efficacy subscales, FV preferences, and FV outcome expectations subscales to determine construct validity.Principal components analysis from the field application indicated two subscales (precontemplation and beyond precontemplation) accounting for 39.5% of variance. Cluster analysis indicated 6 interpretable clusters; 2 (n = 63) provided responses inconsistent with the stages of change theory and 4 (n = 189) provided responses consistent with the theory. Internal consistencies and test-retest reliabilities were acceptable. Students in the "beyond precontemplation" clusters had higher levels of self-efficacy and outcome expectations regarding eating FV.Measuring stages of change other than the precontemplation stage in FV consumption among elementary school children is problematic. Perhaps the theoretical concept does not apply to children, or elementary school children lack the ability to comprehend the questions measuring the concept, or the approach used was not entirely appropriate.

Various nutrition guidelines recommend increased consumption of fruits and vegetables (F+V); a Year 2000 goal targets five or more daily servings of F+V. Decisions are needed regarding how to define F+V to facilitate measurement of goal achievement. Four alternative definitions (narrow and broad, each with and without legumes) were developed and applied to food frequencies from 133 children and 211 parents. Results varied by definition. Mean intake met the goal of five or more daily servings regardless of definition and exceeded it for both broad definitions by children and both broad definitions and the narrow definition with legumes for adults. Median intakes met the goal for all definitions except for children with the narrow definition without legumes, and exceeded it for children with both broad definitions and for adults with the broad definition with legumes. These differences by definition indicate that a clear definition of F+V is needed.

THOMPSON,3 SANDRA B. LEONARD,4 PATRICIA RILEY,2 JANICE BARANOWSKI,3 BONNIE DUDOVITZ, 6 AND MARY SMYTH 6 lGeorgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Augusta, Georgia 30912-3715; 2Division of Behavioral Sciences and Health Education, School of Public Health, Emory University, Atlanta, Georgia 30329; 30fIice of Biostatistics, Medical College of Georgia, Augusta, Georgia 30912-4900; 4Georgia Institute of Human Nutrition, Department of Medicine, Medical College of Georgia, Augusta, Georgia 30912-3102; sOfIice of Public Health Practice, School of Public Health, Emory University, Atlanta, Georgia 30329; and 6Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota, 55454.

The Year 2000 Goals for the U.S. identify a goal of five servings per day of fruits and vegetables (F&V), which is roughly double what children are currently eating. Focus group discussions (based on the reciprocal determinism concept in social learning theory) were conducted with 4th and 5th grade students, their parents, teachers, and school food service workers, in preparation for the design of a school nutrition education program to increase consumption of F&V. A social learning theory perspective was taken because it has been demonstrated to be useful in the design of effective school nutrition education programs. A theory-based protocol delineating the sequence of questions to be asked in each focus group was designed before each group met. Discussions were conducted with ten groups of students, two groups each of teachers and of parents, and one of school food service employees. Three general factors appeared to be most likely to increase F&V consumption in these children: increasing availability of F&V in the home, enhancing liking for vegetables, and providing skills in increasing F&V availability and in preparing F&V.

Determining how children remember what they have eaten may guide the development of specific cues that help children report their diets more accurately. This research used a cognitive-processing approach to examine fourth graders' self-reports of diet. School lunches were observed to determine what was really eaten and the results of these observations were compared with students' reports of what they had eaten and how they remembered that information. Interviews with individual students conducted within 1.5 h of lunch or the following morning included free and prompted report, although prompting was limited to clarifying details about the items and amounts already reported. For analyses, retrieval responses (what the students said in response to the question how do you remember you ate ―――――?) were categorized. A single measure of accuracy that reflected omissions and intrusions was calculated by comparing the student's report with the observation record. Results from one study are provided, along with preliminary results from two additional studies. Research questions and future plans are highlighted, including a Delphi technique study to develop a consensus set of categories of retrieval responses. More accurate assessment of children's diets could increase awareness of changes needed to help establish healthful eating habits in childhood to decrease the risk of chronic diseases in adulthood.

Objectives To determine whether students could verbalize, within 112 hours, how they remembered items eaten at the school lunch; to determine whether the categories of self-reported retrieval mechanisms were similar for two interview styles, integrated and nonintegrated; and to determine the effect of the two interview styles on the accuracy of reporting items eaten by comparing reports with direct observation. Design Two styles of dietary intake interviews were compared with observed intake in a school lunch setting. Setting Two elementary schools in Georgia. Subjects/samples Eighty-two of 106 fourth graders from four classes volunteered; 24 (six per class) were randomly selected and assigned to an interview style. Students interviewed using a nonintegrated style verbalized how they remembered after they had reported everything eaten. Students interviewed using an integrated style verbalized how they remembered at the same time they reported eating each item. Both interview styles included free report followed by prompted report. Main outcome measures Reported retrieval mechanisms were coded into 13 categories. Five measures of performance (specific match rate, general match rate, intrusion rate, omission rate, and overall match rate) were calculated by interview style for free report and prompted report separately. Statistical analyses performed We analyzed the effect of interview style on the number of students reaching 100% accuracy after prompting and on accuracy of reporting condiments using Fisher's exact test. Results Most students could articulate how they remembered items eaten. Reported retrieval mechanism categories were comparable for both interview styles. Visual imagery, usual practice, behavior chaining, and preference were the most commonly reported retrieval mechanisms. Accuracy of free reports did not differ by interview style; however, the nonintegrated interview style produced dietary self-reports with fewer condiment omissions during free report and higher accuracy after prompting. Applications Determining what retrieval mechanisms children commonly use for remembering items eaten may help researchers design cues to improve the accuracy of dietary self-reports. More accurate dietary self-reports could markedly affect the many types of research that use dietary assessment.

A model of cognitive processing is proposed to understand children's self-reports of diet. The model is a simplification of what is known about cognitive processing and includes three structural components: sensory register, short-term memory, and long-term memory. Several processes describe functioning of the model, including attention, perception (or interpretation), organization, retention, retrieval, and response formulation. The ideas explain several phenomena in the literature on children's self-reports of dietary intake. Research questions are identified for each process to help specify the model and lead to improved methods for dietary assessment in children.

Background. Achievement of the nation′s Year 2000 fruit and vegetable goal of five or more daily servings may relate to children′s preferences for fruits and vegetables. There are, however, no easily administered instruments for measuring preferences for fruits and vegetables among children. Methods. An initial questionnaire systematically varied preparation methods after focus group discussions had indicated that this had an impact on fruit and vegetable preferences. The three-part questionnaire (fruits, vegetables, fruit and/or vegetable snacks) was classroom administered. Internal consistencies and test-retest reliabilities were acceptable. Principal components analyses, however, revealed food-specific rather than preparation factors; thus, preparation was eliminated from a revised questionnaire. Results. Repeat classroom administration of the revised questionnaire yielded acceptable internal consistencies and test-retest reliabilities. Preferences were higher for fruits than vegetables. Principal components analyses indicated single fruit and vegetable factors and a two-factor solution for snacks (vegetables, fruits). Pearson correlations between preferences and consumption were significant, but accounted for only a small fraction of the variance. Correlations between fruit exposure and preferences, and between vegetable exposure and preferences were 0.55 and 0.51, respectively. Conclusion. The revised questionnaire provides a reliable, valid, and simple tool for assessing fruit and vegetable preferences of 4th- and 5th-grade students. The relationship between these preferences and actual consumption is weak; however, making fruits and vegetables more available may enhance preferences.

Although achievement of many of the Healthy People Year 2000 nutrition objectives will be determined by dietary assessment, methods for assessing diet are weak, especially for children. Children's self-reports of diet are necessary because parents do not know what children eat at school. Self-reports rely on memory, which is subject to error. Research concerning memory and dietary assessment is limited. The purpose of this study was to compare how 4th-graders remember items and amounts eaten at the school lunch the same day with how other 4th-graders remember items and amounts eaten at the school lunch the previous day. Students from 1 6 classes at 3 schools were randomly selected, observed eating lunch, and interviewed within 2 hours after eating (n = 89) or the following morning (n= 16). Interviews were audio-recorded and included free report, cognitive aspects of free report, prompted report, and cognitive aspects of prompted report. For analyses, responses obtained during each of the two cognitive phases (free, prompted) from same day interviews were grouped according to item, detail, and amount, and categorized into 14 categories of responses (preferences, smell/taste imagery, texture imagery, visual imagery, usual practice, food-related events, read label, read menu, behavior chaining, amount eaten, weight of container, physiological cues, other, unable to verbalize). The process was repeated for next day reports. Chi-square analyses were conducted with the individual student as the unit of analysis. Usual practice was more commonly used during next day than same day recalls for items freely reported (81 % vs. 40%, p

Fourth- and fifth-grade students' food records completed by using a labor-intensive approach (with daily monitoring) or a less labor-intensive approach (with weekly monitoring) were compared with school-lunch observations. Records were completed at three elementary schools for 14-23 d by students in 26 classes. Record pages were printed forms with areas for recording items consumed, number of servings, and locations of meals. Students were randomly selected for lunch observation. Kappa coefficients and percent of agreement for interobserver reliability for both approaches combined ranged from 0.43 to 0.91 and 72.6% to 95.5%, respectively, on 24 observations. Pearson correlations for 117 record/observation matches were significant for eight and three of nine meal items for the daily and weekly monitoring approaches, respectively. Thus, students were reasonably accurate in keeping records and more accurate with the more labor-intensive approach. Researchers need to select an approach based on the degree of accuracy desired and available finances.