"Get Fruved:" A Peer-led, Train-the-trainer Social Marketing Intervention to Increase Fruit and Vegetable Intake and Prevent Childhood Obesity.

The goal of the research is to develop a novel strategy to promote healthy behaviors associated with obesity prevention in older adolescent populations. A community based participatory research (CBPR) approach is used with partnerships among older adolescents, university researchers and faculty, and Extension partners. The objective is to test the effectiveness of a peer-led, train-the-trainer intervention. The intervention is an interactive, non-traditional social marketing, online media, and environmental change approach seeking to promote healthy behavior with communities of college and high school students. Specific health behaviors targeted include increasing intakes of fruits and vegetables, decreasing foods high in saturated fats and added sugars, managing stress, and increasing physical activity. This project uniquely 1) increases participant engagement through creative interactions, participant-created content, and incorporation of age-appropriate technology; 2) incorporates social environments and peer-led strategies; and 3) simultaneously addresses changes in environments to support participant-driven behavior change efforts.

This project is a Pretest-Posttest, Control Group Trial using a nested cohort design with three conditions (intense intervention, diffuse intervention, and control), four control universities and four intervention universities in years 01- 03, one high school as control and one as intervention at each of the four intervention university towns in years 03-04, and disseminated to four additional university and high school pairs in years 04-05.

A CBPR, peer-led approach is used in that upper level college students mentor freshmen 4-H college students through the development of the intervention. The CBPR, peer-led approach continues when the now sophomore 4-H college students implement the intervention with incoming college freshmen in the following year. The train-the-trainer approach is utilized when the now junior level 4-H college students mentor 4-H high school students in the modification of the intervention for high schools. The approach continues when 4-H high school students implement the intervention with incoming freshmen in high schools.

In the fall of year 01, 283 freshman students were recruited from general/survey nutrition courses at the four intervention universities to participate in a special undergraduate spring course (the intense intervention group). 94 freshman students were also recruited from general/survey nutrition courses at the four control universities. During the fall, researchers at the intervention schools worked with nutrition (graduate and undergraduate) students to identify and develop partnerships with student organizations for the development of a social marketing health promotion campaign. Researchers and student partners also worked with local high schools (including student organizations, school food service, Parent Teacher Associations, school wellness committees, and administration) and school boards to formalize research agreements and relationships.

In the spring of year 01, as a part of the newly developed undergraduate course, the freshman students (the intense intervention group) from each intervention university joined their collegiate 4-H program. The courses were offered as independent studies or as a newly developed course through the respective University's PI. The course covered principals of social marketing for health behavior change. University researchers and Extension faculty collaborated and taught in-person classes with their respective collegiate 4-H students. Collegiate 4-H students were co-taught (by all four University's research and Extension faculty) and had the opportunity to interact with the other collegiate 4-H students from all four intervention universities through web-based technologies. Throughout the course, the collegiate 4-H students developed and planned a social marketing campaign. Following a peer-led approach, the 4-H students partnered with and were mentored by upper-level nutrition students and student organizations (student partners) in the development and planning of the campaign.