University of Wisconsin-Eau Claire Getting Children To Eat More Fruits & Vegetables: What Works?...
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University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Getting Children To Eat More Fruits & Vegetables:
What Works?
Getting Children To Eat More Fruits & Vegetables:
What Works?
Students: Tyler Christiansen, Judy Dickinson, Stephen Fisher, Lainee Hoffman, Stephanie Mabrey, Kevin Reinhold,
April Ross, and Laurelyn Wieseman
Faculty Mentors: Dr. Eric Jamelske and Dr. Lori Bica University of Wisconsin-Eau Claire
Economics & Psychology Departments
Chippewa Valley Center for
Economic Research & Development
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
OverviewOverview
Motivation FFVP Background Initial Impact on FV Intake
Impact on attitudes/behavioral intent and intake Explore repeated FV exposure Expanding the Reach of the FFVP
Questions and Discussion
IntroductionIntroduction Inadequate FV consumption (not 5-9 a day) Lots of less healthy alternatives Rising rates of childhood and adult obesity Significant health care concern, annual costs in the BILLIONS of $
IntroductionIntroduction Use school setting to address this very important issue
USDA created Fresh Fruit and Vegetable Snack Program (FFVP) to improve nutrition and combat obesity (2002)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Provides funding for students in selected schools to receive a free FV snack 3-4 days a week through the year.
Elementary schools with at least 50% free/reduced population
Budget guidelines allow spending of $50-75 per student per year
Up to 10% of funds can be used for labor/capital expenses
Schools choose how many days/week, when/where to serve FV snacks, and how much, if any, nutrition education to include.
The Fresh Fruit & Vegetable ProgramThe Fresh Fruit & Vegetable Program
The Fresh Fruit & Vegetable ProgramThe Fresh Fruit &
Vegetable Program USDA http://www.fns.usda.gov/cnd/FFVP/FFVPdefault.htm
Wisconsin Department of Public Instruction http://dpi.wi.gov/fns/ffvp.html
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Wisconsin 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.
Expanding the FFVP nationwide involved significant cost, as funding increased from $18.9 million for 2007-08 to $50 million for 2008-09.
Given the sizeable resources committed to the FFVP, it is important to ascertain the degree to which it has achieved the stated purpose and goals.
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 (n = 124)– free FV morning snack three or four days/week– 2 matched control (n = 134), no free FV snack– 4th and 5th grade students– pre-test/post-test/post-test experimental design
Do students eat the fruit and vegetable snacks?– What did you eat yesterday at school for morning snack?
2008-09 Evaluation Process2008-09 Evaluation Process
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
ConclusionConclusion
The FFVP Works!
All else equal, the FFVP ↑ average FV intake among program students by about 1/2 serving (compared to control)
Program effect is limited to free access at morning snack
Students did not bring FV from home to eat on non-FFVP days
If students are provided with free FV with no alternatives
THEY EAT THEM!
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
2009-10 Research, Part I2009-10 Research, Part I Two Western Wisconsin elementary schools
One program school (n = 76)– Free afternoon FV snack three days/week
One matched control school (n = 110)– No free FV snacks
Pre-test/Post-test experimental design (three survey days each)
Does FFVP increase FV intake for school snack? Examine student attitudes and behavioral intent toward FV
Measure average daily FV snack consumption (3 survey days)
Morning and afternoon snack
Test difference between program and control students
Sample restricted to students who were present on all three survey days for both pre-test and post-test (n = 51, 78)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
The average over three days averaged across all students
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
The average over three days averaged across all students
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Free afternoon snack on 2 days, early release on day 3 Apple (92%), Kiwi (84%)
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Never = 1 Sometimes = 2 Often = 3 Always = 4
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Never = 1 Sometimes = 2 Often = 3 Always = 4
1 2 3 4
1 2 3 4
1 2 3 4
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Never = 1 Sometimes = 2 Often = 3 Always = 4
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Never = 1 Sometimes = 2 Often = 3 Always = 4
1 2 3 4
1 2 3 4
1 2 3 4
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Never = 1 Sometimes = 2 Often = 3 Always = 4
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Never = 1 Sometimes = 2 Often = 3 Always = 4
1 2 3 4
1 2 3 4
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
The FFVP Works!The FFVP Works!
Compared to control students…
Program students increased FV intake for school snack
Program students reported increased willingness to try new FV at home and especially at school
Program students reported asking their parents to buy FV more often when they went shopping
FFVP did not influence willingness to choose FV for snack over chips, cookies or candy
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
2009-10 Research, Part II2009-10 Research, Part II
One Western Wisconsin elementary school (n = 76)
Daily afternoon snack behavior tracked by teacher
Do students eat the free FV snacks?
Explore repeated exposure to FV items
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Daily F&V Snack Track Daily F&V Snack Track
Monday, Tuesday and Thursday are free FV snack days
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Total FV eaten by students on free snack days, divided by the number of student days over the period (omit absences)
Ate none = 0 Tried = 0.25 Ate half = 0.5 Ate all =1
Ate none = 0 Tried = 0.25 Ate half = 0.5 Ate all =1
0.7970.757
0.854
0.592 0.636 0.6650.553 0.654
0.620 0.618
0.685
0.864
0.660 0.6370.709
0.870
0.938
0.858
0.776 0.782
0.604
0.740
0.683 0.630
0.654
0.640
0.750
0.576
0.601 0.540 0.557
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
The FFVP…..The FFVP….. Program served more than twice as much fruit (66) as vegetables (29)
Program relied on available supply of fresh local apples (34)
Reasonable variety of F (8) V (10)
Apples and Oranges, Kiwi and Pear...Blueberries and Watermelon
Carrots, Celery and Cucumber…Pea Pods, Green Pepper and Jicama
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
WORKS!WORKS!
Students generally eat the free FV snacks
Students prefer fruit to vegetables
They didn’t grow tired of apples and apples and apples…An apple a day, keeps the doctor away!
Some evidence of developed FV preferences (likes/dislikes)
Tomatoes, Pea Pods, Green Peppers, Grapes, Pear
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
2009-10 Research, Part III2009-10 Research, Part III
One Western Wisconsin elementary school (n = 76)
Daily afternoon snack behavior tracked by teacher
Days when no free FV snack was provided
Do students bring FV snacks from home on non-FFVP days?
Various phases of incentives, reminders, modeling and praise
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Daily F&V Snack Track Daily F&V Snack Track
Wednesday and Friday are NOT free FV snack days
Non-Free Snack DaysNon-Free Snack Days Six distinct phases of study (October 2009 – May 2010)
Nothing Wall chart with stickers Small prizes Positive role modeling/praise Homework reminders
Phase One: 6 days Phase Two: 6 days Phase Three: 4 days Phase Four: 4 days Phase Five: 19 days Phase Six: 14 days 53 total days
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
FV brought from home by students on non-free snack days, divided by the number of student days over the period (omits absences)
Ate all or at least half = 1
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
Ate all or at least half = 1
Phase One: Baseline, no incentives
Phase Two: Stickers and wall charts
Phase Three: Stickers, wall charts and toy prizes
Phase Four: Back to baseline, no incentives (after winter break)
Phase Five: Toy prizes, modeling, praise and reminders, nothing
Phase Six: Toy prizes, modeling, praise and reminders
Nothing
Chart &
Stickers
Chart, Stickers & Toys
Nothing
Nothing
Reminders, Modeling/Praise & Toys
Nothing
Chart &
Stickers
Chart, Stickers & Toys
Nothing
Reminders & Modeling/Praise
Reminders, Modeling/Praise & Toys
Nothing
Chart &
Stickers
Chart, Stickers & Toys
Nothing
Reminders, Modeling/Praise & Toys
Reminders, Modeling/Praise & Toys
Nothing
Chart &
Stickers
Chart, Stickers & Toys
Nothing
Reminders, Modeling/Praise & Toys
Reminders, Modeling/Praise & Toys
The FFVP Works!The FFVP Works!
Toy PRIZES MATTER!
Homework reminders WORK!
Most successful when combined with POSITIVE MODELING & PRAISE!
A caring and dedicated teacher was able to get 70% of her students to bring FV snacks from home on a regular basis.
University of Wisconsin-Eau ClaireUniversity of Wisconsin-Eau Claire
The FFVP Works!The FFVP Works!
Framework for schools to expand the reach of the FFVP beyond the access to free FV provided as snacks in the classroom.
Feasible and affordable in terms of time, resources and money….SCHOOLS CAN DO THIS!
It seems to work EFFECTIVELY!
FV Brought from Home in AWESOME ClassFV Brought from Home in AWESOME Class
The FFVP
WORKS!The FFVP
WORKS!
Cost is $50 per student plus toy
Prizes and Praise
Benefit is
Priceless >
Questions?Questions?