An Evaluation of the USDA Fresh Fruit and Vegetable Pilot Program in Wisconsin Schools

1. University of Wisconsin-Eau Claire An Evaluation of the USDA Fresh Fruit and Vegetable Pilot Program in Wisconsin Schools Anjali Anand and Beth Lutz Undergraduate Students University of Wisconsin-Eau Claire Eric Jamelske, Ph.D. Assistant Professor, Economics Department University of Wisconsin-Eau Claire Lori Bica, Ph.D. Associate Professor, Psychology Department University of Wisconsin-Eau Claire

2. Overview • Motivation & introduction • Fresh fruit and vegetable program • Evaluation process • Willingness to try new fruits & vegetables • Changes in consumption for low intake students • Teacher & parent surveys • Discussion & future research

3. Introduction • Overweight is now the most common medical condition of childhood in the United States, with the prevalence having more than doubled over the past 20 years • Poor nutrition, including inadequate fruit and vegetable consumption amongst children and adolescents, remains a central cause • In 2002, the U.S. Department of Agriculture (USDA) Fresh Fruit and Vegetable Program (FFVP) was created to improve nutrition and help combat childhood obesity

4. Introduction • In November 2005, Wisconsin was added as an expansion state • 25 schools provided daily fruit and vegetable snacks to students in combination with nutrition education • We evaluate whether this program resulted in positive changes in attitude and behavior in terms of eating fruits and vegetables

5. WI Fresh Fruit & Vegetable Program • Unique partnerships

6. Wisconsin Fresh Fruit &Vegetable Program

7. Evaluation Process • Pre-program survey March 2006 (4th, 7th, 9th grades)* • Post-program survey I May, June 2006 (4th, 7th, 9th grades)* • Post-program survey II March 2007 (5th, 8th, 10th grades) • 25 program and 10 control schools • Monthly food service reports • Teacher and parent surveys (5th grade)*

9. Sample • Pretest sample of 2,863 • 2,287 treatment 576 control • Posttest data entered for a subset of full sample • Further limited to only those with both pretest and posttest responses to survey questions that are the focus of this study • 1,127 participants • 784 in 10 treatment schools & 343 in 10 control schools

11. Measurement & Evaluation • Indicator variable equal to 1 for those students with a positive change between the pre-test and post-test and 0 otherwise

13. Measurement & Evaluation • Probit regression analysis • gender, race/ethnicity, grade, physical activity, TV/video game limits, family dinners, and fast-food consumption • Treatment students were 12.1 percentage points more likely to report increased willingness to try a new fruit at school (p < 0.01) • Treatment students were 6.7 percentage points more likely to report increased willingness to try a new vegetable at school (p = 0.02)

15. Measurement & Evaluation • Students reported their eating patterns using a list of food items, including 39 fruits and vegetables, for three consecutive days • Calculated each student's average daily fruit and vegetable intake for the three-day period • Subset of students who reported average daily fruit and vegetable intake of one or less on the pretest

16. Measurement & Evaluation • Indicator variable equal to 1 for those students with a positive change between the pretest and posttest and 0 otherwise • Positive change was defined as an increase in average daily fruit and vegetable intake of at least 0.2 from pretest to posttest • The mean of this new variable measures the percent of students that increased their average daily fruit and vegetable consumption between the pretest and posttest

18. Measurement & Evaluation • A probit regression analysis with controls • Treatment students who reported low consumption initially were 19.5 percentage points more likely than control school students to report increased average daily intake of fruits and vegetables (p = 0.07) • 4th grade treatment students (n = 40) were 29.7 percentage points more likely than control students (n = 17) to report increased average daily fruit and vegetable intake (p = 0.05)

19. Findings • We find a difference between the groups in willingness to try new fruits and vegetables at school, but not at home • These findings are not surprising given that school is where students are exposed to the new foods and where they are engaging in activities designed to promote fruits and vegetables • We find some evidence of a difference between the groups in increased average daily fruit and vegetable intake among students with low initial consumption • Positive program impacts were largest among 4th graders

20. Findings • Long term program success will require impacting both attitude and behavior beyond school and into the home • We anticipate that differences in attitudes toward trying new fruits and vegetables at home will emerge with longer exposure to the program • We also anticipate that differences in average daily fruit and vegetable intake will grow with longer exposure to the program

21. Future Research Plans • Also important for program success is the commitment and support of school personnel and administration • We conducted surveys of 5th grade teachers (N=38, 15 schools) and parents (N=256, 15 schools) in May 2007 • 1,100 fifth grade students in 16 schools • 52 fifth grade teachers in 16 schools

32. Teacher Comments • We talked about nutrition, good snacks vs. bad snacks. • We had 1/2 a pg. color sheets…they colored it the color of the snack too, to see if they were getting diverse variety of nutrients. • We have a food pyramid & connect to it…we cooked some items and tried recipes. • Students looked forward to the snacks...actually they seemed to work harder and with more focus. • We discussed the nutritional value of fruits & veggies to our bodies. • Our kitchen staff sent emails about the nutrients & the students in my class would look up what the nutrients help in our body.

33. Parent Comments • On weekends fruits and veggies are now also the snack of choice. • My son loves fruits and veggies now. • I only wish it had been offered earlier… • It has helped to reinforce what I've tried to do at home…they've accepted what I'm saying more readily. • When children see other kids eating fruits and vegetables, it makes them want to eat them too. • As parents, we love the fruit and vegetable program. • My son wants me to tell you, Please Don't Stop! • It lets him try a variety of fruits and vegetables we might not always buy at home. • Great Program! Builds awareness of healthy eating habits. Reinforces the message we give at home!

34. Conclusions • Both parents and teachers like the program and perceive that students also like the program • Parents report students trying more new fruits and vegetables and eating more fruits and vegetables overall • Almost half of parents report their children asking to buy more fruits and vegetables • Nutrition education activities in the classroom and parental involvement in the program are lower than desired

35. Future Research • Analyze program effects after one year • Examine food service reports to identify best practices • Focus on schools with intensive intervention • Further examine dietary recall data and changes in average daily fruit and vegetable intake • Continue more detailed analysis of teacher and parent surveys