University of Wisconsin-Eau Claire An Evaluation of the USDA Fresh Fruit and Vegetable Pilot Program...
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University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
An Evaluation of the USDA Fresh Fruit and Vegetable Pilot Program in
Wisconsin Schools
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
OverviewOverview
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
IntroductionIntroduction
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
IntroductionIntroduction
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
WI Fresh Fruit & Vegetable ProgramWI Fresh Fruit & Vegetable Program
Unique partnerships
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Wisconsin Fresh Fruit &Vegetable ProgramWisconsin Fresh Fruit &Vegetable Program
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Evaluation ProcessEvaluation 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)*
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
SampleSample
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Table 1: Pretest Data Willingness to Try New Fruits/Vegetables and to Choose Fruits/Vegetables as Snacks
Variable
N % Willing
Try new fruit at school 1120 33.8%
Try new vegetable at school 1118 20.8%
Try new fruit at home 1121 55.6%
Try new vegetable at home 1121 32.9%
Choose fruit as snack instead of chips/candy 1122 40.0%
Choose vegetable as snack instead of chips/candy 1120 21.0%
Note: The sample size varies due to non-response for some questions.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Measurement & EvaluationMeasurement & Evaluation
Indicator variable equal to 1 for those students with a positive change between the pre-test and post-test and 0 otherwise
14. If you were given a new kind of fruit at home, would you try it? I would not try it I might try it I would try it
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Table 2: Pretest/Posttest Comparison Willingness to Try New Fruits/Vegetables and to Choose Fruits/Vegetables as Snacks
Treatment
Control
Variable
N
% Positive Change
N
% Positive Change
p
Try new fruit at school
741
24.8% 337
12.8%
<0.01
Try new vegetable at school
736
25.1% 337 18.4%
0.01
Try new fruit at home
741
15.4% 336 13.1%
0.31
Try new vegetable at home
740
18.2% 339 17.4%
0.74
Choose fruit as snack instead of chips/candy
742
18.1% 339 15.0%
0.21
Choose vegetable as snack instead of chips/candy
737
20.1% 336 16.4%
0.14
Note: The sample size varies due to missing data for some items.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Measurement & EvaluationMeasurement & 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)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Table 3: Fourth Grade Pretest/Posttest Comparison Willingness to Try New Fruits/Vegetables & to Choose Fruits/Vegetables as Snacks
Variable
Program N
% Program Positive Change
Control N
% Control Positive Change
p
Try new fruit at school
347
25.1% 117
11.1%
<0.01
Try new vegetable at school
345
26.7% 115 12.2%
<0.01
Try new fruit at home
348
19.0% 115 13.9%
0.19
Try new vegetable at home
349
22.9% 117 17.1%
0.16
Choose fruit as snack instead of chips/candy
349
19.8% 117 18.8%
0.82
Choose vegetable as snack instead of chips/candy
346
24.3% 115 14.8%
0.02
Note: The sample size varies due to missing data for some items.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Measurement & EvaluationMeasurement & 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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Measurement & EvaluationMeasurement & 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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Table 4: Students With Low Initial Consumption Pretest/Posttest Comparison Willingness to Try New Fruits/Vegetables & Fruit/Vegetable Consumption
Variable
Program N
% Program Positive Change
Control N
% Control Positive Change
p
Try new fruit at school
83
32.5% 33
15.2%
0.04
Try new vegetable at school
82
32.9% 33 15.2%
0.03
Average Daily Fruit and Vegetable Intake
86
62.8% 34 47.1%
0.13
Note: The sample size varies due to missing data for some items.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Measurement & EvaluationMeasurement & 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)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
FindingsFindings
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
FindingsFindings
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Future Research PlansFuture 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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
T eac her L ikes P rog ram
23.7
76.3
0 10 20 30 40 50 60 70 80 90
S omewhat Agree
Agree
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
S tudents E njoy P rog ram
31.6
68.4
0 10 20 30 40 50 60 70 80
S omewhat A gree
A gree
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
S nac ks G iven In C las s room
2.6
26.3
71.1
0 10 20 30 40 50 60 70 80
S ometimes
Often
Always
T eac her E at S nac ks
5.3
18.4
44.7
31.6
0 10 20 30 40 50
Never
S ometimes
Often
A lways
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Nutrition E duc ation
18.4
47.4
13.2
21.1
0 10 20 30 40 50
Never
S ometimes
Often
A lways
P arents Involved
63.2
15.8
2.6
13.2
5.3
0 10 20 30 40 50 60 70
Never
S ometimes
Often
A lways
No R es pons e
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
P arent L ikes P rog ram
0.8
0.4
7.8
86.7
4.3
0 20 40 60 80 100
Dis agree
S omewhat Dis agree
S omewhat A gree
A gree
No R es pons e
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
C hild E njoys
2.3
1.6
18.4
71.5
2
4.3
0 10 20 30 40 50 60 70 80
Dis agree
S omewhat Dis agree
S omewhat A gree
A gree
Don't K now
No R es pons e
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Quantity of Veg etables C hild E ats
1.6
52
39.1
2
5.5
0 10 20 30 40 50 60
L es s
S ame
More
Don't K now
No R es pons e
Quantity of F ruits C hild E ats
37.9
52.3
3.5
6.3
0 10 20 30 40 50 60
S ame
More
Don't K now
No R es pons e
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
New F ruits T ried
10.2
59.4
21.5
3.9
5.1
0 10 20 30 40 50 60 70
None
S ome
Many
Don't K now
No R es pons e
New Veg etables T ried
16.4
55.1
18.4
5.1
5.1
0 10 20 30 40 50 60
None
S ome
Many
Don't K now
No R es pons e
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
C hild As ks P arent to B uy F &V
48.4
45.7
5.9
0 10 20 30 40 50 60
S ame
More
No R es pons e
P arent B uys F &V When C hild As ks
8.6
24.2
57.4
4.7
5.1
0 10 20 30 40 50 60 70
S ometimes
Often
A lways
C hild Never A s ks
No R es pons e
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Involved as a P arent
76.2
16.4
0.8
2.3
4.3
0 10 20 30 40 50 60 70 80 90
Never
S ometimes
Often
Always
No R es pons e
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Teacher CommentsTeacher 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.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Parent CommentsParent 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.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionsConclusions
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
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Future ResearchFuture 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