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Title:Determining fresh fruit and vegetable program (FFVP) implementation correlates with fruit and vegetable outcomes in K-2nd graders
Author(s):Masis, Natalie M
Director of Research:Chapman-Novakofski, Karen M
Doctoral Committee Chair(s):Nickols-Richardson, Sharon M
Doctoral Committee Member(s):Andrade, Juan; McCaffrey, Jennifer
Department / Program:Nutritional Sciences
Discipline:Nutritional Sciences
Degree Granting Institution:University of Illinois at Urbana-Champaign
Degree:Ph.D.
Genre:Dissertation
Subject(s):nutrition
school
fruit
vegetable
FFVP
Illinois
Abstract:Background: The positive health effects of fruits and vegetables (FV) are well known. School-based FV interventions have been used as preventative child health strategies and may include nutrition education, gardening, or FV distribution. The Fresh Fruit and Vegetable Program (FFVP) supports low-income schools in providing FV as snacks. The objectives of this research were to evaluate available K-2nd grade nutrition curricula related to FV, to determine differences in FV outcomes in an FFVP and non-FFVP school, determine the impact of FFVP on FV preferences, and evaluate the FFVP statewide in Illinois. Methods: Web of Science, EBSCO, and PubMed were searched for articles with named curricula and curricula impact for K-2nd grade. Publications listed (n=5,498) were reviewed for relevancy (grade, curricula named, impact). To evaluate differences in an FFVP and a non-FFVP school, a FV Preference survey was developed for K-2nd graders (12 fruits/12 vegetables). Data were collected from K-2nd graders (n=435, FFVP school n=235 with 12 teachers, non-FFVP school n=200, 10 teachers). Fruits (F=28) and vegetables (V=29) were distributed twice/week over 35 weeks at the participating FFVP school. Preference ratings were analyzed over time. FFVP surveys were developed and distributed to Illinois schools to assess implementation of the program statewide. Additionally, a scoring index was created to classify schools as low/high implementers of the FFVP. Results: Twelve nutrition curricula were found within 11 publications. Most had control groups (n=9); were part of multi-component studies (n=11); and curricula included food model use, healthy eating, and food groups. Regarding preferences, there were significant differences in mean preference scores, with higher fruit scores at the FFVP school (P<.05); higher vegetable scores for the non-FFVP school (P<.05); and fewer I don’t know responses in the FFVP school (P<.01). For the 57 different FV rated for preference over time at the FFVP school, ratings (n=10,335) revealed that fruits had a higher frequency of children choosing I like it than for vegetables (78% F; 38.2% V). Significant relationships were found between liking and: 1) grade (r=-0.02, P=.02), and 2) time (r=-0.09, P<.001). Models indicated that vegetables served (compared to fruits; β=-.40), time point (β= -.07), and grade level (β=-.02) accounted for a significant variance in preference ratings (R2=0.17, P<.001), indicating that preference ratings went down over time. When assessing the FFVP in Illinois schools, it was found that school staff generally had favorable views of the FFVP. Principals (>50%) reported coordinating FV from FFVP with school-wide NE activities, and almost 80% reported having a committee in place for the FFVP. A low percentage of teachers and FFVP coordinators noted receiving training for the FFVP (4.4 to 44.8%). A school categorized as a high implementer, according to the FFVP teacher survey, was a significant predictive variable for the amount of FV consumed by children. However, more teachers and coordinators noted that children consumed all or most of the fruits compared to vegetables. Conclusions: The 12 curricula found had minimal research supporting impact. For differences between the FFVP and non-FFVP school, results suggest the students at the FFVP school had better FV identification. At the FFVP school, it was found that, overall, preference ratings were negatively impacted by time, grade level, and vegetables served. Being exposed to a variety of FV, generally, did not improve ratings for vegetables. Finally, FFVP surveys distributed to schools statewide in Illinois revealed differences between preferences and consumption patterns of children for FV according to teacher and coordinator surveys. High implementer schools may be predictive of children’s consumption of FV. More research is needed to determine factors of implementation that are particularly impactful and methods of improving implementation of the FFVP.
Issue Date:2017-07-13
Type:Thesis
URI:http://hdl.handle.net/2142/98277
Rights Information:Copyright 2017 Natalie Marie Masis
Date Available in IDEALS:2017-09-29
Date Deposited:2017-08


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