University of Wisconsin-Eau Claire
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 Claire
Overview



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


Introduction




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 $
Introduction

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 Claire
The Fresh Fruit & Vegetable Program

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 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 Claire
The Fresh Fruit & Vegetable Program

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.
University of Wisconsin-Eau Claire
2008-09 Evaluation Process

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?
University of Wisconsin-Eau Claire
Conclusion
 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 Claire
2009-10 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 Claire

The average over three days averaged across all students
University of Wisconsin-Eau Claire

The average over three days averaged across all students
University of Wisconsin-Eau Claire


Free afternoon snack on 2 days, early release on day 3
Apple (92%), Kiwi (84%)
University of Wisconsin-Eau Claire

Never = 1 Sometimes = 2 Often = 3 Always = 4
University 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 Claire

Never = 1 Sometimes = 2 Often = 3 Always = 4
University 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 Claire

Never = 1 Sometimes = 2 Often = 3 Always = 4
University of Wisconsin-Eau Claire

Never = 1 Sometimes = 2 Often = 3 Always = 4
1
2
3
4
1
2
3
4
University of Wisconsin-Eau Claire
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 Claire
2009-10 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 Claire
Daily F&V Snack Track

Monday, Tuesday and Thursday are free FV snack days
University 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
0.854
0.797
0.757
0.592
0.636
0.665
0.553
0.654
0.864
0.709
0.620
0.618
0.685
0.660
0.637
0.938
0.870
0.858
0.776
0.782
0.740
0.683
0.604
0.630
0.750
0.654
0.640
0.576
0.601
0.540
0.557
University of Wisconsin-Eau Claire
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 Claire
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 Claire
2009-10 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 Claire
Daily F&V Snack Track

Wednesday and Friday are NOT free FV snack days
Non-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 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 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
& Toys
Chart
&
Stickers
Nothing
Nothing
Reminders,
Modeling/Praise & Toys
Chart,
Stickers
& Toys
Nothing
Chart
&
Stickers
Nothing
Reminders &
Modeling/Praise
Reminders,
Modeling/Praise & Toys
Chart,
Stickers
& Toys
Nothing
Chart
&
Stickers
Nothing
Reminders,
Modeling/Praise & Toys
Reminders,
Modeling/Praise & Toys
Chart,
Stickers
& Toys
Nothing
Chart
&
Stickers
Nothing
Reminders,
Modeling/Praise & Toys
Reminders,
Modeling/Praise & Toys
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 Claire
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 Class
The FFVP
WORKS!
Benefit
is
Priceless
>
Cost is $50 per
student plus toy
Prizes and Praise
Questions?