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The child’s influence on parental purchase patterns for breakfast foods 1983

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THE CHILD1S INFLUENCE ON PARENTAL PURCHASE PATTERNS FOR BREAKFAST FOODS by DOROTHY FISHER B.Sc. University of Alberta 1971 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES (Department of Administrative, Adult and Higher Education) We accept t h i s thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA A p r i l , 1983 (c) Dorothy Fisher, 1983 In presenting t h i s thesis i n p a r t i a l f u l f i l m e n t of the requirements for an advanced degree at the University of B r i t i s h Columbia, I agree that the Library s h a l l make i t f r e e l y available for reference and study. I further agree that permission for extensive copying of t h i s thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. I t i s understood that copying or publication of t h i s thesis for f i n a n c i a l gain s h a l l not be allowed without my written permission. Department of floLu^s-kJin, Adult Its Ji~dt*cd't The University of B r i t i s h Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 DE-6 (3/81) ABSTRACT This study was conducted to examine the effectiveness the preschool c h i l d in stimulating a behavior change within the parent(s) with respect to food purchase patterns and choices o f f e r e d to the c h i l d . One hundred and three families associated with six nursery schools located within the Simon Fraser Health Unit were involved i n the study. The nursery schools were randomly assigned to one of three experimental conditions: the control group whose children c a r r i e d on with r o u t i n e nursery school a c t i v i t i e s , the transfer materials group whose children received n u t r i t i o n pamphlets and the treatment group who i n a d d i t i o n to r e c e i v i n g n u t r i t i o n pamphlets a l s o p a r t i c i p a t e d i n an a c t i v i t y oriented breakfast program over the course of four weeks. Following the four week period the parents of a l l children received a questionnaire which was brought home by the c h i l d and returned anonymously by the parent to the nursery school. A response rate of 89 percent was obtained. The questionnaire used in the study examined two aspects of p a r e n t a l behavior: the food purchase patterns and those patterns centering around the types of foods offered to the preschool c h i l d at breakfast. The p a r e n t s ' b e h a v i o r p a t t e r n s were a n a l y s e d to determine the frequency of purchase of milk products, bread products, f r u i t s , protein sources and cereals containing in excess of f i f t e e n percent sugar and the frequency with which these foods were o f f e r e d to the preschool c h i l d f o r b r e a k f a s t . In g e n e r a l , t h e r e were no s i g n i f i c a n t d i f f e r e n c e s i n the purchase or " o f f e r i n g " behavior of parents i n the three groups. The only differences pertained to p a r e n t a l purchases of c e r e a l s with more than f i f t e e n percent added sugar. The control group reported making a greater number of purchases of cereals with added sugar than d i d e i t h e r of the treatment groups (p < .004). I t was conjectured that sweetened cereal scores of the treatment, transfer and control groups were d i f f e r e n t because shoppers "commitments" to cereals are less stable than "loyalty" to other products. Also, i t appears that previous "persuasion" e f f o r t s have sensitized mothers to problems associated with high sugar foods. I t i s p o s s i b l e that the b r e a k f a s t programme t e s t e d here evoked or r e i n f o r c e d p r e v i o u s l y learned postures concerning cereals with added sugar. TABLE OF CONTENTS PAGE LIST OF TABLES v LIST OF FIGURES v i ACKNOWLEDGEMENTS v i i I. INTRODUCTION 1 Statement of the Problem 2 Definition of Terms 3 Hypotheses 6 II. LITERATURE REVIEW 9 III. METHOD 18 Research Design 18 Treatment Variables 20 Comparability of the Centres 22 Measuring Instruments 25 Data Collection and Analysis 31 Limitations and Assumptions 34 IV. RESULTS AND DISCUSSION 39 Return Rates 39 Characteristics of the Sample 41 Food Purchase Patterns Reported by the Respondents 53 Types of Breakfasts Offered by the Respondents 64 V. SUMMARY AND CONCLUSIONS 66 REFERENCE NOTES 76 BIBLIOGRAPHY 77 APPENDICES APPENDIX A: Samples of Correspondence 80 APPENDIX B: Breakfast Program Guidelines.... 85 APPENDIX C: Fin a l Measurement Instruments... 93 APPENDIX D: Descriptive Comments from Parents and Supervisors 105 iv LIST OF TABLES TABLE PAGE 1 Characteristics of Participating Nursery Schools.... 24 2 Breakfast Foods Eaten as Reported by Parents and Children 29 3 Consistency of Children's Recall of Breakfast Foods Eaten 30 4 Responses to Requests for Participation 36 5 Return of Questionnaires by Centre 40 6 Breakdown of Respondents by Area of Residence 42 7 Data Pertaining to the Equivalence of the Treatment, Control and Transfer Materials Groups.. 43 8 Dist r i b u t i o n of Family Members by Age Categories.... 48 9 Mean Number and Percent of Parents in Treatment, Control and Transfer Materials Groups Who Reported Receiving Transfer Materials 52 10 Mean Food Purchase Scores for Each of the Treatment, Control and Transfer Materials Gr o up s 54 11 Mean Competing Food Purchase Scores for Each of the Treatment, Control and Transfer Materials Groups 55 12 Predictors of Sweetened Cereal Score 62 13 Breakfast Foods Offered to Children in the Treatment, Control and Transfer Materials Groups.. 65 v LIST OF FIGURES FIGURE PAGE 1 Direction of Impact of Education on Behavior.... 15 2 Diagrammatic Representation of the Research Design 18 3 Schematic Representation of the Post test Only Design 20 4 Excerpt from Part One of Parent Questionnaire... 25 5 Excerpt from Part Two of Parent Questionnaire... 26 v i ACKNOWLEDGEMENTS The researcher wishes to acknowledge the contributions of the following: The B r i t i s h Columbia Ministry of Health for granting the education leave to pursue graduate work in thi s area. Dr. Roger Boshier, Department of Administrative, Adult and Higher Education, Faculty of Education, University of B r i t i s h Columbia, for the counsel and guidance in planning and conducting t h i s study. Dr. Todd Rogers, F a c u l t y of Education, U n i v e r s i t y of B r i t i s h Columbia, for assistance p a r t i c u l a r l y r e l a t i n g to the development o f the t e s t i n g i n s t r u m e n t s and the s t a t i s t i c a l analysis of the data. The nursery school teachers and the parents who enthusia s t i c a l l y gave time and energy to the study. F i n a l l y , a s p e c i a l thanks to the preschool c h i l d r e n involved in the study. 1. CHAPTER I INTRODUCTION Anyone who has ever observed an adult shopping with a preschool c h i l d i s aware that c h i l d r e n exert a powerful influence on th e i r parents' selection of food. S i m i l a r l y , i f one watches t e l e v i s i o n commercials on Saturday mornings, i t i s apparent that a d v e r t i s e r s attempt to i n f l u e n c e preschool children. The New York Times i n November of 1980 reported that even the U.S. Department of A g r i c u l t u r e had commissioned "Spiderman" to carry a n u t r i t i o n message about healthy snacks to six to twelve year olds. Berey and Pollay (1968) and Ward and Wackman (1972) have i d e n t i f i e d the c h i l d as p l a y i n g a p o t e n t i a l l y important r o l e i n the parent decision making process. Thus, t h i s study was conducted to further investigate the p o s s i b i l i t y of the c h i l d functioning as a change agent. The aim of the study was to quantify the extent to which the preschool c h i l d generates p a r e n t a l behavior change. Interest in the concept of children as potential change agents, capable of d i r e c t i n g adult behavior patterns, evolved as a result of personal experiences in the f i e l d of community n u t r i t i o n education. The parameters selected for t h i s study were those which allowed f o r the i n c l u s i o n of preschool children l i v i n g in a suburban area and enrolled in a nursery school program. 2. This study was carried out during May and June of 1982 in the Simon Fraser Health Unit with the endorsement of Dr. F.J. Blatherwick, Medical Health Officer. The Simon Fraser H e a l t h U n i t , p a r t of the G r e a t e r Vancouver R e g i o n a l D i s t r i c t , i s p r i m a r i l y an urban area i n c l u d i n g the municipalities of New Westminster, Coquitlam, Port Coquitlam and Port Moody. New Westminster was excluded from the study upon the advice of the committee due to the fact that i t s inclusion would have increased the heterogeneity of the t a r g e t population. The three m u n i c i p a l i t i e s (Coquitlam, Port Coquitlam and Port Moody) chosen are comprised of a high proportion of young families. This resulted in a decision to r e s t r i c t the study to families who had preschool children in attendance at one of the p r o v i n c i a l l y licensed nursery schools. This c r i t e r i o n also f a c i l i t a t e d the organizational aspects of the study. Statement of the Problem The commonly held approach to education i s to view the adult as directing the learning and subsequent behaviors of children — the adult assumes the role of educator and the c h i l d the role of learner. The purpose of t h i s study was to experimentally research the reverse situation. This study 3. was designed to examine the extent to which the preschool c h i l d stimulates behavior change within the parent(s) with respect to food purchase patterns and foods offered to the c h i l d . The c h i l d i n t h i s study was considered to be a change agent. Definition of Terms Breakfast program; a coordinated set of n u t r i t i o n education a c t i v i t i e s related to breakfasts, presented to the children of s e l e c t e d nursery schools by t h e i r regular preschool supervisor over a four week period. O f f e r i n g an a c t u a l breakfast was not included in the program. Canada's Food Guide; "a g u i d e l i n e for food choices of Canadians developed by n u t r i t i o n i s t s as a mechanism to interpret the Canadian dietary standards" (Provincial Child Care F a c i l i t i e s Regulations, 1979) and used in the study to guide the development of breakfast program objectives and the analysis of the data. Foods eaten; breakfast foods a c t u a l l y consumed by the c h i l d . Foods offered; breakfast foods offered to the c h i l d by the parent but which may or may not have been consumed. 4. Food purchase patterns; a d e s c r i p t i o n of parents' food buying behavior as determined by foods which parents indicate that they have bought over the past month and foods c u r r e n t l y i n the home at the time of q u e s t i o n n a i r e completion. Nursery school; a s e t t i n g where the opportunity f o r " s o c i a l , emotional, p h y s i c a l and i n t e l l e c t u a l growth" i s provided for " c h i l d r e n 32 months to the age they enter school in a group setting for periods of not more than three consecutive hours" ( P r o v i n c i a l C h i l d Care F a c i l i t i e s Regulations, 1979). In t h i s study nursery school and preschool are synonymous. Preschool c h i l d ; a c h i l d between the ages of 36 and 66 months. Preschool supervisor; a person who has completed the basic minimum training and holds a preschool supervisor's l e t t e r of q u a l i f i c a t i o n . In the study, the preschool supervisor provided the instruction to the children and also acted as the l i a i s o n with the parents. Traditional program; describes those a c t i v i t i e s providing for the development, care and protection of the children, but which do not include a n u t r i t i o n component. 5. Transfer Materials; the c o l l e c t i o n of pamphlets r e l a t i n g to nutritious breakfasts which were distributed to parents via th e i r children. 6. Hypotheses The two general hypotheses considered i n t h i s study were: (1) There i s no s i g n i f i c a n t difference in the parental purchase patterns for breakfast foods among those parents whose children (i) were involved in a breakfast program, ( i i ) received transfer materials, and those who ( i i i ) carried on with the t r a d i t i o n a l nursery school program. (2) There i s no s i g n i f i c a n t difference in the quality of breakfasts offered to the c h i l d by parents of children in the breakfast program, those who received transfer materials only and those who carried on with the t r a d i t i o n a l program. Two hypotheses were selected for investigation because more than one d e c i s i o n p o i n t i s involved i n the behavior change being evaluated. Through the education of the c h i l d and subsequently the parent l i e s the p o s s i b i l i t y that the parent may modify the s e l e c t i o n of s p e c i f i c foods to be purchased, but may not o f f e r them to the preschool c h i l d . In other words, the foods may be available, but the behavior has not carried through to the extent that the parent thinks to o f f e r the new food. The s e l e c t i o n of two hypotheses allows i n v e s t i g a t i o n of t h i s stepwise m o d i f i c a t i o n of parental behavior. 7. Thus, the dependent variables in thi s study were: (1) parents' purchase d e c i s i o n s regarding breakfast foods and (2) parents' choices with respect to the breakfast foods offered to the c h i l d (a d i s t i n c t i o n was made between "offered" and "consumed" because of the parental behaviors b e i n g the f o c a l p o i n t as opposed to the c h i l d r e n ' s behaviors). The independent v a r i a b l e was the treatment program assigned: (1) a four week Breakfast Program (2) the d i s t r i b u t i o n of Transfer Materials over a four week period (3) the T r a d i t i o n a l Program which excluded a l l nu t r i t i o n related a c t i v i t i e s for a four week period. The s p e c i f i c hypotheses tested were: A. Hypothesis 1 There i s no s i g n i f i c a n t difference among the parents of the three treatment groups regarding the frequency of purchase of: a) milk products b) whole grain bread and cereals c) cereals with more than f i f t e e n percent added sugar d) high quality protein sources and e) f r u i t s and f r u i t juices 8. B. Hypothesis 2 There i s no s i g n i f i c a n t difference among the parents of the three treatment groups regarding the frequency of: a) offering breakfasts to their children b) offering a nutritious beverage at breakfast c) offering a protein source of high quality at breakfast d) offering a whole grain bread or cereal choice and e) offering a cereal containing in excess of f i f t e e n percent sugar. 9. CHAPTER II LITERATURE REVIEW Although the c h i l d i s not f o r m a l l y recognized as a method of adult education; the c h i l d i s p o t e n t i a l l y a dynamic and s u c c e s s f u l change agent. Three avenues have been chosen for exploration to v e r i f y t h i s assumption: (1) the l i t e r a t u r e , (2) l o c a l professionals working in related f i e l d s and (3) a survey of selected programs from across Canada. The Literature 0 An ERIC (Educational Resources Information Centre) search revealed many a b s t r a c t s d e s c r i b i n g programs or studies aimed at a l t e r i n g c h i l d behavior through parent education; the exact opposite of the question posed. Unfortunately, due to the nature of the ERIC search system the computer was unable to discriminate the di r e c t i o n of the impact desired. Thus, a search of the relationship between the c h i l d and parent education produced 212 abstracts. None dealt with the child's influence on parental behaviors. A second search using MEDLINE was completed in hopes of uncovering information related to health education programs directed toward children, yet aimed at the modification of parental behaviors. Once again the search revealed a void. 10. Gates and Campbell (1981) examined the dietary concerns and practices of 176 mothers of preschool children and reported on parents' attempts to make changes i n children's eating habits. This was ty p i c a l of the di r e c t i o n of impact most frequently cited in the l i t e r a t u r e . The r e p l y from the l i b r a r i a n at the u n i v e r s i t y ' s Computer B i b l i o g r a p h i c Search Service supported t h i s conclusion in her statement which read "Just as I suspected. I was unable to weight the search toward educating the parent via the chi l d " (Note, 1). Of 44 ci t a t i o n s printed, seven appeared as remote p o s s i b i l i t i e s , but unfortunately, none of these i l l u m i n a t e d the q u e s t i o n o r i g i n a l l y formulated. At best, the l i t e r a t u r e i n t h i s area can be described as sparse. Local Professionals As a re s u l t of the output received from the l i t e r a t u r e searches, the decision was made to abandon the global view and c o l l e c t " l o c a l " v i e w p o i n t s and documentation. Professionals working with children as change agents within l o c a l programs were selected. They were i n education ( i n c l u d i n g e a r l y c h i l d h o o d and a d u l t e d u c a t i o n ) , l i n g u i s t i c s , n u t r i t i o n and commerce. Contact with resource people in each area was i n i t i a l l y by telephone followed by a l e t t e r r e i t e r a t i n g the research question, and where appropriate by follow-up interview. Of the d i s c i p l i n e s approached, the marketing area of commerce offered the greatest promise. The other areas, as might be expected, were very much involved with the t r a d i t i o n a l approach where parents were perceived as influencing children. However, one exception was noted; a study conducted by Csapo (1974) involved elementary students i n modifying teacher behavior. Although the research sample was small this was the f i r s t documentation found to suggest that children could a s s i s t an adult to modify his/her own behavior. The child's influence on parental purchase patterns has been given most consideration by those involved i n marketing research. Advertising in p a r t i c u l a r i s concerned with this impact. Although these areas have i d e n t i f i e d the child's influence on parental yielding, they have also pointed out the lack of research. Assael acknowledges the lack of research into children's influences and states that "given t h i s potential influence i t i s surprising that almost a l l studies of family purchase decisions have focused on husband and wife influences and have excluded children." (1981, p. 357). Even the American Federal Trade Commission's concern over the e f f e c t s of t e l e v i s i o n a d v e r t i s i n g on c h i l d r e n 12. f a i l e d to examine the p a r e n t - c h i l d i n t e r a c t i o n i n f a m i l y decision making (Assael, 1981). The volume of marketing l i t e r a t u r e concerned with the issue of the child's influence on parental behavior i s not overwhelming, but two studies appear to be c l a s s i c and reappear in the most recent texts on the subject of consumer behavior. They are those conducted by Ward and Wackman (1972) and Berey and P o l l a y (1968). Ward and Wackman studied children's (5-12 year olds) attempts to i n f l u e n c e mothers' purchase behaviors and degrees of y i e l d i n g to i n f l u e n c e attempts. I n f l u e n c e attempts d e f i n e d as "children's attempts to i n f l u e n c e mothers' purchases of various products" (Ward and Wackman, 1972, p. 316) were found to decrease with age while the frequency of mothers' yielding to the purchase requests increased as the c h i l d got older. Berey and Pollay found child-centeredness and purchase patterns to be c o r r e l a t e d (p < .05). The more c h i l d - centered the mother (i.e. the one who took greater care with her child) the more l i k e l y she was to buy what was "right" for the c h i l d as opposed to giving in to the child's wishes. Thus, both studies implicated the c h i l d as an influencer of parent purchase behaviors; the degree of influence mediated by both the child's age and the personality of the parent. The research studies which emerged as a r e s u l t of contact with l o c a l professionals suggested that: 1. the c h i l d does exert an impact on adult behaviors. 2. additional research i s needed regarding the magnitude of the child's influence on adult behavior. Cross Canada Review A t h i r d strategy involved communicating with selected resource people across the country. In so doing, i t was hoped t h a t programs not f o r m a l l y w r i t t e n up i n the li t e r a t u r e would surface. Provincial contacts were made in B r i t i s h Columbia, Alberta, Saskatchewan, Manitoba, Ontario and Prince Edward Island. The resource people contacted occupied a v a r i e t y of p o s i t i o n s w i t h i n the p r i v a t e and p u b l i c sectors. P r o v i n c i a l h e a l t h departments, other university n u t r i t i o n departments and community organizations such as the 4-H Council and the Heart Foundation were among those who replied to the questions: *What Canadian youth programs are operational which function as a means of providing information to the parent(s)? *What i s the best age to provide children with information i n order for i t to reach the parent(s)? From the eight replies received i t became clear that the responses to both questions were s i m i l a r across the country. Each r e p l y had i t s own phraseology but t h i s 14. comment from Prince Edward Island succinctly describes a l l the r e s p o n s e s : "I am not aware of any programs or l i t e r a t u r e which deal with the issue of parent education v i a the child." (Note, 2). Two of the provinces (Manitoba and Prince Edward Island) involved the c h i l d i n education programs as a vehicle by which messages and notices were delivered to the parents. No education per se was involved. Alberta's " N u t r i t i o n At S c h o o l " program had p a r e n t e d u c a t i o n incorporated i n t o the goals and o b j e c t i v e s of the c h i l d ' s n u t r i t i o n education program, but no further references to t h i s i n c l u s i o n were found (Note, 3). Of the feedback received from people who occupy key r o l e s across the country, no one was able to d e t a i l programs f o r m a l l y u t i l i z i n g the concept of the c h i l d as a change agent. Although the pr o v i n c i a l contacts were unable to provide c l e a r l y defined answers to the questions presented, they did provide encouragement to pursue th i s concept. The general tone of the replies can best be described as an interest in t h i s "new and very interesting approach to adult education" (Note, 4). In r e t r o s p e c t , the answers to the i n i t i a l questions posed were d i f f i c u l t to find. However, both the l i t e r a t u r e and the p r o f e s s i o n a l contacts suggested that t h i s was an area f o r r e s e a r c h . M a r k e t i n g i s l i k e l y to c o n t i n u e 15. exploring t h i s avenue because of recent findings suggesting that i t i s the c h i l d who i n i t i a t e s discussions about product purchases and consumption (Assael, 1981). Some groups and organizations, such as commercial ventures, already see the p o t e n t i a l while n u t r i t i o n education planners are j u s t being alerted to the p o s s i b i l i t i e s of the c h i l d as a means of educating the parent. E n t h u s i a s t i c r e p l i e s from the provinces suggested that this idea should be explored from an educational perspective. The notion of using children to educate adults appears to be novel. The e x i s t i n g l i t e r a t u r e i s r e p l e t e with studies describing the impact of parent education and parent behaviors on the development of c h i l d r e n , but not v i c e versa. The c h i l d acting as the change agent i s the reverse of the t r a d i t i o n a l l y accepted model of education as shown i n Figure 1. I II PARENT'S EDUCATION PARENT'S BEHAVIOR CHILD' S BEHAVIOR CHILD' S EDUCATION Figure 1: Direction of Impact of Education on Behavior 16. In Model I, i t i s easy to i d e n t i f y a v a r i e t y of programs which are offered to parents in order for them to m o dify t h e i r c h i l d ' s b e h a v i o r p a t t e r n s . An example c u r r e n t l y used i n the p u b l i c h e a l t h f i e l d i s the STEP program: Systematic Training for Effective Parenting. To f i n d documented examples of Model II i s more d i f f i c u l t . However, a closer look at t e l e v i s i o n commercials directed toward children provides evidence that various organizations such as Kelloggs, General Foods, MacDonalds and Mattel attempt to "educate" the c h i l d in order to affect parental purchase patterns. Due to the highly competitive nature of the m a r k e t p l a c e data r e g a r d i n g the e f f e c t i v e n e s s of educating the c h i l d i s not r e a d i l y a v a i l a b l e . Yet i t i s quite apparent to even the most casual observer that their techniques do work. M i l l i o n s of d o l l a r s are invested annually in the influence children are purported to have on parents' behaviors. Societal and technological changes also provide r e a l - l i f e examples of the p a t t e r n depicted by Model II. The factor "family togetherness" as conceived by Boshier (1982) i d e n t i f i e s reasons for adults p a r t i c i p a t i n g i n adult education classes (e.g. in order to keep up with others in the family, to answer questions asked by the children) and points to the impact which the c h i l d may have on the parent during times of change. One such change which may stimulate 17. p a r t i c i p a t i o n i n an educational a c t i v i t y a r i s e s from the need parents f e e l to become more knowledgeable about the technology f a m i l i a r to t h e i r c h i l d r e n ( i.e. the c h i l d ' s education i s stimulating a parental behavior change). An example of t h i s situation i s demonstrated by the parents who enrol l in computer courses or who purchase home computers as a r e s u l t of the education which t h e i r c h i l d receives with the computer at school. Although there are day to day examples of the influence which the c h i l d may have on parents' behaviors the questions remain: How e f f e c t i v e i s the c h i l d as a change agent? Is one age any better than another? and How compatible i s t h i s concept of the c h i l d as a change agent with the f i e l d of adult education? These questions, at present, do not have d e f i n i t i v e answers. If one stops to take time to observe and r e f l e c t upon the i n f l u e n c e which c h i l d r e n exert on adults the magnitude of t h i s r e l a t i o n s h i p becomes more c l e a r . Using Assael's phraseology, the phenomenon of "child-power" i s growing and l i k e l y to continue to do so as children increase in t h e i r degree of independence during the 80 ' s. It i s t h i s perspective that inspired further study of the process of u t i l i z i n g the c h i l d to educate parents and to u l t i m a t e l y s t imulate behavior change. The merits of the c h i l d as a unique change agent were evaluated f u r t h e r i n this research study. 18. CHAPTER III METHOD Research Design The design selected for this f i e l d based research was the nested or h i e r a r c h i a l design which in th i s case featured a post test only. Three treatment conditions were examined: a breakfast n u t r i t i o n education program, a program u t i l i z i n g n u t r i t i o n transfer materials, but no nu t r i t i o n education and a treatment condition where there was no n u t r i t i o n education nor were t r a n s f e r m a t e r i a l s d i s t r i b u t e d . Six nursery, schools were randomly assigned to the three treatment conditions creating a CRH - 3(2) design (Figure 2). A Breakfast Program B Transfer Materials C Control (neither A nor B) Centres I II III IV V VI Subjects 18 15 22 21 9 18 Figure 2: Diagramatic Representation of the Research Design 19. The s p e c i f i c format of Figure 2 r e s u l t e d from the response to l e t t e r s mailed to each nursery school i n the Simon Fraser Health Unit area. These l e t t e r s described the proposed r e s e a r c h study and i n v i t e d the c e n t r e s to p a r t i c i p a t e . I t was re q u e s t e d t h a t the d e c i s i o n to participate be made j o i n t l y between the preschool supervisor and the parent executive. This was important because the preschool supervisor acted as the researcher's contact with both the parents and the c h i l d r e n . Once the d e c i s i o n to p a r t i c i p a t e was made consent forms were completed and returned to the Simon Fraser Health Unit. Since the research p r o j e c t was endorsed by the h e a l t h u n i t a l l correspondence was d i r e c t e d to the he a l t h u n i t address. Copies of the i n v i t a t i o n a l l e t t e r and the consent form appear i n Appendix A (Correspondence). The response rate and the comments appear in Table 4. Centres were randomly assigned to treatment groups following the A p r i l 2 deadline for the receipt of consent forms. Potential participants who had agreed to accept any one of the t r e a t m e n t s were i n c l u d e d i n the random assignment. The study took place over f i v e consecutive weeks: four weeks devoted to the program treatments and one week devoted to the data c o l l e c t i o n . The study was the post test only design shown in Figure 3. 20. R X r 01 R X 2 0 2 R X 0 0 3 Figure 3: Schematic representation of the post test only design. Treatment Variables Treatment Group Ai Breakfast Program Two centres were assigned to each treatment resulting i n a t o t a l of 33 subjects p a r t i c i p a t i n g i n Treatment A. Treatment A consisted of a Breakfast N u t r i t i o n Education Program presented to the children by t h e i r regular preschool supervisors over a four week period from A p r i l 26 through to May 21. The Breakfast Program involved the c h i l d r e n i n cooking experiences together with n u t r i t i o n education a c t i v i t i e s integrated into t h e i r regular routine on a twice weekly basis. The cooking or food preparation a c t i v i t i e s were used to expose the c h i l d r e n to new breakfast food choices and to r e i n f o r c e the other n u t r i t i o n education a c t i v i t i e s (the Breakfast Check and Puzzle, discussions, art p r o j e c t s ) . Pamphlets r e l a t i n g to each week's theme were sent home with the children. 21. Teachers were interviewed prior to the commencement of the program, and d e t a i l e d , w r i t t e n i n s t r u c t i o n s for the n u t r i t i o n a c t i v i t i e s were p r o v i d e d as a means of standardizing treatments (Appendix B). Teachers were asked to follow the instructions provided for each class. They were allowed to vary the day of the week on which the class was given only i f absolutely necessary. This happened on one occasion due to a previously scheduled f i e l d t r i p . A l l program expenses were covered by the research study thereby eliminating the p o s s i b i l i t y that some a c t i v i t i e s might be excluded due to the centre's f i n a n c i a l l i m i t a t i o n s . Treatment Group B: Transfer Materials Only Treatment B was provided to two centres involving 43 s u b j e c t s . Treatment B i n c l u d e d the d i s t r i b u t i o n of n u t r i t i o n e d u c a t i o n pamphlets d e f i n e d as " t r a n s f e r materials" to the parents v i a the c h i l d . This group was not involved i n any other n u t r i t i o n education a c t i v i t i e s and d i s c u s s i o n s about the pamphlets being taken home were s t r i c t l y avoided. In t h i s treatment condition the c h i l d was acting as a "transfer" agent only — responsible for getting the materials home to the parent. The topic of each week's l i t e r a t u r e corresponded to t h a t b e i n g taught i n the Breakfast Program. Thus, the parents of Group A and B were r e c e i v i n g the same t r a n s f e r m a t e r i a l s each week although 22. Group A supplemented t h e i r d i s t r i b u t i o n with n u t r i t i o n education a c t i v i t i e s for the children. In neither case was any n u t r i t i o n education d i r e c t l y provided to the parents. Topics for the four weeks were modelled a f t e r the Canada Food Guide with the focus being: Week I - Milk and Milk Products Week II - Wholegrain Bread and Cereal Choices Week III - Protein Sources for Breakfast Week IV - Fruits for Breakfast Treatment Group C; Control F i n a l l y , 27 subjects from two centres were assigned to the control group which was asked to r e f r a i n from conducting any n u t r i t i o n education a c t i v i t i e s during the four week period, and to c u r t a i l t h e i r d i s t r i b u t i o n of a l l n u t r i t i o n pamphlets and l i t e r a t u r e during the study period. Comparability of the Centres Apart from the treatment conditions assigned to centres through the process of random assignment, the centres were comparable in most respects. This i s further supported by inf o r m a t i o n c o l l e c t e d through i n t e r v i e w s conducted with centres' s t a f f . Information was obtained about hours of operation, degree of parent involvement, area from which the c h i l d r e n t r a v e l , the fee s t r u c t u r e and the p h y s i c a l 23. d e s c r i p t i o n o f the f a c i l i t y . Table 1 d e s c r i b e s the information collected. Although the characteristics of the nursery schools were similar, the process of randomization served to enhance the comparability of the centres. T a b l e 1 Characterisclcs of Participating Nursery Schools Recent Attendance Centre & Location p r° v *n c t i >lly Morning Degree of Child lives Fee Owner Operated of Supervisor at Comments Licensed Classes Parent Involvement in area of centre Structure Parent Assn. a Nutrition Workshop Centre I - nursery school located o n e h o o l , u p e r v l s o r in a Scout Hall " </ RD ^ * J U / - — -- month Centre I I - located in the supervisor's home $29/month 2 days $36/month 3 days one preschool supervisor Centre I I I - located in a school classroom J $3/sesslon $27/month 2 days S39/monch 3 days Owner Also has a daycare associated with lc at the same locaclon; the cencre has full access to school facilities, e.g. gym Centre IV - located In a' school classroom Centre V - located In a ^ multiple dwelling housing complex Centre VI - located in a church hall / $26/month 2 days $39/month 3 days $2/hour billed monthly $33.86/ month Owner Owner Assn. two regular staff members concerns discussed with parents as necessary other- wise no formal Involvement with cencre'a activities also has a daycare assoc- iated with the preschool; no organized parent Involve- ment; three staff members one preschool supervisor Mote • denotes Yes; X denotes No Degree of Parent Involvement: R-on a regular basis, O-occaslonally when parents want to participate or when there is a special event planned, N-parenta are not Involved In activities other than on an observational level to 25. Measuring Instruments Format It was necessary to develop an instrument to measure the variables i d e n t i f i e d since the focus of the study proved to be an i n v e s t i g a t i o n i n t o a new concept. The f i n a l questionnaire, which was three pages in length, consisted of two parts. Part One, which dealt with the f i r s t hypothesis, s e r v e d t o i d e n t i f y t h e r e s p o n d e n t s ' d e m o g r a p h i c characteristics and to ascertain the food purchase patterns of the parents. In order to evaluate the impact of treatment, 147 p o t e n t i a l b reakfast items were l i s t e d according to t h e i r presence on the shelves of a l o c a l supermarket and presented to the parents in the form of a checklist. A segment of the Preschool Breakfast Program Parent Questionnaire i s shown below: 10 WHAT FOODS.... Did you buy In lh» LAST MONTH? (Note: I hey may still be In your household or may be all used up.) Are In your household TODAY? (Pleas* take lime lo look.) Did you buy Any? (Check) Milk: chocolale Yes D No O evaporated, condensed Yes CJ No U whole, homogenized Yes D No n 2% Yes D No CI skim Yes • No TJ Yes n Yes O Yes D Yes a Yes a Yes a Yes a No n No • No • NO a No • No • No U Milk Mate Inslanl Breaklasl Hoi Choclale Mix Brown Cow Chocolale Syrup Poslum Ovalllne Tea/Collee Yes a Yes rj Yes CI Yes CI Yes l"J Yes a Yes • NO n NO n NO n No u No n No a No 111 Yes • Yes O Yes a Yes r.J Yes a Yes U Yes • No O No O No U No CI No rj No n No IJ Figure 4: Excerpt from Part One of Parent Questionnaire 26. The foods were then c l a s s i f i e d into ten subgroups based upon accepted n u t r i t i o n practice. These subgroups included milk products, modified milk products, whole grain breads and cereals, other baked products, cereals with greater than f i f t e e n percent added sugar, cereals with less than f i f t e e n percent added sugar, high q u a l i t y p r o t e i n sources, low quality protein sources, f r u i t s and f r u i t juices and other beverages. Appendix C gives d e t a i l s of the questionnaire and of s p e c i f i c foods included under each food group for the purposes of the analysis. Part two provided i n f o r m a t i o n r e l a t e d to the second hypothesis and asked the parent to record breakfast foods o f f e r e d to and those eaten by the c h i l d . Part of t h i s section appears in Figure 5. SECTION TWO: Complete for each day your child attends preschool during the week of May 24-28th. Have your child bring i t to preschool on each of these days. FOODS OFFERED TO AND EATEN BY PRESCHOOLERS 1. Oate: 2. Did you offer breakfast to your preschool child this morning? Yes I I No [ _ • 3. Please mark with a CHECK ( J) those foods offered to your preschooler this morning (include those foods offered verbally or actually prepared for the child). STAR (*) those foods which your youngster actually ate. The l i s t inlcudes a variety of foods, but if your child ate something not on the l i s t , please include i t in the section "Others". "y" "*" FOODS i f offered i f eaten Whole milk 2% milk Skim milk Chocolate milk . . . . Oval tine Unsweetened fruit juice Sweetened fruit juice ( ) Figure 5: Excerpt from Part Two of Parent Questionnaire 27. Content. Validity While developing the questionnaire feedback was obtained from colleagues (two n u t r i t i o n i s t s c u r r e n t l y employed in public health and one fellow graduate student in adult education), parents and an expert review provided by advisors on three separate occasions. A l l suggestions and comments were c a r e f u l l y considered i n order that a format and a length would be obtained which would encourage completion while also yielding the desired data. The f i n a l questionnaire is shown in Appendix C. Reliability In order to c o n t r i b u t e to the r e l i a b i l i t y of the questionnaire or the tendency f o r respondents to answer consistently over time, consideration was given to providing clear directions, checking the r e a d i b i l i t y l e v e l and word usage, avoiding the use of jargon, and to ensuring the anonymity of the respondents. Formal measures o f r e l i a b i l i t y and v a l i d i t y were not carried out on Part One. Part Two of the questionnaire did undergo somewhat more rigorous checks on v a l i d i t y and r e l i a b i l i t y . This section of the questionnaire regarding the breakfast patterns of the preschool c h i l d was carried out in the following manner. 28. Validity check 1. Parents completed the questionnaire a f t e r breakfast on one of the days during Week V of the study, and gave i t to the c h i l d to return to the preschool supervisor. 2. Once the c h i l d was at nursery school, the supervisor asked each c h i l d i n d i v i d u a l l y "What did you have for breakfast t h i s morning?" The response was recorded for each c h i l d at approximately nine o'clock. The percent of c h i l d r e n found to agree with t h e i r parents' responses was g r e a t e s t for questions r e l a t e d to whether or not breakfast was offered (87 percent agreed), whether or not cereals were eaten for breakfast (87 percent agreed) and for the consumption of a nutritious beverage at breakfast (75 percent agreed). There was lesser agreement between parents and children on the consumption of protein sources and bread-type products at breakfast (Table 2). 29. Table 2 Breakfast Foods Eaten as Reported by Parents and Children Breakfast/Foods Positive Parent Number of Eaten Replies Children's Percent (number) Replies Agreeing Agreement Breakfast Offered 75 65 87 Nutritious Beverage Eaten 69 50 75 Protein Eaten 24 12 50 Bread-type Food Eaten 43 24 56 Cereal Eaten 52 45 87 Reliability check A subsample of c h i l d r e n were questioned by the same supervisor at both nine and eleven o'clock, on the same day, with the question "What d i d you have f o r breakfast t h i s morning?" These responses were recorded and matched. In t h i s way there was a check on the consistency with which children completed Part Two (Table 3). 30. Children's responses to breakfast foods eaten were checked f o r consistency using the t e s t - r e t e s t method. A subsample of s i x c h i l d r e n (one from each centre i n the study) were chosen to v e r i f y t h e i r responses. One c h i l d refused to respond at eleven a.m. i n d i c a t i n g that he had already told the teacher what he had eaten for breakfastl Of the remaining five who responded there was 100 percent consistency i n r e p l i e s f o r a l l categories except for the type of bread product eaten (Table 3). Table 3 Consistency of Children's Recall of Breakfast Foods Eaten Breakfast/Foods Positive Positive Percent Eaten Replies Replies Consistency 9 a.m. 11 a.m. Breakfast Offered Nutritious Beverage Eaten 5 Protein Eaten 2 Bread-type Food Eaten 4 Cereal Eaten 2 Total 17 100 5 2 3 2 16 100 100 75 100 94 31. Validity V a l i d i t y i n t e r v i e w s were scheduled i n t o the design whereby a personal interview was planned with approximately f i f t e e n percent of the respondents. However, because supervi s o r s chose to c o l l e c t a l l questionnaires and to return them a l l at once a time delay from the actual date of r e t u r n by parents and the date of c o l l e c t i o n from the centres was created. Due to the perishable nature of some of the foods being i n v e s t i g a t e d , i t was u n r e a l i s t i c to conduct the planned interviews as a v a l i d i t y check. The absence of these v a l i d i t y i n t e r v i e w s does present a li m i t a t i o n to the study. Data Collection and Analysis Collection Since the two sections of the questionnaire were to be returned at two d i f f e r e n t times, both se c t i o n s of the questionnaire were given code numbers to f a c i l i t a t e matching. Parts One and Two of the questionnaire were sent home at the same time and were accompanied by a covering l e t t e r c o s i g n e d by the p r e s c h o o l s u p e r v i s o r and the researcher (see Appendix A). This l e t t e r s p e c i f i e d the instructions for the return of the questionnaires: Section One was returned and collected at the next preschool session 32. while Section Two was retained and returned during the week of May 24-28. Questionnaires and accompanying l e t t e r s were distributed to the parents through the children who were i n attendance at n u r s e r y s c h o o l . Each c h i l d took the questionnaire home, parents completed i t and returned i t to the nursery school where a c o l l e c t i o n envelope was provided. This procedure offered anonymity to the parents i n that the preschool supervisor was not required to do any processing of the completed questionnaires f o r Part One. Once the supervisor had collected the questionnaires they were picked up from the nursery school by the researcher. The c o l l e c t i o n of questionnaires was followed by a notice sent home with a l l children as a reminder that the questionnaires were due. Subsequently, a follow-up l e t t e r and a duplicate copy of the questionnaire was sent to those who had f a i l e d to respond as of June 8. These l e t t e r s produced four additional responses. In those cases where Part One had been returned, but Part Two had not, the parent was telephoned to secure responses to Part Two (regarding breakfast foods offered to and eaten by t h e i r preschool c h i l d ) . Questionnaires f o r respondents i n the f i n a l population were coded using the schedule which appears in Appendix C. The coded sheets were then keypunched by s t a f f of the U n i v e r s i t y of B r i t i s h Columbia Computing Centre and a subsample v e r i f i e d by the researcher. Two questionnaires per centre were v e r i f i e d f o r a t o t a l of twelve (15.8 percent). Preliminary Background to the Analysis The d e s i g n chosen f o r t h i s study was a nest e d h i e r a r c h i a l design which, in normal circumstances, would have been analyzed using a multivariate analysis. However, due to the fact that some questionnaires were incomplete and had to be excluded from the f i n a l analysis i t was decided to collapse the centres into the three treatment conditions. C e n t r e s I and I I were combined to form Treatment A (Breakfast Program) with 23 respondents. Centres III and IV to form Treatment B (Transfer Materials) with 32 respondents and Centres V and VI to form Treatment C (Control) with 22 respondents. The variables were discrete, dichotomous and polychotomous variables, and subsequently analyzed using the oneway analysis of variance procedure. A l l analyses were accompanied by analyses of the homogeneity of variance. Departures from homogeniety were not observed when the Bartlett-Box test was applied to the data. The l a t t e r test for homogeneity of variance was selected because there was a lack of equality in sample size for the experimental groups. 34. Main Analysis The data were analyzed using the " S t a t i s t i c a l Package for the Social Sciences Version 9.00 (under MTS)". Cross- tabulations and oneway analysis of variance were employed to analyze the demographic variables while oneway analysis of variance was used with the v a r i a b l e s r e l a t i n g to the hypotheses being tested. Where a s i g n i f i c a n t F was obtained the Scheffe test was run at a relaxed «C of .10 (Ferguson, p. 309). M u l t i p l e r e g r e s s i o n was used i n an attempt to i d e n t i f y v a r i a b l e s a ssociated with the one s i g n i f i c a n t difference, sweetened cereal score. A l l s t a t i s t i c a l tests were examined at the f i v e percent level of significance. Limitations and Assumptions As the study conducted was undertaken i n the f i e l d s e t t i n g as opposed to a l a b o r a t o r y type environment the p o s s i b i l i t y e x i s t e d that groups would d i f f e r from one to another in ways beyond the control of the researcher. An attempt was made to achieve comparability and equivalence by randomly assigning nursery schools to treatments. This was carried out using a hat draw for the nursery schools who had indicated an interest in partici p a t i n g in the study. 35. Table 4 i l l u s t r a t e s the responses to the i n v i t a t i o n d e s c r i b i n g the study and i n v i t i n g the nursery schools' p a r t i c i p a t i o n . Because the centres expressing a desire to participate in the study were randomly assigned to the treatments not the children, the study became a quasi-experiment as opposed to a true experiment due to the researcher's lack of t o t a l control over which children would receive the experimental treatments. Of the seven centres replying a f f i r m a t i v e l y , six were selected and randomly assigned to one of the three treatment conditions. Thus, for th i s study the researcher was able to maintain control over the independent variable only insofar as the a b i l i t y to randomly assign centres. A l i m i t a t i o n to th i s study was the i n a b i l i t y to involve the target population of a l l preschool c h i l d r e n and t h e i r f a m i l i e s i n the study. The r e s u l t s o b t a i n e d are generalizable only to those centres with the ch a r a c t e r i s t i c s i d e n t i f i e d in Table 1. 36. Table 4 Responses to Requests for Participation Number Nursery schools in the Simon Fraser Health Unit area as of March 1, 1982 18 Invitations to participate distributed 18 Replies received 16 Centres interested in p a r t i c i p a t i n g 7 Centres declining to participate 9 Reasons for declining: - in the process of moving 1 - recently did a n u t r i t i o n program 2 - short staffed 1 - study would be inconsistent with the nursery school's philosophy 1 - information would have to be translated into French 1 - only have 3 year olds, no 4's 1 - too busy 1 - not interested 1 Although an attempt was made to control for the manner in which the treatments were carried out i t was not possible to r u l e out a l l extraneous f a c t o r s since the preschool supervisor was the l i a i s o n between the researcher and the children as well as between the researcher and the parents. Care was taken to emphasize the rteed for the centre to carry on with regular a c t i v i t i e s throughout the duration of the study. Internal Validity Given that this lack of control over the sp e c i f i c d a i l y a c t i v i t i e s of the centres could pose a threat to internal v a l i d i t y , frequent v i s i t s to the centres along with telephone conversations with the supervisors were included as part of the study's design. The aim of t h i s monitoring was to detect any excess v a r i a b i l i t y which may have existed between the centres. The v i s i t s to the centres were made at varying times with each v i s i t having a s p e c i f i c purpose: V i s i t . #1 - made prior to commencement of the study in order to personally inform the supervisor which treatment her centre had been assigned to, and to verbally describe what was expected over the five weeks. V i s i t #2 - made p r i o r to the study to p e r s o n a l l y deliver written instructions d e t a i l i n g the a c t i v i t i e s of the centre as they related to the study, and to answer questions which had a r i s e n s i n c e V i s i t #1. S t a n d a r d i z i n g the treatments through the steps taken during V i s i t s #1 and #2 decreased the problems posed by treatment heterogeneity. V i s i t #3 - a b r i e f , i n f o r m a l v i s i t to each centre to see i f there were any d i f f i c u l t i e s and to ask "what had been done during Week I of the study?" 38. V i s i t #4 - made during Week II which was to obtain supervisor's signatures on the covering l e t t e r s f or the questionnaires and to simultaneously check on what had happened during that week. V i s i t #5 - during Week III the questionnaires were distributed to each centre and a short observation was made of the centre's a c t i v i t i e s . Further to the v i s i t s , weekly telephone conversations were held with the supervisors who were assigned to the Breakfast Program i n order to i d e n t i f y problems and to rec e i v e feedback. Further d e t a i l s of these v i s i t s are documented in Appendix D. From the informaion gathered as a res u l t of the v i s i t s and conversations i t was assumed that the centres were following the study's guidelines. Thus, as f a r as i s p o s s i b l e i n a f i e l d s e t t i n g such as t h i s , potential threats to v a l i d i t y were taken into account. 39. CHAPTER IV RESULTS Return Rates Using the s i x c e n t r e s randomly a s s i g n e d to the experimental conditions, a t o t a l of 103 families were sent questionnaires. Of the 92 questionnaires returned, 77 were us a b l e i n t h e i r e n t i r e t y . The r e m a i n i n g f i f t e e n questionnaires were excluded from the f i n a l population due to incomplete data regarding food purchase patterns. Of the questionnaires completed and returned 85 percent were usable for Part One while 100 percent were usable for Part Two. Those deemed unusable f o r Part One were a r e s u l t of some respondents f a i l i n g to turn the page completely over. As a r e s u l t part of the questionnaire was overlooked by these respondents. Supervisors suggested that others may have f a i l e d to return t h e i r questionnaires because they got caught up with many o t h e r a c t i v i t i e s l a t e i n the s c h o o l year. One individual refused to complete the questionnaire because " i t was an infringement on the family's privacy". Table 5 summarizes the return rates. 40. Table 5 Return of Questionnaires by Centre Number of Number of Number of Centre Questionnaires Questionnaires Totally Usable per Distributed Returned Usable Treatment (Number) (percent) (percent) (percent) Breakfast Program I 18 16 (88.9) 15 (83.3) 23 (69.7) II 15 14 (93.3) 8 (53.3) Transfer Materials III IV 22 21 16 21 (72.7) (100) 13 19 (59.1) (90.5) 32 (74.4) Control V 9 7 (77.7) 6 (66.7) VI 18 18 (100) 16 (88.9) 22 (81.5) Total 103 92 (89.3) 77 (74.7) 41. Characteristics of the Sample Gender of respondent Question One was designed to i d e n t i f y the respondent completing the questionnaire. In a l l cases i t was the preschool child's mother who completed the questionnaire. Area of residence A description of the population was obtained from Part One of the questionnaire d i s t r i b u t e d to mothers. As expected, a l l mothers resided within the boundaries of the Simon Fraser Health Unit. Their area of residence by municipality i s shown in Table 6 . Data pertaining to the mothers' employment patterns, gross f a m i l y income, f a m i l y s i z e , and the i n f l u e n c e of various family members on breakfast food purchase patterns and of the t e l e v i s i o n viewing time of the preschool c h i l d are summarized in Table 7. 42. Table 6 Breakdown of Respondents by Area of Residence Treatment Control Transfer Total n = 23 n = 22 n = 32 n = 77 Area of Number/ Number/ Number/ Number/ Residence Percent Percent Percent Percent Coquitlam 15 65.2 3 13.6 30 93.8 48 62.3 Port Coquitlam 8 34.8 14 63.6 2 6.2 24 31.2 Port Moody 0 5 22.7 0 5 6 . 5 Total 23 100 22 100 32 100 77 100 In a post test only design with random assignment i t i s c r u c i a l to know the extent of the s i m i l a r i t i e s and/or differences amongst the groups. Thus, a oneway analysis of variance was c a r r i e d out for each of the demographic variables. The treatment, control and transfer materials groups were found not to d i f f e r s i g n i f i c a n t l y with respect to employment, days worked per month, gross family income, family size, ages of the children, presence of other family members, degree of influence of children and other family members on food purchases, the presence of t e l e v i s i o n and the t e l e v i s i o n viewing time. Hours worked per week, tr a v e l time to work and the degree of influence of the spouse on food purchases were found to d i f f e r s i g n i f i c a n t l y (Table 7). Table 7 Data Pertaining to the Equivalence of the Treatment, Control and Transfer Materials Groups Variable Treatment n - 23 Control n - 22 Transfer Materials n - 32 F-ratio F-prob. X S.D. X S.D. X S.D. Employed 1.35 0.49 1.45 0.51 1.19 0.40 2.32 .11 Hours 3 Worked/Week 0.74 1.21 2.09 2.78 0.59 1.43 4.69 .01* Days Worked/Week 1.09 1.65 1.77 2.16 0.53 1.37 3.45 .04* Travel Time to Work 7.65 13.62 17.14 23.03 3.06 7.54 5.67 .005* (minutes) Gross Family Income 265.21 223.83 288.64 143.87 301.56 173.31 0.27 .77 Family Size 4.17 0.83 4.23 0.75 4.34 0.70 0.38 .70 Number of Children: under 2 years 0.17 0.39 0.27 0.46 0.26 0.44 0.34 .72 2 to 4 years 1.39 0.58 1.23 0.43 1.38 0.49 0.74 .48 in kindergarten 0.13 0.34 0.14 0.35 0.13 0.34 0.007 .99 in elementary school 0.39 0.58 0.50 0.51 0.56 0.62 0.59 .56 in high school 0.04 0.21 0 0 0.03 0.18 0.44 .65 out of school but at home 0 0 0 0 0 0 0 Other family members: spouse 0.96 0.21 0.91 0.29 1.00 0 1.45 .24 grandmother 0.04 0.21 0.05 0.21 0 0 0.72 .49 grandfather 0.04 0.21 0 0 0 0 1.18 .31 other r e l a t i v e 0 0 0.05 0.21 0 0 1.26 .29 :boarder 0 0 0.09 0.29 0 0 2.64 .08 nanny 0 0 0 0 0 0 Age of preschooler (months) 50.61 16.93 56.14 8.33 54.63 7.20 1.49 .23 Degree of influence of: chi l d under 2 0.26 0.54 0.77 1.57 0.34 0.79 1.66 .20 ch i l d i n preschool 3.04 0.98 3.14 1.28 2.88 1.52 0.28 .76 2 to A year old not i n school 0.74 1.51 0.55 1.01 0.94 1.83 0.43 .65 elementary age chi l d 1.43 1.67 1.64 1.53 1.63 1.93 0.10 .90 teenagers 0.17 0.83 0 0 0.09 0.53 0.52 .59 s e l f 5.23 1.70 5.50 1.34 5.50 1.14 0.34 .71 spouse 3.30 1.49 3.82 1.71 4.31 1.06 3.49 .04* other family members 0.22 1.04 0.50 1.44 0 0 1.79 .17 Presence of television 2.00 0 2.00 0 2.00 0 hours watched yesterday 1.48 2.47 1.41 1.26 0.84 0.92 1.30 .28 hours watched last weekend 3.57 3.30 3.55 2.96 2.16 1.30 2.85 .06 a Hours worked per week ; 2 - 1 5 hours per week. are based on the coding of 1 - 10 hours per week. X multiplied by 1000 equals the mid range of gross family income. 44. Employment patterns Mothers who i n d i c a t e d that they were employed were assigned a value of two and those not employed were assigned a value of one. A oneway analysis of variance was performed which y i e l d e d an F = 2.32, p < .11. Upon analyzing three other v a r i a b l e s c l o s e l y r e l a t e d to employment status s i g n i f i c a n t differences were found. It was found that the c o n t r o l group reported working a greater number of hours each week than d i d e i t h e r the treatment or the t r a n s f e r m a t e r i a l s groups (F = 4.69, p < .01). The c o n t r o l group worked an average of 1.77 days per week as compared to 1.09 days per week for the treatment group and 0.53 days per week for the t r a n s f e r m a t e r i a l s group (F = 3.45, p < .04). Travel time to work in minutes was s i g n i f i c a n t l y higher for the c o n t r o l group (F = 5.67, p < .005). The c o n t r o l group reported an average travel time of 17.14 minutes as compared to the treatment group who reported an average of 7.65 and the transfer group an average of 3.06 minutes. A l t h o u g h t h e d i f f e r e n c e s were s t a t i s t i c a l l y s i g n i f i c a n t , from a workaday point of view they were less s i g n i f i c a n t . The differences when translated into p r a c t i c a l figures work into a mean number of hours worked per week of 45. hours worked per week of 7.4 hours for the treatment group as compared to 15 hours per week for the control group and 5.9 hours per week for the group r e c e i v i n g the t r a n s f e r materials. Similarly, the significance of the differences i n t r a v e l time to work i n minutes i s not as great as F = 5.67, p < .005 suggests. Thus, based on the f a c t that the centres were randomly assigned to the three experimental c o n d i t i o n s coupled with the de-emphasis of the observed differences when viewed from the perspective of application to d a i l y l i f e , the three groups were considered to be equivalent with respect to employment patterns. 46. Gross family income Although a number of respondents chose not to respond to the question related to gross family income, the oneway a n a l y s i s of variance performed on t h i s question d i d not reveal any s i g n i f i c a n t differences between the groups. A summary of the income data showed that a t o t a l of 63 (82 percent) mothers answered t h i s question. Reported income ranged from l e s s than $10,000 annually to in excess of $60,000 annually with a mean of $26,521 for the treatment group, $28,864 for the control group and $30,156 for those receiving transfer materials (Table 7). The mean income for the treatment group may be a r t i f i c i a l l y low due to the number of abstentions regarding this question. Sixty-nine percent of the treatment group answered t h i s question as compared to 95.5 percent of the control group and 81 percent of the transfer materials group. Family size Most respondents did not have large families. The mean family size for the treatment group was 4.17, control group 4.23 and f o r the t r a n s f e r m a t e r i a l s group 4.34 (Table 7). An a n a l y s i s of variance d i d not i d e n t i f y any s i g n i f i c a n t differences. Also shown in Table 7 i s the mean age of the 47. a preschool c h i l d who served as the potential change agent in t h i s study. No s i g n i f i c a n t d i f f e r e n c e s (F = 1.49, n.s.) were found among the mean ages of 50.61 months for the treatment group, 56.14 months for the c o n t r o l group and 54.63 months f o r the t r a n s f e r m a t e r i a l s group. The di s t r i b u t i o n of respondents by age i s shown in Table 8. 48. Table 8 Distribution of Family Members by Age Categories Treatment Control Transfer Materials Age of Family Members n = 23 n = 22 n — 32 number per cent number per cent number per cent under 2 years 4 17.4 6 27.3 8 25.0 2 - 4 years 23 100 22 100 32 100 kindergarten 3 13 3 13.6 4 12.5 elementary school age 8 34.8 11 50.0 16 50.0 high school age 1 4.3 0 0.0 1 3.1 out of school but at home 0 0.0 0 0.0 0 0.0 spouse 22 95.7 20 90.9 32 100 grandparents & other re l a t i v e s 2 8.7 2 9.1 0 0.0 boarders 0 0.0 2 9.1 0 0.0 a t o t a l s to more than 100 percent due to multiple responses. 49. Influence of family members on food purchases Family members were not found to have a s i g n i f i c a n t impact on the respondent's food purchases with the exception of the spouse. Upon examining the degree of influence which the respondents i n d i c a t e d each f a m i l y member had on food purchase patterns, a s i g n i f i c a n t difference was found with respect to the degree of influence exerted by the spouse (p < .04). Based on a rating scale of one through six where a value of one corresponded to no influence on food purchase patterns and six corresponded to very much influence, the following means were obtained for degree of influence held by the spouse: treatment group X~ = 3.30, control group X = 3.82 and t r a n s f e r m a t e r i a l s group~X = 4.31. As shown i n Table 7 the analysis of variance of the family influence of the spouse r e s u l t e d i n a s i g n i f i c a n t F value (p < .04). Using Scheffe at .10 the transfer materials group was found to be s i g n i f i c a n t l y d i f f e r e n t from the treatment group with the transfer materials group reporting a higher degree of influence of the spouse. Since the transfer materials group was s i g n i f i c a n t l y d i f f e r e n t from the treatment group a further analysis was performed to determine i f any spousal influence differences existed between respondents of the two centres making up the t r a n s f e r m a t e r i a l s group. No s i g n i f i c a n t differences were found between the respondents from the two centres making up th i s group (F = 1.12, n.s.). 50. Television time The presence of t e l e v i s i o n and t e l e v i s i o n viewing times were compared for the three groups. As seen in Table 7 a l l respondents reported having a t e l e v i s i o n set. Viewing time in hours was not found to be s i g n i f i c a n t l y d i f f e r e n t amongst the groups for the previous day, or for the hours watched by the preschooler l a s t weekend. Random assignment coupled with the a n a l y s i s of the demographic variables as presented indicated that the three experimental groups appeared to be reasonably homogeneous. Distribution of transfer materials S i n c e the d i s t r i b u t i o n of t r a n s f e r m a t e r i a l s (pamphlets, booklets) was an integral part of the study an analysis was carried out to determine to what extent they were received or not received by the respondents. Those respondents who said they did receive the publication were assigned a value of two, those who d i d not receive the p u b l i c a t i o n were given a value of one. In t h i s way a l l r e p l i e s were summed over and d i v i d e d by the number of respondents in each treatment condition. This resulted in means of 1.83 (treatment group), 1.18 (contol group) and 1.81 ( t r a n s f e r m a t e r i a l s group) for the p u b l i c a t i o n the "Breakfast Book". Translated further these means indicate 51. the percent of respondents confirming t h e i r r e c e i p t of a given transfer material. For example, had a l l respondents i n the treatment group reported r e c e i v i n g the "Breakfast Book" the mean value would have been equal to two, had a l l those in the control group reported not receiving i t , the mean value would have been one. Neither extreme was reported, but rather 83 percent (X~ = 1.83) of the treatment group said they received the "Breakfast Book", 18 percent (X = 1.18) of the c o n t r o l and 81 percent (X~ = 1.81) of the transfer materials group. Thus, the control group was, as expected, very d i f f e r e n t from the other two treatment groups. This was al s o r e f l e c t e d by F = 12.11, p < .001 which indicates that i t i s highly unlikely that t h i s value would occur by chance. As planned, the appropriate groups received the t r a n s f e r m a t e r i a l s . Table 9 presents these r e s u l t s . Of the four publications which should have gone out to the treatment group and to the t r a n s f e r m a t e r i a l s group three were distributed with equal frequency. During Week Two, the transfer materials group did not report as high an incidence of receiving "Quick Breakfasts for People on the Go" . Upon f u r t h e r i n v e s t i g a t i o n as to the p o s s i b l e explanation for t h i s difference, i t was found that one of 52. the r e g u l a r nursery school teachers was absent on that particular day. Otherwise, those intended to receive the t r a n s f e r m a t e r i a l s reported doing so. The percent of respondents saying they had received materials was not 100 percent, but some of the discrepancy can also be explained by the car pooling for rides which occured at many nursery schools. Reports were received that on occasion a c h i l d had l e f t the m a t e r i a l s i n a friend's car. The s i g n i f i c a n t r e s u l t s obtained when analyzing t h i s question were i n accordance with what was expected. Table 9 Mean Number and Percent of Parents i n Treatment, Control and Transfer Materials Groups Who Reported Receiving Transfer Materials Treatment Control Transfer Materials _ , n - 23 n - 22 n - 32 F - r a t l ° F " P r o b - Transfer Materials X S.D. per bent X S.D. per cent X S.D. per cent "The Breakfast Book" 1.83 0.39 83 1.18 0.59 27 1.81 0.54 81 12.11 .001* "Quick Breakfasts for People on the Go" 1.61 0.50 61 0.95 0.38 4.5 1.16 0.52 16 11.42 .001* "Sugar Content of Breakfast Cereals" 1.78 0.42 78 0.95 0.38 4.5 1.75 0.57 75 22.60 .001* "Handy Nutrition" 1.61 0.50 61 0.91 0.29 0 1.56 0.62 56 13.78 .001* Other Publications 1.04 0.21 4 0.91 0.29 0 1.13 0.49 13 2.19 .12 Did Not Receive Any Publications 1.00 0 0 1.55 0.67 64 0.91 0.30 3 17.55 .001* a I n the control group there were two non-respondents to this question. Percent of respondents receiving transfer materials have been adjusted to r e f l e c t t h i s . 53. Food Purchase Patterns Reported by the Respondents A l l respondents to the questionnaire were mothers, thus the food purchase patterns to be described are those patterns of the mother as i n f l u e n c e d by the other f a m i l y members as i d e n t i f i e d in Table 7. The f i r s t hypothesis stated: There i s no s i g n i f i c a n t d i f f e r e n c e among the parents of the three experimental groups regarding the frequency of purchase of milk products, whole g r a i n breads and c e r e a l s , c e r e a l s with more than f i f t e e n percent added sugar, high quality protein sources and f r u i t s and f r u i t juices. This hypothesis was evaluated by examining those food purchases which parents reported making over the l a s t month. Individual parent scores were summed over and a mean food purchase score calculated for each of the treatment, t r a n s f e r m a t e r i a l s and c o n t r o l groups. These food purchase scores were then analyzed using the a n a l y s i s of variance procedure (Table 10). The food purchase scores for the cat e g o r i e s milk products, whole grain products, high quality protein sources and f r u i t s and f r u i t juices were not found to be s i g n i f i c a n t l y d i f f e r e n t for the three groups. Table 10 Mean Food Purchase Scores for Each of the Treatment, Control and Transfer Materials Groups „ . Treatment Control Transfer Materials F-ratio F-prob. Number „_•>•» oo „ n = 23 n = 22 n = 32 Food Group of foods i n group - S > D > - S _ D > - g > D > Milk Products 7 2.04 1.11 2.36 1.09 2.31 0.86 0.69 .51 Whole Grain Breads/Cereals 8 3.35 1.37 2.91 1.72 3.44 1.34 0.91 .41 Cereals with Greater than 22 0.69 0.93 1.91 1.63 1.03 1.09 5.90 .004* 15% sugar High Quality Protein 6 5.22 0.85 5.05 1.09 5.25 0.80 0.36 .70 Fru i t s and Fr u i t Juices 16 5.35 2.10 4.68 1.70 5.56 1.85 1.47 .24 55. A s i g n i f i c a n t difference was observed with respect to food purchase patterns r e l a t i n g to bre a k f a s t c e r e a l s containing in excess of f i f t e e n percent sugar. Using the Scheffe procedure (.10) the c o n t r o l group was found to be s i g n i f i c a n t l y d i f f e r e n t from both the treatment and the transfer materials group. To t e s t the p o s s i b i l i t y that food purchase p a t t e r n scores remained constant for the food groups specified i n the hypothesis, but may have changed, for their respective competing groups namely, modified milk products, other baked products, c e r e a l s with l e s s than f i f t e e n percent added sugar, low quality protein sources, and other beverages an a n a l y s i s of variance was performed on these scores. No s i g n i f i c a n t d i f f e r e n c e s were found among the food groups which could have entered in as possible competitors to those cited in Table 10 (Table 11). Table 11 Mean Competing Food Purchase Scores for Each of the Treatment, Control and Transfer Materials Groups Competing Treatment Control Transfer Materials F-ratio F-prob. Food Group Number n « 23 n - 22 n - 32 of foods —— — — in group X S.D. X S.D. X S.D. Modified Milk Products 8 1.26 1.18 1.73 1.28 1.22 1.36 1.15 .32 Other Baked Products 16 2.91 1.53 3.55 2.20 3.47 2.00 0.75 .48 Cereals with Less than 15% Sugar 26 6.87 3.00 6.45 2.61 6.91 2.54 0.21 .81 Low Quality Proteins 4 2.96 0.82 3.14 0.89 2.87 1.04 0.51 .60 Other Beverages 14 3.57 1.50 3.77 1.93 3.63 1.47 0.10 .91 56. Thus, a f t e r examining the f i v e c a t e g o r i e s of foods i d e n t i f i e d in the hypothesis, four yielded non-significant d i f f e r e n c e s . I t appeared that the program only had an impact on the purchase of cereals with added sugar in excess of f i f t e e n percent. Due to the f a c t that f i v e u n i v a r i a t e analyses were conducted the experiment wise error rate was increased, thereby i n c r e a s i n g the p o s s i b i l i t y that the observed difference in sweetened cereal scores was due to chance alone. However, i n s p i t e of the p o s s i b i l i t y t h a t the s i g n i f i c a n t r e s u l t was due to chance, there i s reason to believe that the s i g n i f i c a n t difference observed would be more l i k e l y to occur as a r e s u l t of the treatment conditions imposed. Adult behaviors are often d i f f i c u l t to modify; consequently i t was not a n t i c i p a t e d that s i g n i f i c a n t d i f f e r e n c e s would have been o b t a i n e d f o r a l l food categories. The fact that a s i g n i f i c a n t result was found with foods containing added sugar was consistent with the f i n d i n g s of Gates and Campbell (1981) who reported that Canadian parents were most l i k e l y to alter sugar consumption as one of the f i r s t modifications to the family's diet. The idea that the s i g n i f i c a n t r e s u l t obtained was p u r e l y an a r t i f a c t can also be discounted when one considers the vast number of dollars spent on cereal advertisements directed 57. toward children. The p o s s i b i l i t y exists that although the breakfast program i t s e l f d i d not have an impact on a l l behaviors cited in the hypothesis, i t did exert an influence on the type of cereal purchases made. This may be p a r t i a l l y due to the awareness which many parents already have about the d e t r i m e n t a l e f f e c t s of a d i e t high i n sugar. The population i s already very conscious of sugar and i t s a f f e c t on the body, therefore, i t i s easier to change this parental behavior with s t i m u l a t i o n from the c h i l d than i t i s to change the other behaviors. Another factor which suggests that the s i g n i f i c a n t r e s u l t obtained was not due to chance alone i s the degree of consistency observed between parents and c h i l d r e n i n t h e i r responses to the consumption of cereals (Table 2). Children and parents were in agreement on the fact that cereals were included i n breakfasts eaten. Eighty-seven percent of the time children and parents agreed that cereals were eaten suggesting that the cereals category i s the one most commonly discussed, and the one which the c h i l d readily expresses an opinion on. If t h i s assumption i s accepted then i t would follow that cereals would be the f i r s t category to r e f l e c t a change i n paren t a l purchase patterns due to stimulation from the ch i l d . 58. The f i n d i n g that both the treatment and t r a n s f e r materials group chose s i g n i f i c a n t l y fewer high sugar cereals than d i d the c o n t r o l group can be approached from three points of view. F i r s t l y , i t i s p o s s i b l e to consider the c h i l d as an e f f e c t i v e change agent i n both cases. In the case of the treatment group, the c h i l d returned home not only with the transfer materials in question, but also with added information and possibly with increased enthusiasm due to the breakfast program presented. Meanwhile i n the t r a n s f e r m a t e r i a l s group, the c h i l d returned home with pamphlets only. Because i t was the c h i l d who was delivering the information, the parent(s) paid attention to what i t was that was being brought home. Thus, i t can be argued that the c h i l d was a c t i n g as a s t i m u l a t o r of change i n both cases. A future study examining the impact of t r a n s f e r m a t e r i a l s sent to the parents v i a the mail s e r v i c e would provide further c l a r i f i c a t i o n of the child's role in acting as a change agent. Secondly, the impact of the transfer materials alone i s consistent with other studies c i t i n g sources of n u t r i t i o n information used most frequently by parents and the public. Eppright et a l . (1969) reported that mothers r e l i e d heavily on printed materials for their n u t r i t i o n information while Schwartz anad Barr (1977) reported that Vancouver mothers of 59. young c h i l d r e n u t i l i z e d p r i n t e d sources of n u t r i t i o n i nformation. S u l l i v a n and Schwartz (1981) reported that 88.3 percent of Canadian adults used printed materials as t h e i r primary source of n u t r i t i o n information. In t h i s study which involved 281 B r i t i s h Columbia adults - of whom 57.7 percent were between the ages of nineteen and t h i r t y - five, the most frequently c i t e d sources of information about nu t r i t i o n and cardiovascular disease were magazines, books, newspapers, t e l e v i s i o n , f r i e n d s , the p h y s i c i a n and the family. F i n a l l y , as suggested by the e a r l i e r a n a l y s i s of the demographic variables r e l a t i n g to the degree of influence of family members and the importance of the family in the study of S u l l i v a n and Schwartz (1981) i t became apparent that spousal i n f l u e n c e may have exerted an impact on the food purchase patterns of the mother. For the transfer materials group the family influence of the spouse on food purchase patterns was found to be s i g n i f i c a n t l y d i f f e r e n t from the treatment group. This influence may have contributed to the decreased sweetened c e r e a l score observed f o r the t r a n s f e r m a t e r i a l s group (Table 7). 60. Thus, i t was decided to run a m u l t i p l e r e g r e s s i o n analysis. The aim of t h i s analysis was to determine whether those variables associated with the s i g n i f i c a n t differences observed i n the oneway a n a l y s i s o f v a r i a n c e of the demographic v a r i a b l e s p r e d i c t e d sweetened c e r e a l scores. The dependent v a r i a b l e , sweetened c e r e a l score, was run against the independent variables of experimental condition, employment status, hours worked, days worked, travel time in minutes, income, f a m i l y s i z e and the f a m i l y i n f l u e n c e of each of i t s various members. The independent v a r i a b l e , experimental condition, was ordered in a h i e r a r c h i a l manner such that one denoted those respondents i n the c o n t r o l group, two represented those i n the t r a n s f e r m a t e r i a l s group, and t h r e e those of the t r e a t m e n t group. The independent variables e l i g i b l e for entry into the equation were those f o r which s i g n i f i c a n t d i f f e r e n c e s were found (Table 7): hours worked, days worked, t r a v e l and the family i n f l u e n c e of the spouse. It a l s o included experimental condition on the a p r i o r i grounds that i t was believed to have an affect on the dependent variable sweetened cereal score. Income, f a m i l y s i z e and the i n f l u e n c e of other family members were included because each was considered a subset of the variables yielding s i g n i f i c a n t differences in Table 7. 61. Using the stepwise multiple regression procedure, four independent v a r i a b l e s were i d e n t i f i e d as i n f l u e n c i n g sweetened cereal scores. As shown in Table 12, family size, travel time to work and the influence of the elementary age c h i l d were v a r i a b l e s competing w i t h the c e n t r e i n determining sweetened c e r e a l score. From the r e s u l t s obtained i t appears that the large family i s more l i k e l y to have a higher sweetened cereal score than the small family, and the f a m i l y where the mother's t r a v e l time to work i s greatest i s most l i k e l y to select cereals with added sugar. Influence exerted by the elementary age c h i l d on food purchases i s n e g a t i v e l y c o r r e l a t e d suggesting that t h i s c h i l d may be i n f l u e n t i a l i n decreasing the mother's purchase of c e r e a l s containing added sugar. This i s p o s s i b l y a r e s u l t of the n u t r i t i o n education programs for c h i l d r e n which have been o f f e r e d i n the e a r l y elementary grades, especially kindergarten and grade one. As expected, centre was also negatively correlated indicating that as one moved from the control group to the transfer materials group to the breakfast program group there was a decrease i n sweetened cereal scores. Table 12 shows that family size i s the independent variable of greatest r e l a t i v e importance in p r e d i c t i n g sweetened c e r e a l score. I t i s followed by centre. 62. The variables in the regression equation represent only a p o r t i o n of the many f a c t o r s i n f l u e n c i n g the sweetened cereal purchase patterns of the mother. The four variables singled out in the stepwise multiple regression procedure e x p l a i n a p p r o x i m a t e l y o n e - t h i r d o f the v a r i a t i o n o f sweetened cereal scores. Table 12 Predictors of Sweetened Cereal Score Variable Multiple r Beta (final) F-ratio (at entry) Centre .33 -.28 9.41 Family size .41 .33 7. 70 Travel time to work .48 .26 7.37 Influence of the elementary age c h i l d on food purchases .54 -.26 7.60 The family influence of the spouse which was considered as a p o s s i b l e explanation for the low sweetened c e r e a l purchase score in the transfer group did not appear as one of the variables i n the stepwise regression explaining the behavior of the dependent variable. Thus, the groups were considered equivalent with respect to th i s variable. A l l but one of the other demographic v a r i a b l e s which were 63 . s i g n i f i c a n t in the oneway analysis of variance f a i l e d to be i d e n t i f i e d as a potential predictor of the sweetened cereal purchase score. Again this points to the homogeniety of the groups. Even though t r a v e l i n minutes showed up as a v a r i a b l e i n the r e g r e s s i o n e q u a t i o n , as d i s c u s s e d previously, the true impact of the difference in travel time remains debatable. Family size and the family influence of the elementary age c h i l d were i d e n t i f i e d by the stepwise reg r e s s i o n , but were not i d e n t i f i e d as s i g n i f i c a n t l y d i f f e r e n t v a r i a b l e s i n the a n a l y s i s of variance. Thus, based upon the a n a l y s i s of variance and the stepwise regression, the three experimental groups studied were considered to have come from the same population. From the a n a l y s i s of the study's r e s u l t s , the n u l l hypothesis s t a t i n g that no d i f f e r e n c e s e x i s t among the treatment, c o n t r o l and t r a n s f e r m a t e r i a l s groups with respect to the frequency of purchase of milk products, whole grain breads and cereals, high quality protein sources and f r u i t s and f r u i t juices was accepted. The n u l l hypothesis regarding the frequency of purchase of cereals with greater than f i f t e e n percent added sugar was r e j e c t e d at p < .05. Signi f i c a n t differences were found between the control group and the treatment group, and between the control group and the transfer materials group when Scheffe (.10) was used. 64. The overall program did not work, but one s i g n i f i c a n t r e s u l t was found which prompted further investigation of the question: were the differences in sweetened cereal scores a res u l t of the impact of the treatment or a Type I error? The stepwise multiple regression carried out demonstrated that the treatment (centre) was not an a r t i f a c t , but rather that i t was an independent variable which did have strength in predicting sweetened cereal score. Types of Breakfasts Offered by the Respondents The second hypothesis to be tested stated that there would not be a s i g n i f i c a n t difference among the parents of the three experimental groups regarding the frequency of offering: a) breakfasts to t h e i r children, b) a nutritious beverage, c) a high quality protein source, d) a whole grain bread or cereal choice and e) a cereal containing in excess of f i f t e e n percent sugar at breakfast. Data pertaining to foods offered at breakfast were obtained from parents using a checklist of potential breakfast foods. Responses were coded in t o the above categories on a yes/no b a s i s and an a n a l y s i s of v a r i a n c e conducted. A l l p a r e n t s i n the treatment group reported offering t h e i r children breakfast along with 95 percent of parents in the control group and 97 65. percent of those in the transfer materials group (Table 13). No s i g n i f i c a n t d i f f e r e n c e s were found at the .05 l e v e l of significance with respect to s p e c i f i c foods offered to the children at breakfast. Table 13 Breakfast Foods Offered to Children i n the Treatment, Control and Transfer Materials Croups Foods Treatment Control Transfer Materials F-ratio F-prob. Offered n - 23 n - 22 n - 32 X S.D. Per Cent X S.D. Per Cent "X S.D. Per Cent Breakfast Offered 2.00 0 100 1.95 0.21 95 1.97 0.18 97 0.48 .62 Nutritious Beverage 2.00 0 100 1.77 0.61 77 1.88 0.34 88 1.90 .16 High Quality Protein 1.43 0.51 43 1.27 0.63 27 1.56 0.50 56 1.85 .16 Whole Grain Bread/Cereal 1.61 0.50 61 1.36 0.66 36 1.66 0.48 66 2.04 .14 Cereal with Greater than 15Z Sugar 1.09 0.29 9 1.23 0.43 23 1.09 0.30 9 1.29 .28 66. CHAPTER V SUMMARY AND CONCLUSIONS An i n i t i a l r e t u r n r a t e of 92 parent questionnaires which represented 89 percent of the t o t a l sample was obtained. Of these 77 ques t i o n n a i r e s (75 percent) were included in the f i n a l analysis to determine the influence which the preschool c h i l d had on pa r e n t a l food purchase behaviors re l a t i n g to breakfast food selections. Data on se l e c t e d demographic v a r i a b l e s was al s o analyzed to determine the homogeneity of the three experimental groups involved i n the study. The three experimental groups included in the study, which was a post-test only design, included a c o n t r o l group, a t r a n s f e r m a t e r i a l s group who received n u t r i t i o n pamphlets only and a treatment group whose children participated in a four week breakfast program and who also received those pamphlets given to the transfer m a t e r i a l s group. From the analyses c a r r i e d out i t was deter m i n e d t h a t the respondents were from the same population, and that the impact of treatment was s i g n i f i c a n t with respect to the purchase of cereals containing in excess of f i f t e e n percent sugar. Of the f i v e c a t e g o r i e s of foods i n v e s t i g a t e d i n the h y p o t h e s i s r e l a t e d to p a r e n t a l purchase p a t t e r n s o f breakfast foods, four did not y i e l d s i g n i f i c a n t differences. 67 . No change was observed in the frequency of purchase of milk products used as a beverage, whole grain bread and cereal selections, high quality protein sources or f r u i t s and f r u i t juices. The number of sweetened cereal purchases was found to be s i g n i f i c a n t l y d i f f e r e n t f o r an F = 5.90, p < .004. Through further analysis using the Scheffe (.10) and Tukey pr o c e d u r e s the c o n t r o l group was found to d i f f e r s i g n i f i c a n t l y from both the t r a n s f e r m a t e r i a l s and the treatment groups. Those parents who received nothing but the questionnaire reported choosing a greater number of cereals containing in excess of f i f t e e n percent sugar than did those parents who received the questionnaire plus n u t r i t i o n pamphlets, and in the case of the treatment group, the breakfast program plus n u t r i t i o n pamphlets. The finding that both the transfer materials group and the treatment group were s i g n i f i c a n t l y d i f f e r e n t from the control group prompted further investigation. As a result, those demographic v a r i a b l e s which may have exerted an i n f l u e n c e were re-examined using the stepwise m u l t i p l e regression technique. The only demographic variable which was i d e n t i f i e d by t h i s technique, and which had also been i d e n t i f i e d in the oneway analysis of variance, was travel time. However, because the differences in travel time to work were only a matter of approximately ten minutes t h i s variable was discounted as a major difference amongst the groups. Another explanation for the observed d i f f e r e n c e 68. could be that the c h i l d was i n fact acting as a change agent in both situations: the transfer materials group and the treatment group. In these two groups the c h i l d was a r r i v i n g home with in f o r m a t i o n about breakfast choices and was capable of exerting an influence on the parents' selection of food as evidenced by the lower sweetened cereal scores for these parents. The contention i s that the c h i l d functioned as a change agent and played a r o l e i n parent decision making i n both instances. Although t h i s study did not incorporate a pamphlets only group, t o t a l l y devoid of the child's intervention, i t would be a factor to consider in future investigations. Another study which included a fourth group who received pamphlets v i a the postal service would a l l o w f o r g r e a t e r d e l i n e a t i o n o f the c h i l d ' s influence. This study suggests that i n areas where there has already been extensive p u b l i c education d i r e c t e d toward adults (e.g. the detriments of a d i e t high i n sugar) the c h i l d can act as a c a t a l y s t capable of s t i m u l a t i n g a behavior change. Sweetened cereal score was the only dependent variable to be s i g n i f i c a n t l y d i f f e r e n t among the treatment, transfer m a t e r i a l s and c o n t r o l groups (p < .004). This i s l a r g e l y due to the nature of food habits themselves. For the most 69. part food habits are "deeply imbedded into c u l t u r a l norms and tend to r e s i s t any but moderate m o d i f i c a t i o n s " (Hochbaum, 1981, p. 60). Although a four week program, occurring twice a week, i s deemed to be an intense program by the standards of many h e a l t h p r o f e s s i o n a l s ; deeply engrained l i f e s t y l e patterns a c t u a l l y change over a much longer period of time. Thus, to expect an impact of the breakfast program on a l l aspects of food selections would be u n r e a l i s t i c . The time period during which the c h i l d was employed as a change agent was too short to see differences in each of the food c a t e g o r i e s i d e n t i f i e d or to observe s i g n i f i c a n t differences i n the breakfast food selections offered to the c h i l d by the parent. Although the types of breakfast foods offered were not found to be s i g n i f i c a n t l y d i f f e r e n t at the five percent l e v e l of significance there was evidence of a trend. It was found that the c o n t r o l group was s l i g h t l y less inclined to offer nutritious beverages, high quality protein sources, and whole grain breads and/or cereals than the two "treatment" groups. The scores for the frequency of of f e r i n g a cereal containing in excess of f i f t e e n percent sugar were found to be higher for the control group than for the t r a n s f e r m a t e r i a l s and treatment groups. This i s i n accordance with the f i n d i n g that the c o n t r o l group was s i g n i f i c a n t l y d i f f e r e n t from the other two groups i n the 70. sweetened cereal purchase score. The control group not only purchased a s i g n i f i c a n t l y greater number of c e r e a l s with more than f i f t e e n percent sugar, they a l s o o f f e r e d these cereals to their children more often. Parents rely on a combination of sources for n u t r i t i o n information and the c h i l d i s one of these sources. However, the c h i l d i s a c t i n g as a change agent i n a competing environment which i n c l u d e s the a d u l t ' s p r e c o n c e i v e d perceptions of food, the mass media and the p o t e n t i a l influence of other family members coupled with the parent's response to these i n f l u e n c e s . The c h i l d i s an i n d i r e c t channel of communication and the relevance of this finding should be considered with respect to n u t r i t i o n education programs in particular, and to health programs in general. In order for the c h i l d to function e f f e c t i v e l y as a change agent capable of generating long term p a r e n t a l behavior change care must be taken to ensure that the process i s planned, and that i t allows for a continuing relationship over a period of time. Why the Program Did not Work The following discussion speculates about some of the reasons why the program was not as e f f e c t i v e as d e s i r e d . The comments presented are p a r t l y based on the research findings and casual observations made during the course of the study. 71. This'particular study did not reveal differences either because (a) the breakfast program worked, but the measuring instruments were too insensitive to detect differences or (b) the breakfast program did not work due to factors beyond the control of the researcher, but the measuring instruments were accurate. Program worked Assuming the stance taken i n (a) i t i s p o s s i b l e to argue t h a t the food groups y i e l d i n g non s i g n i f i c a n t differences (milk products, whole grain breads and cereals, f r u i t s and f r u i t juices and high quality protein sources) represented food categories for which parents were already making acceptable selections. The parent questionnaire as i t was designed was not capable of identifying fine tuned alterations in food purchase behavior e.g. the selection of two percent milk as opposed to whole milk. Rather, the fact that either counted toward the food purchase score for that par t i c u l a r group i l l u s t r a t e s the degree of i n s e n s i t i v i t y of the measuring instrument. Another p o s s i b i l i t y i s the f a c t that the food groups were not weighted according to the extent of a d v e r t i s i n g which they received. C l e a r l y , breakfast c e r e a l s are a d v e r t i s e d most often, and a large p r o p o r t i o n of the advertising i s directed toward children. It follows that i t 72. i s quite l i k e l y that this i s one food category to which both parents and c h i l d r e n are already tuned i n . Messages concerning cereals are received from a d i f f e r e n t perspective than for l e s s a d v e r t i s e d products such as whole g r a i n breads, f r u i t s , etc. Again, the questionnaire was not developed with any intention of weighting changes in food purchase scores according to a d v e r t i s i n g time or d o l l a r s invested in a s p e c i f i c food group. However, that i s not to say that i t should not be given future consideration. Program did not work Adopting explanation (b) that the program did not work, i t i s important to i d e n t i f y f a c t o r s which prevented the desired outcome from occurring. In retrospect, time i s the most c r u c i a l factor to consider here. Time should be viewed from two standpoints i n terms of the actual hours devoted to the breakfast education program, and terms of the time of year during which the program was introduced. As mentioned e a r l i e r , behavior patterns surrounding food choices are d i f f i c u l t to a l t e r because of the many connotations each pa r t i c u l a r food choice holds for the individual. In order to modify these behaviors i t i s necessary to extend the program over a longer time span than four weeks. At the outset of the study four weeks, twice weekly was considered to be more intense than many programs, but the r e s u l t s 73. appear to i n d i c a t e that t h i s length of time was only beginning to stimulate behavior change. The options of d a i l y programming over a s p e c i f i e d time span (e.g. four weeks), weekly programming over an entire year anad any time i n between are the other p o s s i b i l i t i e s which could be investigated to find that point at which parental behavior change results from the education experiences provided to the c h i l d . The timespan chosen for this study appears to have been too short. In addition to the length of time, t h i s program did not y i e l d the a n t i c i p a t e d r e s u l t s p o s s i b l y on account of the time of the year during which i t was conducted. Offering a breakfast program at the end of the school year may not be the most appropriate time despite the fact that i t was the o n l y time a v a i l a b l e f o r t h i s study. The concept o f c a p t u r i n g the t e a c h a b l e moment i s an i m p o r t a n t consideration. 74. Implications for future research Although t h i s research study f a i l e d to c l e a r l y i d e n t i f y the c h i l d as a change agent capable of a l t e r i n g p a r e n t a l b e h a v i o r p a t t e r n s i t d i d u n v e i l areas f o r f u t u r e i n v e s t i g a t i o n . The c h i l d as a change agent i s s t i l l a p o t e n t i a l phenomenon of the '80s, the power of which i s p r e s e n t l y unknown. For those adults who possess a given body of knowledge, but who have not yet translated i t into action (behavior) t h i s study suggests that the c h i l d may act as a c a t a l y s t f o r change. The c h i l d , however, does not stimulate change on his/her own. Many other variables (e.g. f a m i l y s i z e , employment c o n d i t i o n s , i n f l u e n c e of other f a m i l y members) i n t e r a c t with the c h i l d i n the change process. Each of these variables as well as the extent of knowledge required by the parent before the c h i l d can e f f e c t i v e l y serve as a c a t a l y s t are t o p i c s deserving of i n v e s t i g a t i o n . In so doing the magnitude of the c h i l d ' s influence might be quantified. This study could be replicated by examining only the sweetened cereal purchase patterns of adults. In so doing, i t shouldbe possible to evaluate the impact of the c h i l d on the parent i n an area where the parent i s faced with selecting among a large number of products. This was not true of some of the other food groups considered i n the 75. present study (i.e. milk products, high q u a l i t y p r o t e i n sources). Another approach would be to focus on lunch where people choose from among a greater array of foods than those normally served at breakfast. By expanding the p o s s i b i l i t y for decision-making, the child's impact on the parent may surface more decisively. 76. REFERENCE NOTES 1. Kent, D. (Woodward Biomedical Library, University of B r i t i s h Columbia) Personal Communication, November 18, 1981. 2. Clarey, J. (P.E.I. Dept. of Agriculture & Forestry) Personal Communication, October 16, 1981. 3. Cox, M. (Alberta Agriculture) Personal Communication, October 28, 1981. 4. Macdonald, J. (Manitoba Department of Health) Personal Communication, October 21, 1981. 77. BIBLIOGRAPHY Assael, H. Consumer behavior and marketing action. Boston: Kent Publishing Co., 1981. Berey, L.A. & Pollay, R.W. The influencing role of the c h i l d i n family decision making. Journal of Marketing Research, 1968, 5̂  70 - 72. Berkman, H.W. & Gilson, C. Consumer behavior. Boston: Kent Publishing Co., 1981. Birch, L. A c a l l for the e x p l i c i t recognition of a f f e c t i n models of human eating behavior. Journal of Nutrition Education, 1981, 13(Suppl.), 49 - 53. Blackburn, D. (University of Guelph) Personal Communication, October 28, 1981. Boshier, R. Education p a r t i c i p a t i o n scale : basic eduction form. Vancouver: Learningpress Ltd., 1982. B r i t i s h Columbia Ministry of Health. The breakfast book. 1981. B r i t i s h Columbia Ministry of Health. Quick breakfasts for people on the go. 1980. Campbell, D.T. & Stanley, J.C. Experimental and quasi- experimental designs for research. Chicago: Rand McNally College Publishing Co., 1966. Clarke, B. (Canadian 4-H Council) Personal Communication, November 30, 1981. Cook, T.D. & Campbell, D.T. Quasi-experimental design and analysis: Issues for f i e l d settings. Boston: Houghton M i f f l i n Co., 1979. Csapo, M. Catch the teacher being good — Pupils aid teachers to develop appropriate classroom behavior. Journal of SPATE, 1974, June, 143 - 150. Dairy Bureau of Canada. Handy n u t r i t i o n . 1978. 78. Dombrow, C. & Horgen, I. Development of a n u t r i t i o n education program for preschoolers. Nutrition Quarterly, 1980, 4, 5 - 7. Dougherty, P. Spiderman to push n u t r i t i o n . The New York Times, 1980, November 7. Epprightj E., Fox, H., Fryer, B., Lamkin, G. & Vivian, V. Eating behavior of preschool children. Journal of Nutrition Education, 1969, 1., 16. Eppright, E., Fox, H., Fryer, B., Lamkin, G., & Vivian, V. Nutrition knowledge and attitudes of mothers. Journal of Home Economics, 1970, £2, 327 - 332. Ferguson, G. S t a t i s t i c a l analysis i n psychology and eduction. Toronto: McGraw-Hill Book Company, 1981. Fisher, D. Grow'n glow - n u t r i t i o n education for preschoolers. Nutrition Reports, 1980, _1, 8 - 1 1 . Fisher, D. & Paine, D. Nutrition education for preschoolers. Journal of the Canadian Dietetic Association, 1980, 41", 323. (Abstract) Gates, L. & Campbell, M. An assessment of the dietary concerns and practices of mothers of preschool children. Ottawa: Health and Welfare Canada, 1982. Health Promotion Directorate. Sources of n u t r i t i o n information. Canadian Health Facts, 1982, Nu-02. Health Protection Branch. The cereal sugar table. Ottawa: Department of National Health and Welfare, 1978. Hochbaum, G. Strategies and their rationale for changing people's eating habits. Journal of Nutrition Education, 1981, 13(Suppl.) 59 - 65. Kierans, B. ( B r i t i s h Columbia Ministry of Health) Personal Communication, March 31, 1983. Kita, S. UBC SPSS. S t a t i s t i c a l package for the so c i a l sciences. Computing Centre, University of B r i t i s h Columbia, 1980. Leavitt, I. (Alberta Agriculture) Personal Communication, October 26, 1981. McEwen, B. Evaluation of the n u t r i t i o n at schools program. Masters thesis, University of Alberta, 1980. Provincial Child Care F a c i l i t i e s Regulations (B.C. Reg. 403/78). V i c t o r i a : Queen's Printer, 1979. Rae, J. & Neilsen, H. Public opinion and perception of recommendations used in n u t r i t i o n education. Journal of the Canadian Dietetic Association, 1980, 41, 85 - 92. Schwartz, N. & Barr, S. Mothers - their attitudes and practices i n perinatal n u t r i t i o n . Journal of Nutrition Education, 1977, 9, 169 - 172. Sullivan, A. & Schwartz, N. Attitudes, knowledge and practice related to diet and cardiovascular disease. Journal of the Canadian Dietetic Association, 1981, 42, 169 - 177. Ward, S. & Wackman, D.B. Children's purchase influence attempts and parental y i e l d i n g . Journal of Marketing Research, 1972, 9, 316 - 319. Williams, T.G. Consumer behavior: fundamentals and strategies. St. Paul Minnesota: West Publishing Co., 1982. Woodward, C. & Chambers, L. Guide to questionnaire construction and question writing. The Canadian Public Health Association, 1980. Talmage, H., Hughes, M. & Eash, M. The role of evaluation research i n n u t r i t i o n education. Journal of Nutrition Education, 1978, 10, 169 - 172. Verner, C. A conceptual scheme for the i d e n t i f i c a t i o n and c l a s s i f i c a t i o n of processes for adult education." Washington, D.C.: Adult Education Association of the U.S.A., 1962. 81. - 2 - :3333SS2S:SSSSSBSS33SBS88aBS3BaSBSS3B3SSS I f y o u r n u r s e r y s c h o o l i s i n t e r e s t e d i n D a r t i c i o a t i n o i n t h i s p r o j e c t , p l e a s e c o m p l e t e t h e a t t a c h e d f o r m and r e t u r n i n t h e e n v e l o p e p r o v i d e d . A l l r e t u r n s a r e r e q u e s t e d by A p r i l 2, 19R2. I l o o k f o r w a r d t o workino w i t h y o u a q a i n . Yours t r u l y , D o r o t h y F i s h e r , Community N u t r i t i o n i s t . DF:qs E n c l . 85. THE BREAKFAST PROGRAM OVERALL GOAL: Through t he p r o v i s i o n o f n u t r i t i o n e d u c a t i o n a c t i v i t i e s f o r t h e p r e s c h o o l c h i l d t h e b r e a k f a s t program i s d e s i g n e d t o i n c r e a s e t h e f a m i l y ' s awareness o f t h e i m p o r t a n c e o f a n u t r i t i o u s b r e a k f a s t . OBJECTIVES: Each p r e s c h o o l c h i l d w i l l a c t i v e l y p a r t i c i p a t e i n : 1. R e c o r d i n g h i s / h e r b r e a k f a s t p a t t e r n s . (The Week ly B r e a k f a s t C h e c k ) . 2. C o l l e c t i n g and a s s e m b l i n g a g r a p h i c r e p r e s e n t a t i o n o f b r e a k f a s t f o o d s . ( P i e c i n g t o g e t h e r t he B r e a k f a s t P u z z l e ) . 3. A d i s c u s s i o n wh i ch f o c u s e s on t h e i m p o r t a n c e o f each o f t h e f o o d groups a t b r e a k f a s t . 4. Food p r e p a r a t i o n a c t i v i t i e s wh i ch emphas i ze b r e a k f a s t f o o d s . 5. Communicat ing i n f o r m a t i o n about t h e b r e a k f a s t program t o o t h e r f a m i l y members. GENERAL PROGRAM INFORMATION: * * C h i l d r e n s h o u l d c o n t i n u e t o e a t t h e i r r e g u l a r b r e a k f a s t a t home. * * Food p r e p a r a t i o n a c t i v i t i e s w i l l r e p l a c e t he snack u s u a l l y s e n t f r om home - c h i l d r e n s h o u l d be reminded no t t o b r i n g a snack on days when t he group w i l l be c o o k i n g . * * I t i s i n t e n d e d t h a t t h e b r e a k f a s t program be c a r r i e d ou t tw i ce/week . The f i r s t s e s s i o n each week a l l o w i n g f o r o r g a n i z a t i o n a l t i m e and t i m e t o a c q u a i n t t he c h i l d r e n w i t h t h e upcoming a c t i v i t i e s . The second s e s s i o n i s de vo ted t o f o o d p r e p a r a t i o n a c t i v i t i e s . * * Keep r e c e i p t s f o r a l l expenses - you w i l l be r e i m b u r s e d . 86 . WEEK I MILK AND MILK PRODUCTS S e s s i o n One: 1. I n t r o d u c i n q t h e program: a) u se t h e " P e r k y and P a t t y " pupDet s k i t - page 9 , " K i d b i t s " b) Make , N Q " badges f o r t h e c h i l d r e n t o wear home. [ j (I'm in the Breakfast Program) c ) I n t r o d u c e t h e "Week ly B r e a k f a s t Check " ( d e s c r i p t i o n a t t a c h e d ) 2 . I n t r o d u c e t h e M i l k Group: a) Teach c h i l d r e n t h e M i l k Cheer - paqe 28 , K i d b i t s . b) Ask c h i l d r e n t o hunt f o r p i c t u r e s o f m i l k and m i l k p r o d u c t s f o r t h e i r p u z z l e c o l l a g e (Reminder fo rms a r e a t t a c h e d a l o n g w i t h a d e s c r i p t i o n o f t he a c t i v i t y ) . c ) Ask c h i l d r e n t o b r i n g a j a r f o r t h e B r e a k f a s t Shake t o be made n e x t s e s s i o n . S e s s i o n Two: 1. Do t h e "Week ly B r e a k f a s t Check " 2. D i s c u s s p i c t u r e s b r o u g h t , c r e a t e t h e p u z z l e c o l l a g e , p o s t . 3. Make B r e a k f a s t Shakes - page 13 , K i d b i t s . 4. Send one copy o f t h e B r e a k f a s t Book home w i t h each c h i l d . 87. WEEK I I BREADS AND CEREALS S e s s i o n One: 1. Have a r e v i e w d i s c u s s i o n o f t he "Week ly B r e a k f a s t Check " n o t i n g t h a t t h i s week Breads and C e r e a l s w i l l be t h e f o c u s . 2. I n t r o d u c e t h e Rreads and C e r e a l s g roup w i t h t he s t o r y , "The L i t t l e Red Hen " . Emphas ize t h e i m p o r t a n c e o f who le g r a i n s . 3. Remind c h i l d r e n t o b r i n g p i c t u r e s , l a b e l s , e t c , o f b r e a k f a s t f o o d s f r o m t h e B reads and C e r e a l s g roup t o t h e nex t s e s s i o n . 4. P l a n a t r i p t o t h e s t o r e t o pu r cha se i t ems needed f o r S e s s i o n Two. A l s o , i n c l u d e a d i s c u s s i o n o f t h e b r e a k f a s t c e r e a l s a v a i l a b l e . S e s s i o n Two: 1. Do t he "Week ly B r e a k f a s t Check " . D i s c u s s p i c t u r e s b r o u g h t , c r e a t e t h e p u z z l e c o l l a g e , add t o t h e p i e c e p o s t e d l a s t week. A g a i n r e - e m p h a s i z e t h e use o f who le g r a i n c h o i c e s and d i s c u s s t h e i m p l i c a t i o n s o f s uga red c e r e a l s . Make who le wheat pancakes - page 16 , " K i d b i t s " . ( A l t e r n a t i v e s c o u l d i n c l u d e : who le g r a i n m u f f i n s , page 15 ; g r a n o l a , page 17; o r b read s c u l p t u r e s , page 18 . ) Rev iew t he v a l u e o f m i l k w i t h t h i s a c t i v i t y . C o l l e c t " q u o t a b l e q u o t e s " f r o m t h e c h i l d r e n d u r i n g each a c t i v i t y . These w i l l be combined i n t o a p a r e n t n e w s l e t t e r f o r Week V. I n v o l v e c h i l d r e n i n d o i n g a r t w o r k f o r a c o v e r page and an a u t h o r page. Send one copy o f "The Sugar Con ten t o f B r e a k f a s t C e r e a l s " and " Q u i c k B r e a k f a s t s f o r P e o p l e on t h e Go" home w i t h each c h i l d . The l i s t o f s uga r c o n t e n t and b r e a k f a s t c e r e a l s c o u l d be po s t ed i n s i d e t h e k i t c h e n cupboa rd d o o r . C o n s i d e r s e n d i n g t h i s s u g g e s t i o n home w i t h t h e c h i l d . 88 . WEEK I I I PROTEINS S e s s i o n One: 1. Have a r e v i e w d i s c u s s i o n o f t he "Week ly B r e a k f a s t Check " n o t i n g t h a t t h i s week foods w h i c h c o n t a i n P r o t e i n w i l l be t h e f o c u s . 2. I n t r o d u c e t h e P r o t e i n g roup t o t he c h i l d r e n g i v i n g examples o f f ood s f i t t i n g i n t o t h i s c a t e g o r y . Remind c h i l d r e n t o b r i n g p i c t u r e s f o r P u z z l e P i e c e Number 3. S e s s i o n Two: 1. Do t he "Week ly B r e a k f a s t C h e c k " . 2 . D i s c u s s p i c t u r e s b r o u g h t , c r e a t e t h e p u z z l e c o l l a g e , add t o t h e o t h e r two p u z z l e p i e c e s p o s t e d . 3. Make one o f : a) peanut b u t t e r - page 22 , " K i d b i t s " (combine w i t h t h e peanut e l f a c t i v i t y - page 29) o r b) s c r amb led eggs w i t h cheese m e l t e d on t o p . 4. R e l a t e t h i s s e s s i o n ' s f o o d a c t i v i t y t o t h e p r e v i o u s a c t i v i t i e s , r e v i e w i n g t h e i m p o r t a n c e o f each f ood group t o b r e a k f a s t . 5. Send one copy o f "Handy N u t r i t i o n M home w i t h each c h i l d . 89. WEEK IV FRUITS S e c t i o n One: 1. Have a r e v i e w d i s c u s s i o n o f t h e "Week ly B r e a k f a s t Check " n o t i n g t h e F r u i t s wh i ch a r e a p p r o p r i a t e b r e a k f a s t c h o i c e s . 2. I n t r o d u c e t he F r u i t s t h r ough t h e m y s t e r y bag r e a ch wh i ch i s a m o d i f i c a t i o n o f t h e V e g e t a b l e Bag Reach - page 18 , " K i d b i t s " . I n s t e a d o f a v e g e t a b l e i n t he bag , use a f r u i t wh i ch m igh t be e a t e n a t b r e a k f a s t . 3. Remind c h i l d r e n t o b r i n g f r u i t p i c t u r e s f o r t he l a s t p i e c e o f "The B r e a k f a s t P u z z l e " . S e c t i o n Two: 1. Do t h e "Week ly B r a k f a s t Check " and d i s c u s s as a g r oup . A f t e r d i s c u s s i n g t h e g r o u p ' s b r e a k f a s t p a t t e r n s , c u t a p a r t each c h i l d ' s i n d i v i d u a l r e c o r d and have each c h i l d make a p e r s o n a l r e c o r d f o r home u se . T h i s c o u l d be p o s t e d on t h e f r i d g e doo r a t home. 2. D i s c u s s f r u i t p i c t u r e s b rough t and c r e a t e t h e l a s t p i e c e o f t h e p u z z l e c o l l a g e . Po s t and d i s c u s s how each o f t h e g roups f i t t o g e t h e r t o make a s e l e c t i o n o f n u t r i t i o u s b r e a k f a s t c h o i c e s . 3. Make one o f : a) a b r e a k f a s t j u i c e f rom f r u i t s , e . g . , o r a n g e s , g r a p e f r u i t , m e l o n s , e t c . b) a f r i e n d s h i p f r u i t s a l a d - page 68 , " K i d b i t s " c ) f r u i t m u f f i n s i f m u f f i n s were not made i n Week I I e . g . , b l u e b e r r y m u f f i n s . 4. F i n a l i z e t h e " q u o t a b l e q u o t e s " and " a r t w o r k " f o r t he p a r e n t n e w s l e t t e r . 5. Send one copy o f t h e B r e a k f a s t Program Q u e s t i o n n a i r e home w i t h each c h i l d . Remind each c h i l d t o r e t u r n i t on t h e nex t s c h o o l day . 90. WEEK V PROGRAM EVALUATION S e s s i o n One and Two: 1. On both d a y s , c omp le te t h e "What I Had Fo r B r e a k f a s t Today " f o o d r e c o r d f o r each c h i l d i n d i v i d u a l l y . (Forms t o be p r o v i d e d ) . T h i s s h o u l d no t be done as a group a c t i v i t y . 2. C o l l e c t t h e "What I Had f o r B r e a k f a s t Today " forms wh i ch have been comp le ted by t h e p a r e n t s and r e t u r n e d by t he c h i l d . (No te : p a r e n t s w i l l have r e c e i v e d t h e s e forms as p a r t o f t h e q u e s t i o n n a i r oackage d i s t r i b u t e d a f t e r t h e l a s t s e s s i o n o f t h e p rog ram. ) 3. C o l l e c t p a r e n t q u e s t i o n n a i r e s . 4. Have program r e c e i p t s c o l l e c t e d f o r r e imbu r semen t . 5. D i s t r i b u t e t h e p a r e n t n e w s l e t t e r . 6 . A b i g thank you t o each and e v e r y one o f you who p a r t i c i p a t e d . CONTINUING PROGRAM ACTIVIT IES A. "THE WEEKLY BREAKFAST CHECK" Once a week each c h i l d w i l l have t h e o p p o r t u n i t y o f c h a r t i n g h i s / h e r b r e a k f a s t p a t t e r n s . T h i s w i l l be c a r r i e d ou t as a g roup a c t i v i t y w i t h accompany ing d i s c u s s i o n f o r each o f Weeks I - IV i n c l u s i v e . A t t he c o n c l u s i o n o f Week IV , each c h i l d w i l l r e c e i v e h i s / h e r own p o r t i o n o f t h e c h a r t f r om wh i ch a p e r s o n a l i z e d r e c o r d can be made and t a ken home t o put on t h e f r i d g e d o o r . An example o f what t h e c h a r t s h o u l d l o o k l i k e appear s be low. EXAMPLE: DISCOVERY HOUSE'S BREAKFAST CHECK C h i l d ' s name Y e s , I had b r e a k f a s t ! Y e s , I had some 1 Week: Robyn 1 * 2 3 4 M i l k B r e a d / C e r e a l e t c . ach week, add a column f o r t h e new f o o d group b e i n g d i s c u s s e d . C h i l d ' s P e r s o n a l i z e d Record m i gh t l o o k l i k e t h i s : ROBYN'S BREAKFAST CHECK Week: 1 Y e s , I had some 2 3 4 5 6 M i l k , B & C P r o t e i n Y e s , I had b r e a k f a s t : * * * * Note : Leave a few b l ank spaces so t h a t t h e c h a r t can be c o n t i n u e d a t home. 92. B. "THE BREAKFAST PUZZLE" Each week have c h i l d r e n b r i n g p i c t u r e s , l a b e l s , empty c a r t o n s , e t c . o f t h e B r e a k f a s t Group o f t h e Week ( e . g . , a cheese l a b e l , p i c t u r e o f an a p p l e , e t c . ) . U s i n g p o s t e r paper w h i c h has been p r e - c u t i n t o f o u r p u z z l e p i e c e s each l a b e l l e d f o r one o f t h e f ood g r o u p s ; make a c o l l a g e ou t o f t h e p i c t u r e s b r ough t by t h e c h i l d r e n f o r t h a t p a r t i c u l a r f ood g r oup . Once t h e p i c t u r e p u z z l e p i e c e i s c o m p l e t e p o s t i t on t h e w a l l and add a new p i e c e f o r each o f t h e f o u r weeks . D i s c u s s each group and i t s r e l a t i o n s h i p w i t h b r e a k f a s t as c h i l d r e n b r i n g t h e i r c o n t r i b u t i o n s f o r t h i s c o l l a g e . EXAMPLE: 1. P r e - c u t p o s t e r i n t o f o u r p u z z l e p i e c e s 3. Protein 4. Fruits 2. Make a c o l l a g e f o r each p i e c e and p o s t . Add s u c c e s s i v e p i e c e s . I. Milk T H E P R E S C H O O L B R E A K F A S T P R O G R A M P A R E N T Q U E S T I O N N A I R E It is Intended that this questionnaire be completed by mothers of children attending preschool. Are you the child's mother? Yes • No • If no, please specify your relationship to the preschooler, (e.g. father, aunt, etc.) Which of the following describes your area of residence? (Check) Coquitlam • Port Moody • • Other No • Yes • Port Coquitlam Are you currently employed? • Specify loction . I _ How many hours per week do you work? (Circle) 10 15 20 25 30 35 40 45 50 How many days per week do you work? (Circle) 1 2 3 4 5 6 7 How long does it tak'e you to get to work? (Print) minutes. In the box print the letter which represents your present gross family income, (i.e. your total family income before taxes and deductions.) A B C D E F Q H I J K L Less than $10,000 annually $10,000 —15,000 — 20,000 — 25,000 — 30,000 — 35,000 — 40,000 — 45,000 — 50,000 — 55,000 — 60,000 $15,001 $20,001 $25,001 $30,000 $35,001 $40,001 $45,001 $50,001 $55,001 Letter More than $60,000 annually How many people Including yourself live in your household? How many members of your household are In each of the following categories? (Circle) a) Children under 2 years None One Two Three Four 2—4 years None One Two Three Four in kindergarten None One Two Three Four 9 4 . in elementary school None One Two Three Four in junior/senior high school None One Two Three Four left school or graduated (but at home) None One Two Three Four b)Spouse or Partner None One Two Three Four Grandmother None One Two Three Four Grandfather None One Two Three Four Other Relative None One Two Three Four Boarder None One Two Three Four Nanny or Housekeeper None One Two Three Four What Is the blrthdate of the child you currently have in preschool? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ — _ — _ _ _ _ _ _ _ To what degree do each of the people in your house influence the food purchases made? Check (•) either applicable or not applicable. If applicable, mark the degree of Influence on the corresponding scale using anX. _ _ I I IntluOTc Influwtc. InthfWK. InfloWK. IMIiMnc* IntluwK. e.g Teenager Applicable. (_J u a) Child under 2 years Check Not Applicable, do not have a child under 2 years • No VwyUnl. Llttto Mod—«t. Much VwyMoch u—n wflc hu— nfluono n , I 1 I I L Applicable, do have a child under 2 years b) Child attending preschool c) Other children 2—4 years but not at preschool. Not Applicable Applicable d) Elementary School Child Not Applicable Applicable e) Teenager Not Applicable Applicable 0 Yourself J_ JL no ™ u m m m Moo—.!* Much v.—Much InfhMnc. tnfluwio tnfh—nc Inttuonc. Inftuwic. Influwic. No V—yUttt. (Jut. Mod-it. Much Vary Much Influwtc. Ifltlu—tc. InlliMnc. Influence InHu—ki Influ—k. O . L . JL v»~ Uttl. IhflUWIC. _ NO VwyUttl. Uttl. MoO-it. Much U ~ Inftomc. Inttuonc. Inftuwic. Influwic. Inflowic Q : 0-*l I i No Vwyuiu. Uttl. MoOwM. Much Inftuwic. InthMnc InlkMAC Intlowic. InthMnc I 1 L • H* VwyUttl* UWt HodwnkB • Hitch Mtome* teHw-wet Iwffwi-B> Mluwic* tfrthMwo* VwyM Inttua Vwn Much ' \nikimnom Other Adults (specify spouse, partner, etc. or enter N/A if not applicable) i . [ 2- [ 3. [ V*ty Infh _1_ Ho VwyUttl* Uttl* Mod«r*t* Much lnftu*ne* InthMnc* InthMnc* InthMnc* InthMnc* 8. Does your household have a television set? No Q Yes • • How many hours ot television did your preschooler watch yesterday? (Circle) 0 1 2 3 4 5 6 7 8 9 10 11 12 and last weekend? (Circle) 2 4 6 8 10 12 14 16 18 20 22 24 26 9. Check (.-) those nutrition pamphlets which you received over the past month. "The Breakfast Book" Q "Quick Breakfast for People on the Go" • "Sugar Content of Breakfast Cereals" • "Handy Nutrition" • Others •Give tltle(s) Check (.'(If you did not receive any of the above publications • 10. W H A T F O O D S . . . . Did you buy In the LAST MONTH? Are In your household TODAY? (Note: they may still be In your household or may (Please take time to look.) be all used up.) Did you buy Any? (Check) Is there any? (Check) Milk: chocolate Yes • No Q Yes • No • evaporated, condensed Yes D No • Yes • No • whole, homogenized Yes • No • Yes • No • 2% Yes • No • Yes • No • skim Yes • No • Yes • No • Buttermilk Yes • No • Yes • No • Eggnog,canned or Yes • • No • Yes • No • eggnog flavorbeads Milk Mate Yes • No • Yes • No • Instant Breakfast Yes • No • Yes • No • Hot Choclate Mix Yes D • No • Yes • No • Brown Cow Chocolate Syrup Yes Q No • Yes • No • Postum Yes • No • Yes • No • Ovaltine Yes D No • Yes • No • Tea/Coffee Yea • No • Yes • No • Iced Tea Yes • No • Yes • No • Lemondae/Limeade Yes • No • YesD No • Apricot Nectar Yes • No • Yes • No • ApplecoUOrangecot nectar Yes • No • Yes • No • Applelime Yes • No • Yes • No a Rlbena Yes • No • Yes • No • Grape Juice Yes • No • Yes • No • Grape Drink Yes • No • Yes • No • Cranapple Yes • No • Yes • No • Cranberry Cocktail Yes • No D Yes • No • Pineapple Juice Yes No a Yes : : No . CPIus Yes No Li Yes I.i No ;: Canned, sweetened juices Yes u No • Yes LI No U Canned, unsweetened juice Yes • No • Yes • No • Froot Loops Yes Q No • Yes • No • Honey Nut Cornflakes Yes • No • Yes • No a Cheerlos Yes • No • Yes • No • Honey Nut Cheerios Yes Q No • Yes Q No • Count Chocula Yes • NO • Yes • No a Boo Berry Yes Q No • Yes • No • Franken Berry Yes Q No • Yes • No • Life Yes • No a Yes a NO • Trlx Yes • No • Yes • NO • Total Yes a NO • Yes a NO • Red River/Sunnyboy Yes • No • Yes • NO • Ready-to-Serve Oatmeal Yes • No • Yes • No • .. Quick Quaker Oats Yes O No • Yes • No • Creamy Wheat Yes • No • Yes • No a Zoom Yes • No • Yes • No • Vita-B Yes • No • Yes • No Q Stone Buhr 7 grain cereal : Yes • No • Yes • No • Cinnamon Rolls Yes • No • Yes • No • Crumpets Yes D No • Danish Pastry Yes • No • Yes • No • Ding Dongs Yes • No • Yes • No D Doughnuts • Yes • No D Yes D No • English Muffin Yes • No • Yes • No • Pancakes/Waffles from a mix Yes • No • Yes • No • Eggo Frozen Waffles-bran Yes • No • Yes • No a Eggo Frozen Waffles - others Yes • No • Yes • NO a Aunt Jemina Frozen Waffles Yes • No • Yes • No • Snacking' Cake Yes • NO a Yes • No • Muffins from mix Yes • No • Yes • No • (bran or fruit) Frosted Pop Tarts Yes • No • Yes • No • Plain Pop Tarts Yes • No • Yes • No a Digestive Biscuits/ Yes • No • Yes • NO a Graham Wafers Granola-type snack bars Yes • No • Yes • No • Meiba Toast/ Yes • No • Yes • No • Wholewheat Crackers Twinkles Yes • No • Yes • No • Pizza Yes • No • Yes • No • Macaroni & Cheese Yes • No a Yes • No • Rice Pudding/ Yes • No • Yes • No • Tapioca Pudding-bought Rice Pudding/Tapioca Yes • No • Yes • No • Pudding - Homemade Scones Yes • No • Yes • No • Fruits: fresh (banana. Yes • NO a Yes • NO • apple, grapefruit, etc.) dried (dates, figs. Yes • No • Yes • No a prunes, raisins) Canned (e.g. pineapple, etc.) Yes • NO a Yes • No • Fried Potatoes Yes • No • Yes • No Q Ham Yes O No • Yes a No • Luncheon meats Yes • No • Yes • No n Bacon Yes • No n Yes 1 : No Weiners Yes a No • Yes i j No Lj Peanut butter Yes • No • Yes • No a Eggs Yes • NO a Yes • No • Nuts Yes • No • Yes • No • 9 7 . Cheese: Cheddar Yes • No • Yes • No • collage Yes • No • Yes a . No • processed (e.g. Ingersoll Yes • No • Yes • No • CheezWhiz) cheese slices Yes • No O Yes • No • Yogurt: plain Yes • No • Yes • No • Yogurt: fruit flavored Yes • No • Yes • No • Butter Yes O No • Yes • No • Margarine Yes a No • Yes • No • Sugar Yes Q No • Yes Q NO • Honey Yes a No • Yes • No • Sugar Substitute Yes' D No O Yes • No a Fudgslcle/Revel Yes • No • Yes • No • Popslcle : Yes • No 0 \ Yes • No • Chocolate Bars Yes • NO • Yes • No • Thank you for taking time to complete this questionnaire. SECTION TWO: Complete f o r each day y o u r c h i l d a t t e n d s p r e s c h o o l d u r i n g t h e week of May Z4-Z8th. Have y o u r c h i l d b r i n g I t t o p r e s c h o o l on each o f t h e s e d a y s . FOODS OFFERED TO AND EATEN BY PRESCHOOLERS 1. Date: 2. D i d you o f f e r b r e a k f a s t t o y o u r p r e s c h o o l c h i l d t h i s morning? Yes I I No | I 3. P l e a s e mark w i t h a CHECK ( J) t h o s e f o o d s o f f e r e d t o y o u r p r e s c h o o l e r t h i s morning ( i n c l u d e t h o s e f o o d s o f f e r e d v e r b a l l y o r a c t u a l l y p r e p a r e d f o r t h e c h i l d ) . STAR (*) t h o s e f o o d s w h i c h y o u r y o u n g s t e r a c t u a l l y a t e . The 1 1 s t i n l c u d e s a v a r i e t y o f f o o d s , b u t i f y o u r c h i l d a t e something n o t on t h e l i s t , p l e a s e I n c l u d e 1 t i n t h e s e c t i o n " O t h e r s " . FOODS , i f o f f e r e d i f e a t e n Whole m i l k 2X m i l k Skim m i l k C h o c o l a t e m i l k Oval t i n e Unsweetened f r u i t j u i c e . . . Sweetened f r u i t j u i c e . . . . D r i n k made f r o m c r y s t a l s . . . T e a / c o f f e e O t h e r m i l k d r i n k s , e.g. eggnog White b r e a d / t o a s t Wholewheat b r e a d / t o a s t . . . . R a i s i n b r e a d / t o a s t C o l d unsweetened c e r e a l . . . Name C o l d , sweetened c e r e a l Name Hot c e r e a l Pancakes, homemade W a f f l e s , homemade . . Pancakes, bought W a f f l e s , bought, e.g. Egqo Sweet buns, cinnamon r o l l s , p o p - t a r t s P i z z a Eggs Cured meat - ham, bacon Peanut b u t t e r Cheddar c h e e s e C o t t a g e cheese P r o c e s s e d cheese s l i c e s Cheese s p r e a d , e.g. Cheez Whiz . . Y o g u r t , p l a i n Y o g u r t , f r u i t f l a v o u r e d D r i e d f r u i t s , e . g . , d a t e s , prunes F r e s h f r u i t Canned f r u i t B u t t e r M a r g a r i n e Jam, j e l l y Honey . . . Suqar O t h e r : ( ) i 1 ( ) ! i ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) I i ( ) ( ) ( ) ( ) i 1 i 1 ( ) i 1 ( ) 9 9 . CODING SCHEDULE FORTRAN CODING FORM COLUMN NUMBER VARIABLE CODE 1 - 3 4 5 6 7 8 10 11 12 13 - 14 15 - 17 18 19 20 21 22 23 24 25 Dl, I.D. D2, Centre D3, Card Number Blank D4, Mother ? D5, Respondent D6, Residence D7, Employed D8, Hours Worked D9, Days Worked D10, Travel, minutes D l l , Income 01 - 106 1 - 6 1 No=l = 1 = 2 = 3 = 4 5 Yes=2, Mother Father Aunt Nanny Sibling= Coquitlam = 1 Port Coquitlam - 2 Pt. Moody = 3 New Westminster=4 Yes=2, No=l 0=0, 10=1 15=2, 20=3 25=4, 30=5 0 to 7 00 to 99 A 075 B = 125 C — 175 D = 225 E SB 275 F s= 325 G ss 375 H ss 425 I s= 474 J ss 525 K s= 575 L s= 625 D12, Family Size D13, Number of Children Under 2 Years D14, Children 2 to 4 Years D15, Kindergarten Age Children D16, Elementary Age Children D17, High School Children D18, Out of School but at Home D19, Spouse 100. 26 27 28 29 30 31 32 - 33 34 35 36 37 38 39 40 41 42 43 44 - 45 46 - 47 D20, D21, D22, D23, D24, D25, D26, D27, D28, D29, D30, D31, D32, D33, D34, D35, D36, Gr andmo the r Grandfather Other Relative Boarder Nanny Blank Age of 50 to 65 Preschooler (months) Family Influence Under 2 c h i l d N/A = 0 No Influence=l Child in Preschool Very L i t t l e =2 2 to 4 year old Elementary Child Teen Self Spouse Other Blank Television: Hours watched yesterday? Hours watched l a s t weekend? L i t t l e Moderate Much Very Much Yes=2, No=l =3 =4 =5 =6 48 49 50 51 52 53 D3 7, Breakfast Book Yes=2, No=l Received? D38, Quick Breakfasts Yes=2, No=l Booklet Received? D39, Sugar Content? Yes=2, No=l D40, Handy Nutrition? Yes=2, No=l D41, Other Publications? Yes=2, No=l D42, No Publications Received Yes=2, No=l 101 COLUMN NUMBER VARIABLE CODE 1 - 3 Dl, I.D. 01 to 106 4 D2, Centre 1 to 6 5 D3, Card Number 2 to 5 6 Blank 7 onward Food L i s t Yes = 2, NO e.g. Milk: 7 - 8 chocolate Yes = 2, No 9 - 1 0 evaporated Yes - 2, No condensed 11 - 12 whole, homogenized Yes = 2, No 77 - 78 Chocolate bars Yes = 2, No 79 - 80 Blank 5 D3, Card Number 6 6 Blank 7 Bl,~Parent Offered Breakfast Yes = 2, No B2, Parent Offered 8 Nutritious Beverage Yes = 2, No 10 B4, Parent Offered High Quality Protein Yes = 2, No 12 B6, Parent Offered Wholegrains Yes = 2, No 14 B8, Parent Offered Sweetened Cereal Yes =2, No 102. POOD CLASSIFICATIONS MILK PRODUCTS - BEVERAGES evaporated milk whole milk 2% milk skim milk buttermilk Dairy Maid 2% goat's milk WHOLE GRAIN PRODUCTS Multigrain bread 100% wholewheat bread 60% wholewheat bread wholewheat crackers bran or f r u i t muffins bran "Eggo" waffles granola-type bars CEREALS WITH MORE THAN 15 PERCENT SUGAR Froot Loops Honey Nut Cornflakes Honey Nut Cheerios Count Chocula Boo Berry Frankenberry Honeycomb Alphabits Sugar Crisp Fruity Pebbles Cocoa Pebbles Raisin Crisp Apple Jacks Sugar Smacks Cap'n Crunch Frosted Flakes Miniwheats Nabisco 100% Bran Buckwheat & Maple Apple Harvest Crunch Cracklin Bran Alpen HIGH QUALITY PROTEIN SOURCES ham peanut butter eggs nuts cheddar cheese cottage cheese FRUITS AND FRUIT JUICES fresh f r u i t dried f r u i t canned f r u i t raspberry c o c k t a i l apricot nectar applecot/orangecot applelime ribena grape juice cranapple cranberry c o c k t a i l pineapple juice canned juices (sweetened & unsweetened) 103. MODIFIED MILK PRODUCTS BEVERAGES Chocolate milk eggnog flavor beads Milkmate Instant Brerakfast Hot Chocolate Mix Brown Cow Chocolate Syrup Dr. Oh Dairy Mail Chocolate Milk CEREALS WITH LESS THAN 15 PERCENT SUGAR Cheerios L i f e Total Red River/Sunnyboy Quaker Oats Creamy Wheat Zoom Vita B Stone Buhr 7 Grain Puffed Wheat Farmhouse Bran Whetabix Grapenuts Flakes Bran Crunchies Rice Flakes Team Granola Special K Cornflakes Product 19 Rice Krispies Raisin Bran A l l Bran Bran Flakes Shredded Wheat OTHER BAKED PRODUCTS Cinnamon Rolls Crumpets Danish Pastry Ding Dongs Doughnuts English muffin Other "Eggo" waffles Aunt Jemima waffles Snackin' Cake Frosted Pop Tarts Plain Pop Tarts Twinkies Scones Enriched White Bread Raisin Bread LOW QUALITY PROTEIN SOURCES luncheon meats bacon weiners processed cheese OTHER BEVERAGES Postum Ovaltine Tea, Coffee Iced Tea Lemonade Grape Drink "C" Plus Super Soco Quench Hawaiian Punch KoolAid Tang Rise 'n Shine 104. Sugar Content of Breakfast Cereals An Information Letter on the "Nutritional Re- quirements of Breakfast Cereals" sent from the Health Protection Branch in August 1977 to manufacturers in- cluded the following proposal for sugar declaration: "It is proposed that the total content of sugar and other sweeteners be declared as a percentage of the total weight of the cereal on the principal display panel of the label of all breakfast cereals. It is pro- posed that a declaration such as the following be us- ed: "Contains (x) % sugar" when only sugar is used, or "Contains fx)% sugar and other sweeteners" when more than one sweetener is used. This declara- tion would be based on the total amount ofhexoses and disaccharides in the product as sold." Although this proposal is still under review, the following results of a HPB survey of the sugar content of 74 breakfast cereals will be a useful reference for Nutritionists. SUGAR BY WEIGHT — 0-4.9% Puffed Rice (Quaker) Oatmeal, Quick Cooking (McNair) Oatmeal, Quick Cooking (Quaker) Shredded Wheat, Spoon Size (Nabisco) Cream of Wheat, Regular (Nabisco) Puffed Wheat (Newport) Puffed Wheat Peter Pan (Quaker) Oatmeal, Instant (Quaker) Puffed Wheat (Quaker) Cream of Wheat, Mix V Eat (Nabisco) Oatmeal, Instant (Quaker) Shredded Wheat, Malt Flavoured (Quaker) Red River Cereal (Maple Leaf) Shredded Wheat (Nabisco) Cream of Wheat, Quick (Nabisco) Oatmeal (Ogilvie) Grape-Nuts (General Foods) Cheerios (General Mills) Wheetabix (Wheetabix) Wheaties (General Mills) 5.0-9.9% Corn Flakes (Kellog's) Special K (Kellog's) Corn Flakes (General Mills) Product 19 (Kellog's) Bran Flakes (Kellog's) Rice Krispies (Kellogg's) 10.0-14.9% Grape Nut Flakes (General Foods) Rice Flakes (Nabisco) Raisin Bran (Kellogg's) All-Bran (Kellogg's) Granola, Crunchy with Honey and Almonds (Sunny Crunch) 4 Grain Team (Nabisco) Pep (Kellogg's) Shreddies (Nabisco) 15.0-19.9% Granola (Canadian Cereal Sales) Harvest Crunch (Quaker) Bran Flakes (General Foods) Mini-Wheats, Brown Sugar (Kellogg's) Buckwheat & Maple, Whole Wheat (Kellogg's) Granola, Crunchy, with Fruit & Nuts (Sunny Crunch) Mini-Wheats, Frosted (Kellogg's) Alpen (Wheetabix) Granola, with Nuts & Raisins (Canadian Cereal Sales) 1007* Bran (Nabisco) Bran Buds (Kellogg's) Granola, with Honey & Almonds (Sunny Crunch) Harvest Crunch, with Apples & Cinnamon (Quaker) Oatmeal, Instant, with Sugar and Spice (Quaker) 20.0-29.9% Oatmeal, Instant, Pre-sweetened (Robin Hood) Granola, with Raisins (Sunny Crunch) Oatmeal, Instant, with Apple & Cinnamon (Robin Hood) Oatmeal, Instant, with Apple & Cinnamon (Quaker) Oatmeal, Instant, with Maple & Brown Sugar (Robin Hood) Oatmeal, Instant, with Maple & Brown Sugar (Quaker) Golden Honeys (Nabisco) Oatmeal, Instant, with Cinnamon & Spice (Quaker) Alpha-Bits (General Foods) Honeycomb (General Foods) Harvest Crunch, with Raisins & Dates (Quaker) 30.0-39.9% Oatmeal, Instant, with Raisins & Spices (Quaker) Sugar Crisp (General Foods) Trix (General Mills) Frosted Flakes (Kellogg's) Captain Crunch (Quaker) Cocoa Puffs (General Mills) Lucky Charms (General Mills) Froot Loops (Kellogg's) 40.0-55.7% Boo Berry (General Mills) Sugar Pops (Kellogg's) Count Chocula (General Mills) Apple Jacks (Kellogg's) Frankenberry (General Mills) Doris Noble Health Protection Branch 105. DESCRIPTIVE COMMENTS ABOUT THE BREAKFAST PROGRAM WEEK I: - President of one of the parent groups commented: the program i s going very w e l l , the c h i l d r e n are r e a l l y p a r t i c i p a t i n g . - Teacher at another centre involved i n the breakfast program commented that i t i s a great program; the kids are "right into i t " . WEEK I I : - The program i s going w e l l , parents are g e t t i n g i n v o l v e d . A p p r o x i m a t e l y 40 p e r c e n t o f the p i c t u r e s requested for the food collage were cut out by the parent. One c h i l d turned out to be a l l e r g i c to milk products which stimulated a good d i s c u s s i o n . C h i l d r e n are i n d i v i d u a l l y p a r t i c i p a t i n g i n the cooking experiences. WEEK I I I : - Program i s going very w e l l . The c h i l d r e n want to evaluate t h e i r b r e a k fasts on a d a i l y b a s i s as opposed to just twice a week. 106. WEEK IV: - Teachers report that the program i s getting easier for them to do. Moms are starting to t e l l the teachers what their children have had for breakfast. Program i s going so well - can hardly believe i t i s almost overl Throughout the four weeks i t was evident that the instructions were being followed as presented. i

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