title: Student feedback to improve the United States Department of Agriculture Fresh Fruit and Vegetable Program.
abstract: OBJECTIVE
  Fruit and vegetable consumption of children in the United States falls below recommendations. The U.S. Department of Agriculture Fresh Fruit and Vegetable Program (FFVP) is a national free-fruit and vegetable school distribution program designed to address this problem. This permanent, legislated program provides funding to qualified elementary schools for provision of additional fruit and vegetables outside of school meals. The objective of this study was to understand children's perceptions of FFVP after the intervention and formulate recommendations that may improve success of the intervention.
  
  
  METHODS
  Secondary data were obtained from 5,265 4(th)-6(th) graders at 51 randomly-selected FFVP intervention schools in Indiana. Anonymous questionnaires were completed late in the 2011-2012 academic year. Multilevel logistic regressions were used to determine associations between students' perceptions of program effects (4 close-ended items) and their preference toward the program. Content analysis was applied to a single open-ended item for program comments.
  
  
  RESULTS
  Over 47% of students reported greater intake of fruit and vegetables due to FFVP, and over 66% reported liking the program. Student-reported program effects were positively associated with preference for the program (P < 0.01). Themes that emerged during analysis of 3,811 comments, included, students liked: the opportunity to try different kinds of fruit and vegetables, types and flavors of fruits served, and benefits of eating fruit. Fewer students liked the types of vegetables and their benefits. A small group disliked the program citing poor flavor of vegetables and quality of fruits. Important suggestions for the program include serving more dipping sauces for vegetables, cooking vegetables, and providing a greater variety of produce.
  
  
  CONCLUSIONS
  The degree that students liked FFVP may predict the program's effects on fruit and vegetable intake. FFVP may become more acceptable to students by incorporating their suggestions. Program planners should consider these options for achieving program goals.
authors.affiliation: School of Public Health, Indiana University Bloomington, 1025 E 7th St., PH 116, Bloomington, IN 47405, USA.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Lin
authors.affiliation: School of Public Health, Indiana University Bloomington, 1025 E 7th St., PH 116, Bloomington, IN 47405, USA.
authors.forename: Alyce D
authors.initials: AD
authors.lastname: Fly
keywords: Fruit intake; environmental intervention; program evaluation; school nutrition; vegetable intake