title: Farm to elementary school programming increases access to fruits and vegetables and increases their consumption among those with low intake.
abstract: OBJECTIVE
  To assess the effectiveness of Wisconsin Farm to School (F2S) programs in increasing students' fruit and vegetable (FV) intake.
  
  
  METHODS
  Quasi-experimental baseline and follow-up assessments: knowledge and attitudes survey, food frequency questionnaire (FFQ), and lunch tray photo observation.
  
  
  METHODS
  Wisconsin elementary schools: 1 urban and 8 rural.
  
  
  METHODS
  Children, grades 3-5 (n = 1,117; 53% male, 19% non-Caucasian).
  
  
  METHODS
  Farm to School programming ranging from Harvest of the Month alone to comprehensive, including school garden, locally sourced produce in school meals, and classroom lessons.
  
  
  METHODS
  Knowledge, attitudes, exposure, liking, willingness; FFQ-derived (total), and photo-derived school lunch FV intake.
  
  
  METHODS
  t tests and mixed modeling to assess baseline differences and academic-year change.
  
  
  RESULTS
  Higher willingness to try FV (+1%; P < .001) and knowledge of nutrition/agriculture (+1%; P < .001) (n = 888), and lunch FV availability (+6% to 17%; P ≤ .001) (n = 4,451 trays), both with increasing prior F2S program exposure and across the year. There was no effect on overall dietary patterns (FFQ; n = 305) but FV consumption increased among those with the lowest intakes (FFQ, baseline very low fruit intake, +135%, P < .001; photos: percentage of trays with no FV consumption for continuing programs decreased 3% to 10%, P ≤ .05).
  
  
  CONCLUSIONS
  Farm to School programming improved mediators of FV consumption and decreased the proportion of children with unfavorable FV behaviors at school lunch. Longer-term data are needed to further assess F2S programs.
authors: Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI. Electronic address: ayoder@wisc.edu.
authors: Andrea B
authors: AB
authors: Bontrager Yoder
authors: Wisconsin Department of Health Services, Nutrition, Physical Activity, and Obesity Prevention Program, Madison, WI.
authors: Janice L
authors: JL
authors: Liebhart
authors: School of Health Care Professions, University of Wisconsin-Stevens Point, Stevens Point, WI.
authors: Daniel J
authors: DJ
authors: McCarty
authors: Wisconsin Obesity Prevention Network, School of Medicine and Public Health, Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, WI.
authors: Amy
authors: A
authors: Meinen
authors: Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI.
authors: Dale
authors: D
authors: Schoeller
authors: Wisconsin Department of Agriculture, Trade, and Consumer Protection, Madison, WI.
authors: Camilla
authors: C
authors: Vargas
authors: Department of Family Medicine, University of Wisconsin-Madison, Madison, WI.
authors: Tara
authors: T
authors: LaRowe
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005518:Food Preferences; D005522:Food Services; D005638:Fruit; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015397:Program Evaluation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014675:Vegetables; D014922:Wisconsin
keywords: child; diet; educational activities; farm; overweight; school