University of Wisconsin-Eau Claire Evaluating the USDA Fresh Fruit & Vegetable Program Using...
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University of Wisconsin-Eau Claire University of Wisconsin-Eau Claire Evaluating the USDA Fresh Fruit & Vegetable Program Using Incentives and Reminders to Increase Fruit and Vegetable Intake Among Wisconsin Elementary School Students Amber Jamelske, Bryan Reinhold, Kevin Reinhold and Elizabeth Reinke Faculty Mentors: Dr. Lori Bica and Dr. Eric Jamelske University of Wisconsin-Eau Claire Economics & Psychology Departments Chippewa Valley Center for Economic Research & Development
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Transcript of University of Wisconsin-Eau Claire Evaluating the USDA Fresh Fruit & Vegetable Program Using...
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Evaluating the USDA Fresh Fruit & Vegetable Program
Using Incentives and Reminders to Increase Fruit and Vegetable Intake
Among Wisconsin Elementary School Students
Evaluating the USDA Fresh Fruit & Vegetable Program
Using Incentives and Reminders to Increase Fruit and Vegetable Intake
Among Wisconsin Elementary School Students
Amber Jamelske, Bryan Reinhold, Kevin Reinhold and Elizabeth Reinke
Faculty Mentors: Dr. Lori Bica and Dr. Eric Jamelske
University of Wisconsin-Eau ClaireEconomics & Psychology Departments
Chippewa Valley Center for
Economic Research & Development
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
OverviewOverview Introduction USDA Fresh Fruit & Vegetable Program
2008-09 Evaluation– Morning Snack– F&V Coupons
2009-10 Evaluation– Daily Snack Track– Incentives & Reminders
Questions and Discussion
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
IntroductionIntroduction
Overweight and obesity among children.
Inadequate fruit and vegetable consumption (not 5-9 a day).
USDA Fresh Fruit and Vegetable Program (FFVP) was created to improve nutrition and help combat childhood obesity (2002).
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
The FFVP provides funding for students from selected schools to receive a free fruit or vegetable (FV) snack 3-4 days a week for an academic year.
Wisconsin first received FFVP funding in 2006 and the FFVP was expanded to all 50 states plus the District of Columbia, Guam, Puerto Rico and Virgin Islands through the 2008 US Farm Bill.
USDA– http://www.fns.usda.gov/cnd/FFVP/FFVPdefault.htm
Wisconsin Department of Public Instruction– http://dpi.wi.gov/fns/ffvp.html
The Fresh Fruit & Vegetable ProgramThe Fresh Fruit & Vegetable Program
The Fresh Fruit & Vegetable ProgramThe Fresh Fruit & Vegetable Program
The Fresh Fruit & Vegetable ProgramThe Fresh Fruit & Vegetable Program
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
4 Western Wisconsin Elementary Schools– 2 program and 2 matched control– 4th and 5th grade students
Survey questions– How many FV do students eat?– Day In The Life Questionnaire (DILQ)– Average daily F/V intake (measured over 3 days)
2008-09 Evaluation Process2008-09 Evaluation Process
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Full Sample Demographics N = 347Full Sample Demographics N = 347
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
2008-09 Evaluation Process2008-09 Evaluation Process
Pre-test survey – September 2008
Program began – October 2008 Morning snack in classroom (3 or 4 days a week)
Post-test I survey – December 2008 Post-test II survey – April 2009
Pre-test – Post-test II change in FV intake– DILQ, average daily F/V intake (measured over 3 days)
Baseline Fruit & Vegetable IntakeBaseline Fruit & Vegetable Intake
Average FV intake generally low. Students do not eat FV for Morning snack.
Most FV consumption during lunch. Differences in FV intake attributable to FV offered on lunch menu.
FV Offerings at School LunchFV Offerings at School Lunch
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Fruit & Vegetable Snacks & SurveysFruit & Vegetable Snacks & Surveys Free FV snack in the classroom for morning snack
Surveys conducted on Tuesday, Wednesday and Thursday FV intake recall from Monday, Tuesday and Wednesday
School 1: Four days per week
School 2: Three days per week
School 1: cauliflower (50%), papaya (51%), pineapple (81%)– Fruit: 2 out of 3 days (2/3) Vegetable: 1 out of 3 days (1/3)
School 2: none, papaya (18%), orange (80%)– Fruit: 2 out of 3 days (1/3) Vegetable: 1 out of 3 days (1/3)
Change in FV Intake at Morning SnackChange in FV Intake at Morning Snack
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Fruit & Vegetable Snacks & SurveysFruit & Vegetable Snacks & Surveys Free FV snack in the classroom for morning snack
Surveys conducted on Tuesday, Wednesday and Thursday FV intake recall from Monday, Tuesday and Wednesday
School 1: Four days per week
School 2: Three days per week
School 1: watermelon (92%), cucumber (73%), apple (81%)– Fruit: 2 out of 3 days (2/3) Vegetable: 1 out of 3 days (1/3)
School 2: none, grapes (84%), carrots (62%)– Fruit: 1 out of 3 days (1/3) Vegetable: 1 out of 3 days (1/3)
Change in FV Intake at Morning SnackChange in FV Intake at Morning Snack
Morning Snack ComparisonMorning Snack Comparison
Free F/V morning snack (Tuesday survey, Monday recall)– School 1: watermelon (92%) – School 2: none
What FV Snacks Were Provided?What FV Snacks Were Provided?
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionConclusion
The FFVP Works!
Meaningful ↑ FV intake for intervention students by providing free access during the morning snack period (compared to control group).
Program effect is limited.
No evidence of ↑ FV intake without free access.– Breakfast, after-school snack, dinner, night-time snack, non-FFVP days
If students are provided with free FV with no alternatives
THEY WILL EAT THEM!
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Free and Discount CouponsFree and Discount Coupons
34 families of students from the two intervention schools were given 5 free coupons each redeemable for $2 free FV (valid one week).
Same families also given 3 discount coupons each redeemable for $2 off a $5 FV purchase (valid the following week).
Coupon redemption rates.
DILQ given 3 days during week that free coupons were valid.
Did students that redeemed free coupons show increased FV intake compared to control group from same schools?
Free and Discount CouponsFree and Discount Coupons
Nearly every family took advantage of the free coupons which required nothing more than a trip to the grocery store to buy the FV.
27 families redeemed at least 4 free coupons.
Most families did not make use of the discount coupons which would have required them to spend some of their own money in addition to going to the grocery store.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionConclusion
Small, but significant increase in FV intake among free coupon students compared to control students.
Limited to FRUIT: breakfast, dinner and night-time snack.
Increases occurred when parents were likely home.
Schools cannot afford to use free FV coupons to expand the reach of the FFVP into the home.
This research could be applied to other USDA programs considering FV: WIC and Food Stamps.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
2009-10 Research Evaluation2009-10 Research Evaluation
Four New Western Wisconsin elementary schools
One intensive intervention*
Daily FV snack tracking*
Incentives and reminders*
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Intensive InterventionIntensive Intervention
4th and 5th grade classrooms (4)
Free FV snacks served three days a week for afternoon snack.
Do students bring FV snacks from home on non-FFVP snack days?
Do incentives and reminders help?
F&V Snack Track – Binder - Wall ChartF&V Snack Track – Binder - Wall Chart
Wednesday & Friday: Teacher writes FV snack brought from home.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
FFVP Snack DaysFFVP Snack Days
October 2009 – March 2010.
Do students eat FV snacks FFVP snack days?
Celery, Jicama, Pear, Kiwi served multiple times.
Four classrooms.
Free FFVP SnacksFree FFVP Snacks
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Non-FFVP Snack DaysNon-FFVP Snack Days
Five periods of study between October 2009 – March 2010.
Do students bring FV snacks from home on non-FFVP snack days?
Do incentives and reminders help?
Three teachers.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Non-FFVP Snack DaysNon-FFVP Snack Days
Period 1: No incentives.
Period 2: Sticker wall chart.
Period 3: Sticker wall chart and toy prizes.– Holiday Break
Period 4: No incentives
Period 5: Mixed incentives and reminders
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Period 5Period 5
Teacher 2: Stop everything (only track in binder).– She was doing HW reminders and positive modeling and praise
Teachers 1 & 4: HW reminders, positive modeling, praise and toy prizes.
Teacher 3: HW reminders, positive modeling, praise, but no toy prizes.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionConclusion
Using toy prizes as incentives can influence students to bring FV items from home to eat as a snack at school when they otherwise would not have done so.
Most successful when teacher uses HW reminders and engages students with positive modeling and praise.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionConclusion
This research is compelling because it provides a framework for schools to expand the reach of the FFVP beyond the access to free FV provided as snacks in the classroom.
Perhaps the most important aspect of the incentive scheme presented in this study is that it is both feasible and affordable in terms of time, resources and money….
And it seems to work effectively!
Come see our two posters in the Riverview Ballroom**
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
