Pick it! Try it! Like it!: A Grocery Store-Based Approach to Increasing Fruit and Vegetable Consumption

Background

Fruit and vegetable (F&V) consumption in South Dakota (SD) is among the lowest in the nation, with 39.6% and 26.3% of adults eating F&V less than once per day, respectively (Centers for Disease Control and Prevention, 2013). Extension efforts in SD, like most of the U.S., are needed to promote and increase intake of F&V. Although lesson-based nutrition education (Cason, 2005), newsletters and counseling with a Registered Dietitian (Chipman & Litchfield, 2012), and online messages (Nyquist et al, 2011) have shown promise for changing behavior, educational materials are needed that can reach a wider audience in a shorter amount of time.

Program Description

Pick it! Try it! Like it! (PTL) is a collection of resources providing information on 43 different F&V that can be grown in Midwestern climates. It has evolved, since its inception, as a tool to educate the public about growing, selecting, and preparing various F&V. The program has changed in response to needs identified by Extension educators and requests from stakeholders and partners.

The collection of PTL materials was first introduced as a series of F&V fact cards shared by University of Nebraska Extension. The cards were updated from the original version with Nutrition Facts and information for use in farmers markets and 4-H gardening programs. A later revision added a simple recipe for each food, an interactive whiteboard flipchart, and a video showing the recipe being prepared.

The cards, rebranded as Pick it! Try it! Like it!, were then picked up by the state Departments of Education and Health and promoted as an extension of the already popular elementary F&V educational resource called SD Harvest of the Month (HOM). Supplemental Nutrition Assistant Program-Education (SNAP-Ed) assistants and 4-H advisors also used the cards in youth garden trainings and in after-school programs. With the addition of the igrow.org information-sharing platform for South Dakota State University Extension <http://igrow.org>, the set of materials for each produce item (which now includes a two-page fact flyer, a half-page summary and recipe card, produce area signs, and the video recipe demonstration) is available for printing or showing at <http://igrow.org/healthy-families/health-and-wellness/pick-it-try-it-like-it/>.

Grocery Store Component and Evaluation

The idea for educational programming in grocery stores was sparked by a report on a point-of-purchase program called Smart Choices for Families from Virginia Cooperative Extension's Family Nutrition Program <http://www.fcs.ext.vt.edu/fnh/fnp/programs/smart-choices.html>. The SD version became a monthly feature in seven stores and included tasting stations, consumer handouts, and discussion. Displays, recipes, and nutrition tips were shared by Nutrition assistants (EFNEP and SNAP-Ed) to educate limited-resource audiences. Over several years of implementation, the program evolved from covering a broad range of topics (i.e., other food groups, general shopping tips) to using solely PTL materials and focusing on F&V consumption—a result of the low intake of F&V by South Dakotans.

Although PTL materials were an obvious tool to use as part of a point-of-purchase grocery store component, there was a desire to test the effectiveness of these materials as a social marketing tool. Ten stores with $50,000+ electronic benefit transactions (EBT) per month were provided ½ page rack cards and produce area signs. Educational materials were provided for in-store display once per month and included ½ page recipe/fact cards on cabbage, tomato, spinach, asparagus, watermelon, and cucumber. Data were collected before and after implementation of PTL in eight of the 10 eligible grocery stores in SD. Shoppers completed an anonymous survey assessing program recognition, F&V intake, and shopping/cooking habits for a chance to win a gift basket valued at $25. In total, 181 surveys were collected at baseline, and 164 were collected at follow-up. T-tests were used to examine differences between baseline and follow-up data for statistical significance.

Survey Results

Program recognition significantly increased from baseline to follow-up (P < 0.001), with 20% of respondents indicating they had heard of Pick It! Try It! Like It! and 31% recognizing the logo. Intake of "other vegetables" was higher at follow-up compared to baseline (1.3 vs. 1.0 servings, P < 0.05); however, no other differences in F&V consumption were seen. Overall, respondents indicated they spent an average of 9.6 hours each week preparing food. Table 1 highlights additional behaviors.

Implications for Extension

In areas where access to fresh produce can be limited and in states where F&V consumption is low, the information gleaned from the point-of-purchase campaign described here can inform programming efforts. The increase in program recognition is encouraging and reinforces expanded use and additional development of PTL-type educational materials. Since 80% of respondents indicated they like trying new recipes, programs would be wise to create recipe cards and place them throughout grocery stores not only by F&V, but also by other ingredients from the recipes. Given that most people were deciding that day what to eat, sample menus with shopping lists or bags filled with ingredients to make the recipes could also be created. Although shoppers indicated cost was not prohibitive for F&V purchasing, PTL-style materials could be placed near canned and frozen F&V to highlight their benefits as well.

Moreover, point-of-purchase education could coincide with grocery store promotions, where the featured food would be offered at a discount, further enhancing its appeal. In a poll of participating grocery stores, a majority indicated that they would continue to provide PTL materials for their shoppers if the cost of printing could be kept below $25 per month per store. With the cards now being available online, any produce department in the nation could participate for relatively little cost.

The ultimate goal is to have consistent messaging and promotion of F&V consumption spanning all age-groups in a community. In SD, the PTL grocery store component complements the statewide HOM materials being used in schools. A PTL flyer highlighting a fruit or vegetable of the month is now being used as a "newsletter" by partners who deliver publications to senior audiences. Additionally, Extension educators are promoting the PTL materials through horticulture and farmers markets programs. Other states could follow a similar model in their communities, targeting different demographic groups or community-based locations with consistent messaging and educational materials.

References

Cason, K. L. (2005). Effectiveness of a program to increase fruit and vegetable consumption. Journal of Extension [On-line], 43(4) Article 4IAW2. Available at: http://www.joe.org/joe/2005august/iw2.php

Centers for Disease Control and Prevention. (2013). State indicator report on fruits and vegetables. Retrieved from: http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf

Chipman, K., & Litchfield, R. (2012). Extension newsletters and individual counseling: Equally effective in changing worksite wellness participants dietary intakes. Journal of Extension [On-line], 50(3). Article 3FEA5. Available at: http://www.joe.org/joe/2012june/a5.php

Nyquist, H., Rhee, Y., Brunt, A., & Garden-Robinson, J. (2011). Promoting healthy eating and exercise through online messages: A pilot study. Journal of Extension [On-line], 49(6) Article 6FEA6. Available at: http://www.joe.org/joe/2011december/a6.php