1. Background EAT.RIGHT.NOW. (ERN) is a nutrition education outreach program, available to Supplemental Nutrition Assistance Program (SNAP) eligible students enrolled in The School District of Philadelphia (SDP). ERN is a component of the PA TRACKS initiative, funded by the U.S. Department of Agriculture (USDA) Food and Nutrition Service (FNS), with matching state and local support. Research shows that vegetable consumption has positive effects on children’s health and weight status. 1,2 Low vegetable intake can be attributed to a number of factors that influence behavior, including knowledge, attitude, self-efficacy, and preference. 3,4 Project Overview Vegetable Core (VC) is a fourth grade classroom-based standardized intervention that aims to increase vegetable consumption in children. VC was implemented and evaluated in select SDP schools during the 2011-12 school year (SY). The School District of Philadelphia (SDP) Office of Research and Evaluation (ORE) aimed to investigate changes in student content knowledge and other key VC measures over an extended period of time. Methods During the 2011-12 SY, 588 4 th grade students participated in the VC evaluation. They completed pre- and post-surveys which included questions regarding VC knowledge, self-efficacy, attitude, and preference measures. In the 2012-13 SY follow-up evaluation, the final sample was reduced to 365 students. Results/Conclusions Results from the 2011-12 SY pre- and post-surveys indicated VC significantly improved students’ knowledge, attitude, self-efficacy, and preference regarding vegetables (see Table 1). Although there was a significant decrease in VC knowledge scores from 4 th grade post-survey to 5 th grade follow-up (see Table 2), the mean score at 5 th grade follow-up was significantly higher than 4 th grade pre-survey scores (see Table 3), indicating that VC knowledge was retained to some extent (see Figure 1). Research to Practice Strategies The VC intervention did not generate persistent long- term positive results. With the absence of the VC lessons, there were significant declines in students’ vegetable attitudes and preferences during the 2012-13 SY. ORE recommends that nutrition education be delivered over longer periods of time with reinforcement lessons or activities in order to help sustain knowledge, self-efficacy, attitude and preference toward vegetable consumption and other healthy eating behaviors. Eat.Right.Now. Nutrition Education: Long-term Impacts of 4 th Grade Vegetable Core Intervention Contact Information Alicia A. Dahl, M.S. Research Specialist The School District of Philadelphia Office of Research and Evaluation (215) 400-6491 adahl@philasd.org VC MeasureMax. Score 4 th Pre Mean 5 th Follow- Up Mean t- value p-value Knowledge42.733.12-5.025<0.001 Attitude107.877.602.3810.018 Self-efficacy107.737.650.6080.544 Preference5035.9135.431.2540.211 VC MeasureMax. Score 4 th Post Mean 5 th Follow- Up Mean t- value p- value Knowledge43.923.1610.19<0.001 Attitude107.907.632.190.029 Self-efficacy107.857.611.910.57 Preference5037.4835.594.87<0.001 Table 3. Vegetable Core Pre- and Follow-up Scores Figure 1. Estimated Marginal Means of VC Knowledge Scores from Pre(1), to Post (2), to Follow-Up(3) Surveys Table 2. Vegetable Core Post- and Follow-Up Scores VC MeasureMax. Score 4 th Pre Mean 4 th Post Mean Mean Change p-value Knowledge42.703.811.11<0.001 Attitude107.838.010.180.038 Self-efficacy107.677.890.220.016 Preference5036.2437.531.29<0.001 Table 1. Vegetable Core Pre- and Post-Survey Scores 1 Centers for Disease Control and Prevention. (2013). State Indicator Report on Fruits and Vegetables 2013. National Center for Chronic Disease Prevention and Health Promotion: Division of Nutrition, Physical Activity, and Obesity. Retrieved from http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdfhttp://www.cdc.gov/nutrition/downloads/State-Indicator-Report-Fruits-Vegetables-2013.pdf 2 Tohill, B. C. (2005). Dietary intake of fruit and vegetables and management of body weight. World Health Organization. Retrieved from http://www.who.int/dietphysicalactivity/publications/f&v_weight_management.pdf?ua=1http://www.who.int/dietphysicalactivity/publications/f&v_weight_management.pdf?ua=1 3 Reinaerts, E., de Nooijer, J., Candel, M., & de Vries, N. (2007). Explaining school children’s fruit and vegetable consumption: The contributions of availability, accessibility, exposure, parental consumption and habit in addition to psychosocial factors. Appetite, 48(2), 248-258. http://dx.doi.org/10.1016/j.appet.2006.09.007http://dx.doi.org/10.1016/j.appet.2006.09.007 4 Wall, D. E., Least, C., Gromis, J., & Lohse, B. (2011). Nutrition education intervention improves vegetable-related attitude, self-efficacy, preference, and knowledge of fourth- grade students. Journal of School Health, 82(1), 37-43.