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. University of Wisconsin-Eau Claire 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. University of Wisconsin-Eau Claire 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. University of Wisconsin-Eau Claire WI Fresh Fruit & Vegetable Program  Unique partnerships

6. University of Wisconsin-Eau Claire Wisconsin Fresh Fruit &Vegetable Program

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

8. University of Wisconsin-Eau Claire

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

10. University of Wisconsin-Eau Claire

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

12. University of Wisconsin-Eau Claire

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)

14. University of Wisconsin-Eau Claire

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. University of Wisconsin-Eau Claire 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

17. University of Wisconsin-Eau Claire

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)  4 th 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. University of Wisconsin-Eau Claire 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 4 th graders

20. University of Wisconsin-Eau Claire 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. University of Wisconsin-Eau Claire Future Research Plans  Also important for program success is the commitment and support of school personnel and administration  We conducted surveys of 5 th 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

22. University of Wisconsin-Eau Claire

32. Teacher Comments  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.  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.

33. University of Wisconsin-Eau Claire Parent Comments  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!  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.

34. University of Wisconsin-Eau Claire 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. University of Wisconsin-Eau Claire 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