Exposure to a Comprehensive School Intervention Increases Vegetable Consumption

Exposure to a Comprehensive School Intervention Increases Vegetable Consumption

May C. Wang Suzanne Rauzon Natalie Studer Anna C. Martin Launa Craig Caitlin Merlo Kelly Fung Deniz Kursunoglu Muyun Shannguan Patricia Crawford

PWP-CCPR-2009-076

December 2009 Last Revised: December 2009

California Center for Population Research On-Line Working Paper Series

Accepted for publication by the Journal of Adolescent Health December 15, 2009 ===========================================================

Title: Exposure to a comprehensive school intervention increases vegetable consumption.

Authors: May C. Wang Dr.P.H.a,b, Suzanne Rauzon M.P.H.c, Natalie Studer M.P.H.c, Anna C. Martin Ph.D. c, Launa Craig B.S.c, Caitlin Merlo M.P.H.c, Kelly Fung M.P.H.c, Deniz Kursunoglu B.S.a,c, Muyun Shannguan M.S.b, Patricia Crawford Dr.P.H., R.D.a,c a

School of Public Health, University of California at Berkeley UCLA School of Public Health, University of California at Los Angeles c College of Natural Resources, University of California at Berkeley b

Corresponding Author:

May Choo Wang DrPH UCLA School of Public Health Department of Community Health Sciences 650 Charles E. Young Drive South, CHS 26-051B Los Angeles, CA 90095 Telephone: 310 206-5306 Fax: 310 794-1805

Acknowledgements: The authors would like to thank the Chez Panisse Foundation, through the generous support of Rodale Inc. and The Rosalinde and Arthur Gilbert Foundation, for funding this work. They would also like to thank community partners for their involvement and the staff from the Network for a Healthy California for their assistance in shaping the evaluation. Finally, this study would not have been possible without the support and cooperation of school district staff, students and families.

1

Accepted for publication by the Journal of Adolescent Health December 15, 2009 =========================================================== ABSTRACT Purpose The current epidemic of childhood overweight has launched a variety of school-based efforts to address the issue. This study reports on the first two years of a three year evaluation of one school district’s comprehensive intervention to transform school foodservices and dining experiences, offer cooking and gardening programs, and integrate nutrition and food systems concepts into the academic curriculum.

Methods This three-year prospective study, enrolled 327 4th and 5th graders in a mid-sized school district in California, and followed them into middle school. Intervention exposure was determined through interviews with school staff, and through student surveys. Student knowledge and attitudes were assessed annually by questionnaire, and student behavior was assessed annually by 3-day food diary. Household information was gathered by parent questionnaire. Changes in knowledge, attitudes and behavior were compared by level of intervention exposure using analysis of covariance; pairwise differences were evaluated using Bonferroni’s test at a procedure-wise error rate of 5%.

Results After controlling for family sociodemographic background, students most exposed to the intervention increased their consumption of fruits and vegetables by nearly 0.5 cups (1 standard serving) while students least exposed decreased their consumption by 0.3 cups (p