Identifying opportunities for strengthening advice to enhance vegetable liking in the early years of life: Qualitative consensus and triangulation methods

Lucinda K. Bell, Claire Gardner, Saravana Kumar, Hoi Y. Wong, Brittany Johnson, Rebecca Byrne, Karen J. Campbell, Djin Gie Liem, Catherine G. Russell, Elizabeth Denney-Wilson, Merryn Netting, Lola Bishop, David Cox, Astrid A.M. Poelman, Jennifer C. Arguelles, Rebecca K. Golley

Research output: Contribution to journalArticlepeer-review


Objective: To prioritise and refine a set of evidence-informed statements into advice messages to promote vegetable liking in early childhood, and to determine applicability for dissemination of advice to relevant audiences. Design: A nominal group technique (NGT) workshop and a Delphi survey were conducted to prioritise and achieve consensus (≥70% agreement) on 30 evidence-informed maternal (perinatal and lactation stage), infant (complementary feeding stage) and early years (family diet stage) vegetable-related advice messages. Messages were validated via triangulation analysis against the strength of evidence from an Umbrella review of strategies to increase children's vegetable liking, and gaps in advice from a Desktop review of vegetable feeding advice. Setting: Australia. Participants: A purposeful sample of key stakeholders (NGT workshop, n=8 experts; Delphi survey, n=23 end-users). Results: Participant consensus identified the most highly ranked priority messages associated with the strategies of: 'in-utero exposure' (perinatal and lactation, n=56 points); and 'vegetable variety' (complementary feeding, n=97 points; family diet, n=139 points). Triangulation revealed two strategies ('repeated exposure' and 'variety') and their associated advice messages suitable for policy and practice, 12 for research and four for food industry. Conclusions: Supported by national and state feeding guideline documents and resources, the advice messages relating to 'repeated exposure' and 'variety' to increase vegetable liking can be communicated to families and caregivers by healthcare practitioners. The food industry provides a vehicle for advice promotion and product development. Further research, where stronger evidence is needed, could further inform strategies for policy and practice, and food industry application.

Original languageEnglish
JournalPublic Health Nutrition
Publication statusAccepted/In press - 2021


  • Children
  • Delphi
  • Guidelines
  • Nominal Group Technique
  • Stakeholders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

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