Participants Seventy-six 4th and 5th grade students from one Wisconsin FFVP school participated in...

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Participants Seventy-six 4th and 5th grade students from one Wisconsin FFVP school participated in the portion of this study analyzing fruit and vegetable intake. There were two 4th grade classes and two 5th grade classes with an average age of 9.6 years old. There were approximately equal numbers of male (48.4%) and female (51.6%) students; however, there were more 4th graders (59.2%) than 5th graders (40.8%). Just over 95% of students were Caucasian/White, while 3.2% were African American/Black and 1.6% were Hispanic/Latino/Latina. All demographic information was provided by school administration. In the analysis of other behaviors related to fruit and vegetable consumption, two 4 th grade and two 5 th grade classes from a matched control school were added to the study. The sample was restricted to students who were present on both the pretest and posttest survey days. The resulting sample consisted of 169 students, 62 from the program school and 107 from the control school. Program and control samples for this analysis were similar with respect to gender and age distributions. Background Most children and adolescents in the United States consume less than recommended amounts of fruit and vegetables (1, 2). Experts and advocates recognize the school environment as a fundamental setting for providing children access to nutritious food and opportunities to learn about the importance of healthy eating (3, 4, 5, 6). The United States Department of Agriculture (USDA) initiated its Fresh Fruit and Vegetable Program (FFVP) in 2002 as part of a broad effort to address poor nutrition and rising obesity rates among children. The FFVP began as a pilot and was expanded in 2004 and 2006, eventually becoming nationwide in 2008. This program allocates funding for selected schools to provide students with free fresh fruit and vegetable snacks outside of school lunch. The program aims to identify and develop best practices for increasing consumption of fruit and vegetables in schools to improve nutrition and combat childhood obesity. The history and implementation of the FFVP is described in more detail elsewhere (7, 8, 9, 10). Students: Judy Dickinson, Stephen Fisher, Lainee Hoffman, Stephanie Mabrey, Kevin Reinhold, April Ross and Laurelyn Wieseman Faculty Mentors: Eric Jamelske (Economics) and Lori Bica (Psychology) We gratefully acknowledge generous funding support from the UWEC Office of Research and Sponsored Programs, Blugold Commitment, Xcel Energy of Eau Claire, and Northwestern Bank of Chippewa Falls. The hypothesis that students would consistently eat the free snacks served to them is supported by current findings. Table 1 shows that on average, the students ate the entire snack nearly 75% of the time when fruit was served and just over 50% of the time when vegetables were served. In contrast, students did not even try the snack just 3.6% and 10.2% of the time when fruit and vegetables were served respectively. Figure 2 shows students ate a variety of fruit at very high rates with pear and blueberries being the least preferred. Figure 3 shows much lower rates of eating the entire snack and somewhat higher rates of not trying the snack when vegetables were served. Carrots and cucumber were eaten the most, while jicama, cauliflower, sweet potato and radishes were eaten the least. The hypothesis that program students would exhibit positive change in other behaviors related to fruit and vegetable consumption compared to control students was also supported by current findings. Repeated measures ANOVA analysis indicated that average fruit and vegetable behavior among program students at the posttest (M = 2.94, SD = .65) was higher than at the pretest (M = 2.50, SD = .72), t(61) = 6.33, P < .001. For the control students, average fruit and vegetable behavior at the posttest (M = 2.38, SD = .73) was not significantly different than the pretest (M = 2.36, SD = .71), t(106) = .266, P = .791. Figures 4 – 11 provide a more detailed look at responses from program students to individual items on this survey. Program students noticeably moved from reporting never and sometimes towards often and always for 7 of the 8 items measuring student behavior related to fruit and vegetable consumption. The only exception was choosing fruit as a snack over chips, cookies, and candy. Changes are most noticeable for trying new fruit and vegetables in school, with the percent of students reporting they would often or always nearly doubling from 46.8% to 87.1% for fruit and more than doubling from 33.9% to 74.2% for vegetables. Also noteworthy is the rising percent of students reporting they often or always ask their parents to buy fruit and vegetables which increased by nearly one-third from 50.0% to 64.5% for fruit and almost doubled from 19.4% to 37.1% for vegetables. There are limitations to the present study that could be addressed by future research. First, analyses of the impact of the FFVP would benefit from using larger, randomized samples. Second, although we find positive change in behaviors related to fruit and vegetable consumption for program students, what students report doing in a variety of circumstances may or may not reflect actual behavior. For example, since the FFVP exposed students to a variety of fruit and vegetables, including many new or unfamiliar items, and given evidence that students typically eat snacks served through the FFVP, it is reasonable to assume the reported rise in trying new fruit and vegetables at school accurately reflects students’ behavior. Reported increases in trying new fruit and vegetables at home and asking parents to purchase fruit and vegetables suggests the influence of the FFVP has reached into the home. However, we have no corroborating evidence for these self-reported behavior changes. Nevertheless, the overall consistent pattern of positive behavior change related to fruit and vegetable consumption found in this study, both at school and in the home, is encouraging. Previous Research The research literature examining the effectiveness of the FFVP is small and still developing (11, 12, 13, 14). Given the sizeable resources committed to funding the FFVP, more information is needed to understand the successes, limitations, and potential in meeting its stated goals. Previous research in Wisconsin found a significant increase in fruit and vegetable intake for participating students during school snack compared to control students (14). These results were based on intake measured at three points in time over three consecutive days in each period. This research can be improved upon in two ways which are undertaken in the present study. First, more detailed fruit and vegetable consumption data would be desirable. Second, it would be useful to know if any other behavioral changes accompanied the increased intake of fruit and vegetables for participating students. Current Research In this study, we investigated the impact of the 2009-10 FFVP on intake and other behaviors related to fruit and vegetable consumption among Wisconsin 4 th and 5 th grade students. Consumption of fruit and vegetables served through the FFVP was observed and recorded by teachers over 95 days. We hypothesized that students would consistently eat the free snacks served to them. Analyses of other behaviors related to fruit and vegetable consumption compared pretest and posttest data from an 8 item survey between program and control students. We hypothesized that program students would report Data Collection Fruit and vegetable intake data were collected only at the program school. Teachers in each of the four classrooms were trained to observe and record the rate at which students ate the fruit and vegetable snacks served through the FFVP. Teachers were provided a binder of weekly calendar pages with the name of each student. On each day a free fruit or vegetable was served, teachers recorded student behavior as absent, ate none, tried, ate half or ate all. In all, student behavior during afternoon snack was observed and recorded on 95 FFVP days. Data for other behaviors related to fruit and vegetable consumption were collected at both the program and control schools. Students completed an 8 item pretest survey before the FFVP began and a comparable posttest survey after six months. There were four questions about fruit: trying new fruit offered at home; trying new fruit offered at school; choosing fruit as a snack instead of chips, cookies or candy; asking parents to buy fruit when food shopping. There were four parallel questions for vegetables. Response options for all 8 questions were 1 = never, 2 = sometimes, 3 = often, and 4 = always. Behavior scores were calculated by taking the average across all 8 items with higher scores representing more positive behavior. Chronbach alphas calculated at the pretest (α =.85) and at the posttest (α =.88) indicate this survey Procedure The FFVP began in the program school in October 2009 with free fruit and vegetable snacks served to students three days per week. Fruit was served 66 times and vegetables were served 29 times. Figure 1 shows the variety of fruit and vegetables as well as the number of times each item was served during the study. The snacks were prepared in the school kitchen and distributed to classrooms for an organized afternoon snack shared by students and teachers. Students were allowed to bring snacks from home to eat in the afternoon on non-FFVP snack days, as was the case before the FFVP began. Introduction Method Results & Discussion

Transcript of Participants Seventy-six 4th and 5th grade students from one Wisconsin FFVP school participated in...

Page 1: Participants Seventy-six 4th and 5th grade students from one Wisconsin FFVP school participated in the portion of this study analyzing fruit and vegetable.

ParticipantsSeventy-six 4th and 5th grade students from one Wisconsin FFVP school

participated in the portion of this study analyzing fruit and vegetable intake. There

were two 4th grade classes and two 5th grade classes with an average age of 9.6

years old. There were approximately equal numbers of male (48.4%) and female

(51.6%) students; however, there were more 4th graders (59.2%) than 5th graders

(40.8%). Just over 95% of students were Caucasian/White, while 3.2% were

African American/Black and 1.6% were Hispanic/Latino/Latina. All demographic

information was provided by school administration.

In the analysis of other behaviors related to fruit and vegetable

consumption, two 4th grade and two 5th grade classes from a matched control

school were added to the study. The sample was restricted to students who were

present on both the pretest and posttest survey days. The resulting sample

consisted of 169 students, 62 from the program school and 107 from the control

school. Program and control samples for this analysis were similar with respect to

gender and age distributions.

BackgroundMost children and adolescents in the United

States consume less than recommended amounts of

fruit and vegetables (1, 2). Experts and advocates

recognize the school environment as a fundamental

setting for providing children access to nutritious food

and opportunities to learn about the importance of

healthy eating (3, 4, 5, 6). The United States

Department of Agriculture (USDA) initiated its Fresh

Fruit and Vegetable Program (FFVP) in 2002 as part of

a broad effort to address poor nutrition and rising

obesity rates among children.

The FFVP began as a pilot and was expanded in

2004 and 2006, eventually becoming nationwide in

2008. This program allocates funding for selected

schools to provide students with free fresh fruit and

vegetable snacks outside of school lunch. The program

aims to identify and develop best practices for

increasing consumption of fruit and vegetables in

schools to improve nutrition and combat childhood

obesity. The history and implementation of the FFVP

is described in more detail elsewhere (7, 8, 9, 10).

The Impact of the USDA Fresh Fruit & Vegetable Program on Children’s Consumption and Other Related Behaviors

Students: Judy Dickinson, Stephen Fisher, Lainee Hoffman, Stephanie Mabrey, Kevin Reinhold, April Ross and Laurelyn Wieseman

Faculty Mentors: Eric Jamelske (Economics) and Lori Bica (Psychology)

We gratefully acknowledge generous funding support from the UWEC Office of Research and Sponsored Programs, Blugold Commitment, Xcel Energy of Eau Claire, and Northwestern Bank of Chippewa Falls.

We would also like to thank Dr. April Bleske-Rechek, Dr. Jeffrey Goodman, Dr. William Klish, and the many teachers, administrators and food service personnel in the two participating schools.

The hypothesis that students would consistently eat the free snacks served to them is supported by current findings. Table 1 shows that

on average, the students ate the entire snack nearly 75% of the time when fruit was served and just over 50% of the time when vegetables were

served. In contrast, students did not even try the snack just 3.6% and 10.2% of the time when fruit and vegetables were served respectively.

Figure 2 shows students ate a variety of fruit at very high rates with pear and blueberries being the least preferred. Figure 3 shows much

lower rates of eating the entire snack and somewhat higher rates of not trying the snack when vegetables were served. Carrots and cucumber

were eaten the most, while jicama, cauliflower, sweet potato and radishes were eaten the least.

The hypothesis that program students would exhibit positive change in other behaviors related to fruit and vegetable consumption

compared to control students was also supported by current findings. Repeated measures ANOVA analysis indicated that average fruit and

vegetable behavior among program students at the posttest (M = 2.94, SD = .65) was higher than at the pretest (M = 2.50, SD = .72), t(61) =

6.33, P < .001. For the control students, average fruit and vegetable behavior at the posttest (M = 2.38, SD = .73) was not significantly

different than the pretest (M = 2.36, SD = .71), t(106) = .266, P = .791.

Figures 4 – 11 provide a more detailed look at responses from program students to individual items on this survey. Program students

noticeably moved from reporting never and sometimes towards often and always for 7 of the 8 items measuring student behavior related to fruit

and vegetable consumption. The only exception was choosing fruit as a snack over chips, cookies, and candy. Changes are most noticeable for

trying new fruit and vegetables in school, with the percent of students reporting they would often or always nearly doubling from 46.8% to

87.1% for fruit and more than doubling from 33.9% to 74.2% for vegetables. Also noteworthy is the rising percent of students reporting they

often or always ask their parents to buy fruit and vegetables which increased by nearly one-third from 50.0% to 64.5% for fruit and almost

doubled from 19.4% to 37.1% for vegetables.

There are limitations to the present study that could be addressed by future research. First, analyses of the impact of the FFVP would

benefit from using larger, randomized samples. Second, although we find positive change in behaviors related to fruit and vegetable

consumption for program students, what students report doing in a variety of circumstances may or may not reflect actual behavior. For

example, since the FFVP exposed students to a variety of fruit and vegetables, including many new or unfamiliar items, and given evidence

that students typically eat snacks served through the FFVP, it is reasonable to assume the reported rise in trying new fruit and vegetables at

school accurately reflects students’ behavior. Reported increases in trying new fruit and vegetables at home and asking parents to purchase

fruit and vegetables suggests the influence of the FFVP has reached into the home. However, we have no corroborating evidence for these self-

reported behavior changes. Nevertheless, the overall consistent pattern of positive behavior change related to fruit and vegetable consumption

found in this study, both at school and in the home, is encouraging.

Overall, the FFVP increases availability and accessibility and provides repeated exposure to a variety of fruit and vegetables for

participating students resulting in positive changes in intake as well as other behaviors related to fruit and vegetable consumption. Further

advances in the study of the FFVP will require collaborative partnerships between researchers and school staff to design more thorough

evaluations. This could include providing students with choices between fruit, vegetables and other alternatives to observe their behavior.

Student behavior could also be observed as they are actively encouraged to bring fruit and vegetables from home for school snack on non-

FFVP days. Such efforts would also benefit from data collection in the home via parent survey or even direct home observations.

Previous ResearchThe research literature examining the

effectiveness of the FFVP is small and still developing

(11, 12, 13, 14). Given the sizeable resources

committed to funding the FFVP, more information is

needed to understand the successes, limitations, and

potential in meeting its stated goals. Previous research

in Wisconsin found a significant increase in fruit and

vegetable intake for participating students during

school snack compared to control students (14).

These results were based on intake measured at

three points in time over three consecutive days in each

period. This research can be improved upon in two

ways which are undertaken in the present study. First,

more detailed fruit and vegetable consumption data

would be desirable. Second, it would be useful to

know if any other behavioral changes accompanied the

increased intake of fruit and vegetables for

participating students.

Current ResearchIn this study, we investigated the impact of the

2009-10 FFVP on intake and other behaviors related

to fruit and vegetable consumption among Wisconsin

4th and 5th grade students. Consumption of fruit and

vegetables served through the FFVP was observed and

recorded by teachers over 95 days. We hypothesized

that students would consistently eat the free snacks

served to them. Analyses of other behaviors related to

fruit and vegetable consumption compared pretest and

posttest data from an 8 item survey between program

and control students. We hypothesized that program

students would report favorable behavior changes

related to fruit and vegetable consumption compared

to control students.

Data Collection Fruit and vegetable intake data were collected only at the program school.

Teachers in each of the four classrooms were trained to observe and record the rate

at which students ate the fruit and vegetable snacks served through the FFVP.

Teachers were provided a binder of weekly calendar pages with the name of each

student. On each day a free fruit or vegetable was served, teachers recorded

student behavior as absent, ate none, tried, ate half or ate all. In all, student

behavior during afternoon snack was observed and recorded on 95 FFVP days.

Data for other behaviors related to fruit and vegetable consumption were

collected at both the program and control schools. Students completed an 8 item

pretest survey before the FFVP began and a comparable posttest survey after six

months. There were four questions about fruit: trying new fruit offered at home;

trying new fruit offered at school; choosing fruit as a snack instead of chips,

cookies or candy; asking parents to buy fruit when food shopping. There were four

parallel questions for vegetables. Response options for all 8 questions were 1 =

never, 2 = sometimes, 3 = often, and 4 = always. Behavior scores were calculated

by taking the average across all 8 items with higher scores representing more

positive behavior. Chronbach alphas calculated at the pretest (α =.85) and at the

posttest (α =.88) indicate this survey maintains good internal consistency.

All surveys were conducted with paper and pencil in classrooms with

assistance from teachers and trained student research assistants. Instructions were

read aloud to the entire class while others circulated through the room helping

students understand and answer the questions.

Procedure The FFVP began in the program school in October 2009 with free fruit and

vegetable snacks served to students three days per week. Fruit was served 66

times and vegetables were served 29 times. Figure 1 shows the variety of fruit

and vegetables as well as the number of times each item was served during the

study. The snacks were prepared in the school kitchen and distributed to

classrooms for an organized afternoon snack shared by students and teachers.

Students were allowed to bring snacks from home to eat in the afternoon on non-

FFVP snack days, as was the case before the FFVP began.

Introduction Method Results & Discussion