title: Exposure to a comprehensive school intervention increases vegetable consumption.
abstract: OBJECTIVE
  The current epidemic of childhood overweight has launched a variety of school-based efforts to address the issue. This study reports on the first 2 years of a 3-year evaluation of one school district's comprehensive intervention to transform school foodservices and dining experiences, offer cooking and gardening programs, and integrate nutrition and food systems concepts into the academic curriculum.
  
  
  METHODS
  This 3-year prospective study enrolled 327 4th and 5th graders in a mid-sized school district in California, and followed them into middle school. Intervention exposure was determined through interviews with school staff and student surveys. Student knowledge and attitudes were assessed annually by questionnaire, and student behavior was assessed annually by 3-day food diary. Household information was gathered by parent questionnaire. Changes in knowledge, attitudes, and behavior were compared by level of intervention exposure using analysis of covariance; pairwise differences were evaluated using Bonferroni's test at a procedure-wise error rate of 5%.
  
  
  RESULTS
  After controlling for family sociodemographic background, students most exposed to the intervention increased their consumption of fruits and vegetables by nearly 0.5 cups (one standard serving), whereas students least exposed decreased their consumption by 0.3 cups (p < .05). Students most exposed to the programming also showed a significantly greater increase in preference for fruit and green leafy vegetables, compared to students least exposed to the programming (p < .05).
  
  
  CONCLUSIONS
  Future research is needed to better understand the relative importance of the different components of such a program, and their cost-benefits as well as health impacts.
authors.affiliation: School of Public Health, University of California at Berkeley, Berkeley, CA, USA. maywang@ucla.edu
authors.forename: May C
authors.initials: MC
authors.lastname: Wang
authors.forename: Suzanne
authors.initials: S
authors.lastname: Rauzon
authors.forename: Natalie
authors.initials: N
authors.lastname: Studer
authors.forename: Anna C
authors.initials: AC
authors.lastname: Martin
authors.forename: Launa
authors.initials: L
authors.lastname: Craig
authors.forename: Caitlin
authors.initials: C
authors.lastname: Merlo
authors.forename: Kelly
authors.initials: K
authors.lastname: Fung
authors.forename: Deniz
authors.initials: D
authors.lastname: Kursunoglu
authors.forename: Muyun
authors.initials: M
authors.lastname: Shannguan
authors.forename: Patricia
authors.initials: P
authors.lastname: Crawford
mesh_terms: D002140:California; D002648:Child; D003479:Curriculum; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D005522:Food Services; D005638:Fruit; D051639:Gardening; D006266:Health Education; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D052756:Nutritional Sciences / Q000193:education; D011446:Prospective Studies; D014675:Vegetables