RESEARCH ARTrCLE Children's Fruit and Vegetable Intake: Socioeconomic, Adult-Child, Regional, and Urban-Rural Influences SUSAN D. KIRBY ,' TOM BARANOWSKI , 2 K IM D. REY NO LD S," GRETCHEN TAYLOR,4 AND DIA NN E BINKLEY ' lEmory University School of Public Hea lth , Center for Public Healt h Practice, Atlanta, Georgia 30322; 2 Emory Univers ity School of Public Health, Department ofnehavioral Sciences and H ealth Edu cation , Atlanta, Georgia 30322; JUniversity of Alabama at Birmingham Sc hool of Public Health, Birmingham, Alabama 35294-2025; Department of He alth, Division of Family Health, Minneapolis, Minnesota 55440 ABSTRACT Natio n al objectives for fruit and vegetable (f'&V ) consumpt ion have be en se t atfive or more servings per day. The National Cancer Institute fund ed three interventions aimed at increasing f&V consumption among eleme ntary sc hool children. Focus group discussions were held with fourth- and fifth-grade s tudents, their parents, teachers, and food service wor kers in three regions to determine if environ- mental, personal, and behavioral influences differed across socioeconomic status (5E5), regional, urban-rural, adult-child, and ethnic groups. Discussion guides for focus group sessions we re based on the three domains of social cognitive th eory's re ciprocal determinism: environmental, behavioral, and per- so na l characteristics. Discussions we re conducted with groups of studen ts (15), parents (11 ), teachers (6), and food se rvice workers (6). A systematic content analysis was conducted with THE ETHNOGRAPH ,I!! a software system. Differences in the three major components of reciprocal determinism were found across SES, urban- rural, regional, and adult-child fac tors. Mid- dle to high SES gro up s reported a much larger varie ty ofF&Vs available in their home s. Chi ldren from low and very low SES groups ap peared to be responsible for preparing more meals alone. Children, n ot adults, thought ofvcgctablcs as "grown- up" foods. UNE 27:261-271, 1995) I NTRODUCT I ON A diet rich in fruits and vegetables (F&V) has multiple health benefits.! Nutrients in fruits and vege tables (e.g., vit amin The review proc ess for this manuscript was completed under the tenure o rtormer IN£:: Ed itor Karen G lanz. ','h is research was su p ported by grant # I-tOl-CA-6' 596 from the Nation al Ca nc er Ins titute. Address for correspondcuce: Susan D. Ki rby, Dr. P.H., Emory Univcl1iity School of Public H ealth, Cemer for Public Health Practice, 1518 Clifton Rd . NE, Athnta, GA 30322; T el: (404) 727-7854 ; Fax: (404) 727-9198. 01995 SOC IETY FOR NUTRITIO N EDUCATION 261 A, beta- carotene, dietary fiber, and complex carbohydrates) help protect individuals from cardiovascular disease and certain l() Because of these benefits, the H ealthy People 2000 report incl ud es a national objec ti ve for eating five or mo re servings of f&V per day.ll In response , the National Cancer Institute (NCI) and th e Prod uce for Be tter Health Foundation developed the national Five A Day campaign, which include s mass media, in -store promotions, and research components. 12 The Fiv e A Day programs are ai med at many segments of the U.S. popu lati on, incl uding sch ool-aged chil dren. Some researchers believe that food preferences and die- tary habits are establish ed during the early years of llfe.13 Thu s, childhood would be an ideal time to intervene for improving diet. Social cognitive theory (SeT) pro vides a foundation for desig ning interventions. It has been useful in the de s ign of dietary change programs because it h as strong empirical support and provide s a basis for under- standing how complex characteristics interact. 14 The SeT concept of reciprocal determ inism posits that th e environ- ment, an ind ividual's behavior, and an individual 's personal characteristics continuously affect one anot her. IS The envi- ronment refe rs to the ph ysical, institutiona l, and social surroundings in wh i ch a child must regularly cope and in whi ch b ehavi or takes place. For example, a child may have to learn how to order F&Vs in the environment of a fast food restaurant. Behaviors are the actions a child take s in an envi ro nment, and a variety of skills (e.g.,-F&V preparation) are often prerequisite to performing those behaviors (e.g., F&V cons umption). Chi ldren usu.ally have few food prepa- ration skills, whic h may limit their consumption ofF&Vs.16 Personal c haracteristics are an individual' s uniqu e aspects th at are relevant to behaviors, such as taste preferences. For instance, c hildren report that they pref er fruit mor e than vegetables. Indi viduals may also be characterized by their outcome expectations, w} uc h are the events that they be-