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Description
The U.S. Department of Agriculture’s (USDA) National School Lunch Program and School Breakfast Program provide nutritious meals to school-age children. USDA’s Community Eligibility Provision (CEP) is designed to extend the reach of these programs by allowing schools in low-income areas to provide free school meals to all students at no

The U.S. Department of Agriculture’s (USDA) National School Lunch Program and School Breakfast Program provide nutritious meals to school-age children. USDA’s Community Eligibility Provision (CEP) is designed to extend the reach of these programs by allowing schools in low-income areas to provide free school meals to all students at no cost to families. CEP has been shown to increase school meal participation, nutritional intake, academic achievement, and attendance in previous research studies. This study aims to examine the impact of long-term CEP participation on student weight outcomes. Nurse-measured height and weight data for school years 2013-14 to 2019-20 were collected from 141 K-12 public schools in four low-income cities. School-level prevalence of obesity was calculated from students’ heights and weights using the Centers for Disease Control and Prevention protocol. CEP participation for each school year was obtained from the state Department of Education. Schools in the sample began participating in CEP at different times yielding varying numbers of years of CEP exposure over the study period. Multivariable analyses examined the relationship between school CEP exposure and the prevalence of obesity, controlling for school-level covariates. Multivariable analyses showed that for every additional year of CEP participation, the school-level prevalence of obesity was 0.4% lower (p=0.018). The regression-adjusted obesity prevalence for schools that never participated in CEP was 28.0%, while the obesity prevalence for schools with 6 years of CEP participation was 25.4%. The lower prevalence of obesity in CEP-participating schools was primarily driven by elementary schools. These results suggest that the benefits of CEP participation can cumulate over time, significantly reducing school-level obesity prevalence over time.
ContributorsDykstra, Tatum Nicole (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / Acciai, Francesco (Committee member) / McCoy, Maureen (Committee member) / Arizona State University (Publisher)
Created2024
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Description
Despite the literature suggesting that fruits and vegetables (F&V) can have a protective outcome against overweight, obesity and chronic diseases, consumption is still inadequate. In order to address under consumption of F&V among children, schools have become a platform for a variety of food programs. The Fresh Fruit and Vegetable

Despite the literature suggesting that fruits and vegetables (F&V) can have a protective outcome against overweight, obesity and chronic diseases, consumption is still inadequate. In order to address under consumption of F&V among children, schools have become a platform for a variety of food programs. The Fresh Fruit and Vegetable Program (FFVP), a United States Department of Agriculture (USDA) initiative, aims to increase exposure and consumption of F&V in low-income school children by providing F&V snacks. Participation in FFVP has been associated with higher preference and consumption of F&V and research also suggests that the program has the potential to decrease rates of overweight and obesity. The benefits of this program have been found to extend outside of the school setting, with higher requests for F&V at home and at the grocery store. This study aims to explore how children’s participation in the FFVP influences home food environments and shopping practices through qualitative analysis focus group data. Four focus groups were held with parents (n=25) from three FFVP participating schools. The data was analyzed using an inductive thematic analysis approach to find themes within the discussions. The findings were grouped into three categories: General Perceptions of FFVP, Impact of FFVP on the Home Food Environment, and Impact of FFVP on Shopping Practices. For General Perceptions of FFVP, themes were: Children learn about and enjoy F&V, awareness of farm to school programs, and children make healthier choices. Impact of FFVP on the Home Food Environment included the themes: Choosing heathier foods and snacks, parent F&V behaviors, children request F&V at home, and children talk about or bring F&V home. Finally, Impact of FFVP on Shopping Practices included the themes: children’s involvement in shopping, children request to buy F&V, children request non-produce items, and parents decline or limit unhealthy requests. This qualitative study provides valuable insights about how FFVP participation influences child and family behaviors towards F&V at home and in the grocery store. School food programs, such as the FFVP, have a positive influence on F&V related behaviors among children and should be continued and expanded.
ContributorsAcosta Ortiz, Marina (Author) / Ohri-Vachaspati, Punam (Thesis advisor) / DeWeese, Robin (Thesis advisor) / Gruner, Jessie (Committee member) / Arizona State University (Publisher)
Created2018