Frequent consumption of fruits and vegetables has been linked to better dietary quality and positive health outcomes. Unfortunately, fruit and vegetable consumption among elementary school children falls far short of the recommendations. Therefore, finding strategies to promote fruit and vegetable consumption in children is a public health priority. One such strategy is the United States Department of Agriculture’s (USDA) Fresh Fruit and Vegetable Program (FFVP), which provides fresh fruits and vegetables as snacks, at least twice per week, in elementary schools with high student enrollment from low-income households. The program aims to expand the variety of fruits and vegetables children experience, impacting their present and future health outcomes.  Another USDA initiative, the Supplemental Nutrition Assistance Program Education (SNAP-Ed), offered in community and school settings, aims to improve the likelihood that SNAP eligible individuals will make healthy food choices consistent with the Dietary Guidelines for Americans.  SNAP-Ed is a potential resource for FFVP schools, providing nutrition education, staff training, and promotional materials.

Many factors influence children’s health behaviors and health outcomes. The Social Ecological Model (SEM) groups these factors into interactive layers, creating a framework for understanding their influence and for designing interventions to achieve positive change. The layers of influence in the SEM include individual, interpersonal, organizational, community, and policy factors (see figure). The New Jersey Child Health Study (NJCHS) was designed to examine how specific layers of the SEM, particularly food and physical activity environments in schools and communities, affect obesity outcomes in children