Fresh Fruit and Vegetable Program and Requests for Fruits and Vegetables Outside School Settings

J Acad Nutr Diet. 2018 Aug;118(8):1408-1416. doi: 10.1016/j.jand.2017.10.013. Epub 2018 Jan 8.

Abstract

Background: Consumption of fruits and vegetables (F/V) among elementary school-aged children remains inadequate, especially among low-income children. The US Department of Agriculture's Fresh Fruit and Vegetable Program (FFVP) provides F/V as snacks to children during the school day, outside of school meals. School-based initiatives are successful in changing behaviors in school settings; however, their influence on behaviors outside of schools needs investigation.

Objective: To examine whether FFVP participation is associated with F/V requests at stores, self-efficacy to ask for and choose F/V at home, and F/V consumption.

Design: Cross-sectional study.

Participant/setting: Fourth graders in six classrooms (n=296) from three urban, low-income school districts in Phoenix, AZ, were surveyed during 2015; one FFVP and one non-FFVP school from each district that were similar in school size, percent free/reduced-price meal eligibility, and race/ethnicity of enrolled students were selected.

Main outcome measures: Children's self-reported F/V requests during shopping, their self-efficacy to ask for and choose F/V at home, and F/V consumption on the previous day (non-FFVP school day) were measured using questions adapted from validated surveys.

Statistical analysis: Multivariable mixed-effect regression models, adjusting for clustering of students within classes and classes within schools were explored.

Results: In models adjusting for individual-level factors (ie, age and sex) only, several significant positive associations were observed between school FFVP participation and healthier F/V outcomes. After additionally adjusting for school-level factors (ie, total enrollment and % Hispanic/Latino students) significant associations were observed between school FFVP participation and more requests for vegetables during shopping (P<0.001), higher scores on self-efficacy to choose vegetables at home (P=0.004), stronger preferences for vegetables (P<0.001), and more frequent consumption of fruit (P=0.006).

Conclusions: School FFVP participation was associated with more requests for vegetables during shopping and higher self-efficacy to make healthy choices at home, suggesting the influence of the FFVP may extend beyond the school day.

Keywords: Fresh Fruit and Vegetable Program; Fruits and vegetables; Low-income; School Food Program; School food.

MeSH terms

  • Arizona
  • Child
  • Cross-Sectional Studies
  • Diet / psychology
  • Diet / statistics & numerical data*
  • Female
  • Food Preferences / psychology*
  • Food Services*
  • Fruit
  • Humans
  • Male
  • Poverty / psychology
  • Program Evaluation
  • School Health Services*
  • Students / psychology*
  • United States
  • United States Department of Agriculture
  • Urban Population / statistics & numerical data
  • Vegetables