BackgroundFruits and Vegetables (FV) consumption is considered a marker of social inequalities in health since it is considerably decreased in disadvantaged populations. The main objective of this trial was to evaluate the impact of vouchers for FV purchase on the consumption of FV among children living in disadvantaged families in a French urban district.MethodsThe FLAM study was a controlled randomized intervention trial, performed in Saint-Denis (North suburbs of Paris). The study group (intervention or control) was randomly attributed to parent-child pairs at inclusion. The intervention group received vouchers exchangeable for FV over a 1 year period. Nutritional education through workshops was available for both groups. FV consumption was assessed through face-to-face food frequency questionnaires. Participants who reported eating less than 3.5 FV per day were considered low FV consumers.ResultsA total of 92 parent-child pairs were included, in which 45 were allocated to the intervention group and 47 to the control group. Amongst them, 64 completed the final follow-up questionnaire (30% lost to follow-up). After one year, the proportion of low FV consumers in children was significantly lower in the intervention group (29.4%) compared to the control group (66.7%, p = 0.005). Overall, 82% of the vouchers were used by the families.ConclusionsThis study found a decreased proportion of small consumers in children after 1 year of distribution of FV vouchers compared to the control group. FV vouchers could be an effective lever to increase FV consumption among children from disadvantaged households.Trial registrationClinicalTrials.gov identifier no. NCT02461238.

Cet article se propose d’explorer la configuration des logiques familiales autour des enjeux alimentaires. Les repas quotidiens sont le théâtre de négociations, d’un contrôle par les parents variable, plus ou moins intériorisé par les enfants, ou de stratégies et de tactiques utilisées par chacun en réponse aux normes nutritionnelles en vigueur et aux normes familiales. La méthodologie utilisée est ethnographique : 70 entretiens ont été menés dans les familles des élèves enquêtés après avoir passé un an à les observer au collège. Les enfants agissent différemment en fonction de leur milieu social d’origine, de leur rapport au corps mais aussi de leur groupe de pairs. Concernant le rapport aux normes nutritionnelles, nous repérons des pratiques davantage curatives en milieu populaire et davantage préventives chez les familles de milieux plus favorisés.

BackgroundThe FLAM study was set up in order to assess the effectiveness of FV vouchers allowed to low-income households, on their FV consumption. The aim of the present study was to investigate issues associated with conducting interventional trials in disadvantaged populations using the FLAM study as an example of reaching target populations and recruitment difficulties.MethodsFamilies were recruited in Saint-Denis city (North Paris suburb), via social and municipal structures. Main interest variables in the study (food consumptions) were collected using face-to-face food interviews, either at home or municipal facilities. A qualitative analysis was performed among people who refused to participate in order to understand the barriers to participation.ResultsA total of 95 parents-child pairs were included from May 2015 to May 2016. The families were mostly in precarious situation (63.3%), and most of parents were unemployed (71.3%). Almost the two third of children and 79.4% of parents were small consumers of FV (less than 3.5 servings per day). Several reasons for non-participation were reported including time constraints, understanding and mistrust issues.ConclusionsThough using facilitating strategies, we recruited fewer participants than expected. The population finally included was mainly made of precarious families with a low consumption of FV. These results highlight the importance of identifying effective facilitating strategies to improve recruitment in disadvantaged populations.Trial registrationClinicalTrial.gov no. NCT02461238, on June 3, 2015, retrospectively registered.

Taking into account healthcare professionals' perceptions of maternal behavior will help improve education for these professionals. Indeed, knowing precisely what difficulties are met by healthcare professionals when they encounter medication use during breastfeeding can help educators improve training for these professionals.