Lunch4Tots

1. Lunch4Tots
Group 1: Elizabeth Griffin, Katy Hamlin, Donna Javellana,
Liyana Abdul Kadir, Judy Mendel

2. Background
 Concept: A texting program focusing on the importance and
practice of packing healthy, well-balanced lunches and
snacks for toddlers.
 Target Population: Parents of toddlers, age 2 – 5, who
attend a daycare/preschool/pre-K that requires parents to
provide packed lunches in the greater D.C. metropolitan
area.

3. Objectives
 Behavioral Objective: Increase the number of fruits,
vegetables and whole grains parents pack for their 2 – 5 year
olds lunches/snacks over the course of 2 weeks by 40%.
 Health Objective: To increase by 50% the percent of
toddlers within the program who achieve the recommended
daily nutritional standards for their age group, as defined by
the American Academy of Pediatrics.

4. Communication Objectives Based
on the Health Belief Model
 Perceived Benefits: By the midpoint of the study, 100% of
parents will be aware of the health benefits of packing a
healthy home-made lunch for their toddler.
 Perceived Barriers: By the midpoint of the study, 100% of
parents will be aware of time management tips to prepare
healthy meals.
 Perceived Severity: By the end of the first week of the
campaign, 80% of parents will be aware of the serious
consequences poor nutrition can have on a developing
toddler.

5. Communication Objectives Based
on the Health Belief Model
 Self-Efficacy: By the end of the texting campaign, 75% of
parent participants will feel confident in their ability to pack
healthy lunches.
 Cues to Action: By the end of the texting campaign, 50% of
parent participants will use a text tip to help pack a healthy
lunch for their toddler.

6. Lunch4Tots Text Messaging
Program
 Recruited 7 mothers
 Eligibility criteria:
 Have children between the ages of two and five years
 Reside in the D.C. metro area
 Have a toddler attending a daycare or preschool that
requires them to bring a packed lunch each day
 Pre-test administered
 Two week text messaging pilot program
 ~2 text messages sent/day
 Post-test administered at end of pilot program

7. Message & Construct Examples
Message HBM Construct
Lunch4Tots: Make meal planning easy. Create Perceived Barriers
a grocery list for the whole week.
Lunch4Tots: Challenge your little ones to follow the Perceived Benefits
rainbow! Pack colorful fruits and veggies, they will
get a healthy boost of vitamins and minerals.
Lunch4Tots: Try making tiny tea sandwiches on Cue to Action
whole grain bread. Cucumber and low-fat cream
cheese or egg salad are yummy fillings.
Lunch4Tots: An interactive lunch-packing activity! Self Efficacy
Help your tots make trail mix with their favorite dried
fruit and whole grain cereal.

8. Participants
 6 out of 7 participants completed the pre/post test
 Average age: 37.8 years
 Race:
 33.3% white (2 participants)
 33.3% Asian American (2 participants)
 16.7% Did not specify (1 participant)
 16.7% Latina (1 participant)
 Number of toddlers in household
 83.3% with 1 toddler (5 participants)
 16.7% with 2 toddlers (1 participant)

9. Results
What are the recommended daily servings of fruits for toddlers?
Pre-test: Post-test:
¼ cup ¼ cup – 16.7% (1 participant)
½ cup ½ cup – 16.7% (1 participant)
1cup – 83.3% (5 participants) 1 cup – 50.0% (3 participants)
3 cups - 16.7% (1 participant) 3 cups – 16.7% (1 participant)
What are the recommended daily servings of
vegetables for toddlers?
¼ cup ¼ cup – 16.7% (1 participant)
½ cup – 16.7% (1 participant) ½ cup – 16.7% (1 participant)
1cup – 33.3% (2 participants) 1 cup – 50.0% (3 participants)
3 cups - 50.0% (3 participants) 3 cups – 16.7% (1 participant)

10. Results
Which of the following foods listed below is a good source of protein for your
toddler?
Hummus Hummus - 16.7% (1 participant)
Eggs Eggs
Chicken Chicken
Tuna Tuna
All of the above - 100% (6 participants) All of the above - 83.3% (5 participants)
Which of the following represents the LEAST healthy option for your toddler's
lunch?
Pita pockets Pita pockets
Wheat bread – 16.7% (1 participant) Wheat bread
White Bread – 66.7% (4 participants) White Bread – 83.3% (5 participants)
English muffins – 16.7% (1 participant) English muffins – 16.7% (1 participant)
Which beverage item has the most nutritional value for your toddler?
Skim Milk – 100% (6 participants) Skim Milk – 100% (6 participants)
Fruit flavored juice Fruit flavored juice
Powdered drink mix (sugar added) Powdered drink mix (sugar added)
Soda Soda

11. Results
I am confident that my toddler’s diet meets the
recommended daily nutritional standards.
Pre-test: Post-test:
Strongly Agree – 16.7% (1 participant) Strongly Agree – 16.7% (1 participant)
Agree Agree – 33.3% (2 participants)
Neutral – 16.7% (1 participant) Neutral – 33.3% (2 participants)
Disagree – 66.7% (4 participants) Disagree – 16.7% (1 participant)
Strongly Disagree Strongly Disagree
I am satisfied with the lunches I pack for my toddler.
Strongly Agree Strongly Agree – 16.7% (1 participant)
Agree – 20% (1 participant) Agree – 66.7% (4 participants)
Neutral – 20% (1 participant) Neutral – 16.7% (1 participant)
Disagree – 60% (3 participants) Disagree
Strongly Disagree Strongly Disagree

12. Results
I am confident in my ability to utilize time management skills
in order to pack a healthy lunch for my toddler.
Pre-test: Post-test:
Strongly Agree – 16.7% (1 participant) Strongly Agree
Agree –16.7% (1 participant) Agree – 66.7% (4 participants)
Neutral – 33.3% (2 participants) Neutral –16.7% (1 participant)
Disagree – 33.3% (2 participants) Disagree –16.7% (1 participant)
Strongly Disagree Strongly Disagree
Text messages help me remember to pack
a healthy lunch for my toddler.
Strongly Agree Strongly Agree
Agree Agree – 50% (3 participants)
Neutral – 100% (6 participants) Neutral – 16.7% (1 participant)
Disagree Disagree – 33.3% (2 participants)
Strongly Disagree Strongly Disagree

13. What did moms think?
 How often did you use a Lunch4Tots tip to help you pack a lunch?
 Sometimes – 83.3% (5 participants)
 What did you like about the Lunch4Tots text messaging program?
 I like the concise information.
 It was encouraging.
 Creative tips for lunch-packing (i.e ants on a log)
 Would you recommend Lunch4Tots to a friend/family member?
 Yes – 50% (3 participants)
 Maybe – 16.7% (1 participant)
 No – 33.3% (2 participants)

14. Recommendations from Moms
 What would you like to see improved?
 Shorten URLs – links hard to read on smart phone
 Adjust timing and frequency of text messages
 Send tips via e-mail
 Link to user-friendly (less text heavy) websites
 Provide more specific lists of options to pack

15. SAM Evaluation
Fry Graph and Reading Grade Level
• Nine sets of 100 words in Lunch4Tots
• Average # of sentences = 11.9
• Average # of syllables = 134.6
• 4th Grade Reading Level = Superior

16. SAM Areas For Improvement
 Consider including a summary or review of messages
 Provide more context before message
 SMS limits
 Improve and incorporate layout factors
 Visual cuing devices
 Consistent sequence of information
 Match to cultural logic, language, experience (LLE)
 Foods rarely eaten or unavailable
 Cultural images and examples
 Cultural images and foods presented in positive way

17. Considerations for Future & App
 Design graphic sections of Lunch4Tots with SAM evaluation
in mind
 Cover graphics show purpose
 Type of graphics
 Relevance of illustrations
 List, tables, etc. explained
 Captions used for graphics
 Recalculate SAM score to incorporate changes in program

18. Questions?