Progress 10/01/12 to 09/30/14
Outputs
Target Audience: This project serves scientific, government and community organizations who are interested in the improvement of the nutritional quality of school lunches and other meals. Such improvements touch all children in the United States, with special attention to minority and under privileged children who are at greater risk of developing obesity and early onset chronic disease. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? This project provided training in public health research for two graduate students and two undergraduate students from the University of Wisconsin. One of these graduate students earned her PhD in 2014 and the second is working toward a 2015 completion date. Both undergraduate students have earned their BS degrees. Training activities not listed above include the opportunities for the graduate students to attend and participate in national scientific conferences. These include the 2013 and 2014 Obesity Week conferences and the 2013 American Public Health Association conference. In addition, the graduate students planned and presented the above described workshops. The projects provided the undergraduate students with the opportunity to participate in organized research and earn Independent Study credits toward graduation. They were also able to prepare and present posters describing their research projects during the UW-Madison spring research symposia. How have the results been disseminated to communities of interest? Results were disseminated to local schools in Wisconsin through annual reports that were sent to each school that participated in the Farm-to-School evaluation. These reports indicated how the Farm-to-School program influenced students in those schools with regard to knowledge of Wisconsin agriculture, exposure to and liking of common fruits and vegetables, and the fruit and vegetable components of the school lunches as served and consumed. Our findings were also shared with other investigators from the University of Wisconsin-Madison and were important in identifying evidence based programs that were implemented to improve the access to fruits and vegetables as well as the children's fruit and vegetable consumption in efforts prevent childhood obesity. These efforts were or continue to be part of programs funded by the Center for Disease Control or the University of Wisconsin-Madison's community partnership program. Our findings were also shared with other scientists across the nation and globe through peer-reviewed publication as listed above. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
Accomplishments of this project included the provision of evidence on positive changes in the school lunches of Wisconsin children. a. Project Background and Aims: The Farm-to-School Program includes both in school and out of school nutritional education to improve children's diets and help prevents childhood obesity. A comprehensive Farm-to-School program includes the following components: 1) use of locally produced food in school meals and salad bars with an emphasis on fresh fruits and vegetables, 2) nutrition education 3) agricultural education, 4) school gardening, 4) student healthy lifestyle engagement activities. The central aim of our project was to evaluate the effectiveness of Farm-to-School in regards to: 1) assess the changes in student knowledge of production agriculture and attitudes towards fruit and vegetable consumption 2) assess changes in lunch food selection and consumption, 3) assess changes in the students total diet, 4) assess changes in the accretion of excess weight, absenteeism, and standardized test scores. In addition, 5) assess the potential economic impact on local communities from Healthy, Hunger-Free Kids Act , and 7) qualitative assessment of the challenges and opportunities encountered during implementation of Farm-to-School at the individual school level. b. Results: The project supported a two year period of assessment for Farm-to-School programs initiated over a five year period in 14 Wisconsin. Children, grades 3-5 (n = 1,117; 53% male, 19% non-Caucasian) were included in the evaluations. Pre- and post-meal digital photographs of students' school lunch trays to estimate fruit and vegetable availability and consumption. Fruit and vegetable items were categorized for factors suspected to impact waste: prior farm to school years, placement (main menu, salad bar), procurement (local, conventional), preparation (cooked, raw) and meal component (entrée, side, topping). Knowledge, attitudes, exposure, liking, willingness were assessed by questionnaires completed by the students. The effects of Farm-to-School were accessed between schools as a function of the number of years that a school had active Farm-to-School programs, and within schools with regard the changes from the fall to the spring semesters. The Farm-to-School program was effective in improving the quality of children's school lunches. It was found that there was an increase in the volume fruit and vegetables on the children's lunch trays (+6% to 17%; P ≤ .001) (n = 4,451 trays) with years of prior Farm-to-School programing and across the year. The greatest effect was observed in the children with no lunchtime fruit or vegetable consumption. The children also had a higher willingness to try fruit and vegetables (+1%; P < .001) and knowledge of nutrition/agriculture (+1%; P < .001) (n = 888) across the year. There was no effect on overall dietary patterns as measured by self-report for a one week period (FFQ; n = 305), but fruit and vegetable consumption 135% increase in fruit consumption among those with the lowest intakes (FFQ, baseline fruit intake in the lowest quartile, P < .001). In summary, Farm to School programming improved mediators of fruit and vegetable consumption and decreased the proportion of children with unfavorable fruit and vegetable consumption during school lunch. Longer-term data are needed to further assess Farm-to-School programs on the 24 h (school and home) diets of children. In addition to studying the lunch food consumption of the children, the amount of food waste was also assessed. This was reported to the food service directors with the goal of providing them with knowledge that would help them to reduce lunch room waste. Many differences were detected overall and/or across time. Cooked fruits were wasted less than raw, while cooked vegetables were wasted more than raw. Where identified, locally sourced items were wasted more than conventionally sourced (+0·1 cups, P<0·0001) and salad bar items were wasted more than main menu items (+0·01 cups, P<0·0001). Increasing prior Farm-to-School years decreased waste (-0·02 cups, P<0·0001). Items previously tried were wasted at the same volume whether reported as liked or not. New school lunch meal pattern requirement implementation did not uniformly impact fruit and vegetable waste across all categories and there was no change in waste for seven of fifteen assessed categories. This evaluation of Farm-to-School effects also had an impact on school lunch policy in Wisconsin. State Senator Julie Lassa has been a major proponent for healthy school lunches in Wisconsin and helped to create Farm-to-School programs across the State of Wisconsin. As part of the educational efforts of our community partners, our findings, in the form of a peer reviewed scientific journal article, were provided to Senator Lassa. She has been using the evidence provided by this evaluation to continue and strengthen the Farm-to-School program in our State.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
Fruits and vegetables displace, but do not decrease, total energy in school lunches. Bontrager Yoder AB, Schoeller DA. Child Obes. 2014;10:357-64. PMID: 24988122.
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
Farm to elementary school programming increases access to fruits and vegetables and increases their consumption among those with low intake. Bontrager Yoder AB, Liebhart JL, McCarty DJ, Meinen A, Schoeller D, Vargas C, LaRowe T. J Nutr Educ Behavior. 2014;46:341-9. PMID: 24953435
- Type:
Journal Articles
Status:
Accepted
Year Published:
2015
Citation:
Factors affecting fruit and vegetable school lunch waste in Wisconsin elementary schools participating in Farm to School programs. Bontrager Yoder AB, Foecke LL, Schoeller DA. Public Health Nutr. 2015 PMID: 25728060
- Type:
Journal Articles
Status:
Accepted
Year Published:
2015
Citation:
School Gardens Enhance Academic Performance and Dietary Outcomes in Children. Berezowitz C, Bontrager-Yoder A, Hanna B, Schoeller D. J School Health. In press, 2015.
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Progress 01/01/13 to 09/30/13
Outputs
Target Audience: The primary target audience has been local county health professionals in Wisconsin. Annual outcome evaluations have been returned to the local health professions comparing the elementary school children in their community school with those in the other ten partner communities across Wisconsin with respect to knowledge of nutrition and food production agriculture, consumption of fruits and vegetables, and quality of school lunches. The most successful communities then have shared their strategies for farm-to-school programming with health professionals from all 72 Wisconsin counties. In addition, our findings have been shared with a national health profession audience through the presentation of scientific presentation at local, regional and national public health meetings. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided? Two graduate students, one of which was directly supported, have received scientific experience in the design and evalaution of public health initiatives to improve nutrition. In addition, three undergraduate students received mentored experience in the analysis of data for teh evalaution of public health initiatives. How have the results been disseminated to communities of interest? Reports were generated at the end each data collection cycle and sent to teh community member who was working with each school. This reported the survey resultsfor the specific school and the average for all the schools. This permitted to schools to compare the baseline and later the change scores for teh students in their school with that of all the schools. What do you plan to do during the next reporting period to accomplish the goals? We are continuing to to follow the cumulative affects of the Farm-to-school in five of these schools. An important addition in these schools is that they are linking the data to each child's relative body weight (body mass index) using non-identifiable coding to protect participant privacy. This will allow to evaluate the impct of the Farm-toschool on excess weight gain. We are also collecting data on academic performance to dtermin if the healthier diets reduce absenteeism and improve standardized test scores.
Impacts
What was accomplished under these goals?
IMPACT: Successful completion of this project will have several impacts. The first is to increase the knowledge of local agricultural food production. The second is expose children to more fruits and vegetables and increase the number of fruits and vegetables that children like to eat. The third goal is increase the number and quantity of fruits and vegetables that children consume from their school lunches. The fourth impact will be to reduce absenteeism, and standardized test scores by improving the diet of children. In addition, the data as well a qualitative data on barriers to incorporating Farm-to-School programming into the school day will be used to increase the number of schools that use the Farm-to-School program. Lastly, Farm-to-School will increase the amounts of Wisconsin produced fruits and vegetables and thus help to provide more sales opportunities to Wisconsin producers. PROGRESS: Data collection to date: Participants included 1117 de-identified students from nine schools. The children’s mean age was 9.6 ± 0.9 years and 53% of students were male. Most students (44%) were fourth-graders; 36% were third-graders, and 27% were fifth-graders. Most (57%) of students came from schools that had ≥2 prior years of F2S programming; 21% were in their second year, and 29% were in schools new to F2S programming in fall 2010. Knowledge of local agriculture with regard to food production, general liking and wiliness to consume fruits and vegetables, exposure to and liking of 40 specific common fruits and vegetable, analysis of photo records of school lunch serving and consumption were performed in fall and again in spring after the year of farm-to-school programming. A total of 888 students finished at least one complete construct within baseline and follow-up KA surveys and could be paired across the year (79% of participants completed both surveys). 1. Increase the knowledge of local agricultural food production: Across the year, there were significant increases in Attitudes (3% points) towards consuming fruits and vegetables and Knowledge of Wisconsin agricultural production (4%), When change scores were categorized by prior F2S years, only two constructs yielded significant differences: Knowledge (larger increase among second-year F2S students’ scores) and Liking (new-site students decreased their liking of FV tasted). All constructs (except Liking) showed small school-year increases in continuing groups. At baseline, Attitudes scores were higher with increasing prior F2S exposure (3.9 % points among students with the most prior F2S compared to new schools). The remaining constructs did not differ at baseline according to prior F2S exposure. It was concluded that Farm-to-school programming in schools increased the predictors of fruit and vegetable consumption among 3rd through 5th graders in participating Wisconsin elementary schools. 2. Expose children to more fruits and vegetables and increase the number of fruits and vegetables that children indicate they like to eat: Exposure (3%, or approximately half of one FV item), and Willingness (2%; all p<.001) to consume fruits and vegetables. There was no increase in these measures, however, with increasing number of years of Farm-to-school programming after controlling for the children’s age. Thus, although children displayed an increase in exposure to a wider range of fruits and vegetables and more willingness to consume them with age, there was no cumulative effect of Farm-to-school programming these measures of fruit and vegetable consumption behaviors. 3. Increase the number and quantity of fruits and vegetables that children consume from their school lunches. A total of 850 students had lunch trays photographed, yielding 4,451 student school lunch trays were photographed before and after lunch. Initial adjusted means (grade, %FRPL, school) revealed no significant differences by prior F2S years at baseline, nor in the degree of change. Across the year, there were significant increases overall in the variety of FV available on students’ trays, but not the amount of fruits and vegetables consumed. Trays from schools with more prior F2S showed increases in the number of FV, but also a small decrease in the FV cups available on the trays. Adjusted across-year degrees of change did not differ significantly between groups. Because change among children who already consumed amounts of fruits and vegetables that met national guidelines for lunch, data were reanalyzed concentrating on lunches with inadequate fruit and vegetable consumption. At baseline, 24% of trays showed no FV consumption. The percent of trays showing no FV items and no FV disappearance was lower among trays from schools with more prior F2S at baseline and follow-up, and improved across the year. Fruit consumption increased, while the consumption of vegetables was not significantly affected. We concluded that Farm-to school programming was associated with greater consumption of at least some fruit at lunch, but not average total fruit and vegetable consumption. This was observed for both the current school year and across schools with increasing years of Farm-to-school programming. 4. Reduce absenteeism, and standardized test scores by improving the diet of children: Data to address this aim is currently being collected. Forty Wisconsin schools have been identified; half with current comprehensive Farm-to-school programming and half without any Farm-to-school programming or programming history. Data on standard academic tests scores, absenteeism and disciplinary actions will be obtained at the grade and school level (no individual data). We will compare between the two groups of schools. 5. Identify qualitative data on barriers to incorporating Farm-to-School programming into the school day will be used to increase the number of schools that use the Farm-to-School program: Interviews have been collected from school administrators, teachers, parents and local fruit and vegetable supplies for the nine elementary schools included in this evaluation. Information has yet to analyzed. 6. Increase the number of schools and economic impact of Farm-to-school participation: This is information will be available from USDA national Farm-to-school network and thus its collection will not be duplicated by us. The data is expected to be available during the coming year and we will access the data to investigate this outcome.
Publications
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2013
Citation:
Farm to school programs: Evaluating the development, perceptions, and benefits. A Bontrager-Yoder, T Engle, S Gaulocher et al. American Public Health Association, Boston, MA, paper 280026, 2013
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2013
Citation:
Workshop: Evaluation of Farm-to-school programing. A. Bontrager Yoder, A Meinen, D Schoeller. Wisconsin Farm-to-school Summit, La Crosse, WI 2013
- Type:
Conference Papers and Presentations
Status:
Accepted
Year Published:
2014
Citation:
Workshop: Common methods for evaluating school food procurement and student learning and health behaviors. Farm-to-cafeteria Conference. Austin, TX, 2014.
- Type:
Journal Articles
Status:
Under Review
Year Published:
2014
Citation:
Farm to Elementary School Programming Increases Access to Fruits and Vegetables and Increases Their Consumption Among Those with Low Intake. Andrea B Bontrager Yoder, MM; Janice L Liebhart, MS; Daniel J McCarty, PhD; A Meinen, D Schoeller, Camilla Vargas, Tara L La Rowe. J Nutr Ed Behav.
- Type:
Journal Articles
Status:
Submitted
Year Published:
2014
Citation:
School Gardens Enhance Academic Performance and Dietary Outcomes in Children. C Berezowitz, A Bontrager-Yoder, D. Schoeller. J School Hlth.
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Progress 01/01/12 to 12/31/12
Outputs
OUTPUTS: Interim results of the evaluation of efficacy of selected elementary school Farm-to-School programs in the State of Wisconsin were reported back to participating schools during the fall semester of 2012. Schools received their aggregate student state as well the averages scores from all 9 schools (without school identities). Scores were reported for student knowledge of how food is produced, students liking of specific fruits and vegetables, fruit and vegetable consumption from the school lunch program from analysis of lunch tray photos, and fruit and vegetable consumption from all meals and snacks of students from a food-frequency survey. Results were also disseminated to a Wisconsin audience during an oral presentation at the Wisconsin Farm-to-School Summit and to a national audience during a poster session at the annual meeting of the Obesity Society. PARTICIPANTS: This project has involved partnerships with the Wisconsin Department of Health Services, the Wisconsin Department of Agriculture, Trade and Consumer Protection, The University of Wisconsin Center for Integrated Agricultural Systems, and nine Wisconsin School Districts. A. Bontrager-Yoder is a graduate student in Nutritional Sciences and this project is being performed as part of her requirements for completing a Ph.D. TARGET AUDIENCES: The subjects who were included as study participants were 3rd, 4th, and 5th graders in public schools in the State of Wisconsin. The targets for dissemination are public health investigators and practitioners. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Background: Farm to School (F2S), a national program, pairs healthy eating with agriculture and nutrition education to encourage healthy lifestyles, and decrease obesity risk. Objectives of this study include assessing student attitudes, behaviors, and health indicator outcomes in the context of program activities. Methods: Eight WI F2S schools participated in a photographic analysis of school lunch trays for four days at baseline and follow-up. Numbered trays enabled pre/post-meal pairing. Trays were assessed for the number of different fruit and vegetable (FV) items, cups of FV, and cups consumed. Analysis compared pre/post differences, by schools' length of F2S experience and program intensity (number of activities). Results: At baseline, 2,214 trays showed (mean +/- SD) 1.4 +/-0.9 different FV totaling 0.53+/-0.43 cups, and 0.37+/-0.36 cups FV consumed. At follow-up, 2,139 trays showed increases in FV items but not cups of FV on trays or consumed. Trays from schools with 1 or ≥2 prior years of F2S program exposure showed increased FV items (+0.31+/-0.76 and +0.10+/-0.98, respectively). At baseline, 34% of new-site trays contained no FV and 39% showed no FV consumption; 15% of trays from sites with ≥2 prior years of exposure contained no FV items and 22% showed no consumption; all values decreased at follow-up. Program intensity showed similar trends: trays at high- (versus low-) intensity sites showed more FV items and consumption. In 144 obese students there were increases in FV cups on and consumed-from trays. Conclusions: FV access increased among students participating in F2S programs. Increased access was positively related to F2S program years and intensity. The report given at the Wisconsin Farm-to-School Summit helped to inform technical assistants working in the Wisconsin Department of Agriculture who provide assistance to Wisconsin schools interested in starting or improving Farm-to-School programs. It also informed the technical assistants hired as part of CDC Transformation Grant here in Wisconsin, which is aimed at preventing obesity through the increased utilization of Farm-to-School programing in Wisconsin. Our experience with the instruments we used in this evaluation were also used to inform the evaluation of a larger Farm-to-School implementation that was launched in Wisconsin in 2012.
Publications
- Bontrager Yoder, A.B., Engel, T., Gaulocher, S., Knitter, A., Liebhart, J.L., McCarty, D.L., Meinen, A.M., Schoeller, D.A.,Tedeschi, S., Vargas, C., and LaRowe, T. 2012. Wisconsin Farm to School Evaluation: Fruit and Vegetable Access Improved Over One Year of Farm to School Implementation . The Obesity Society. 828-P, S238.
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