Background:  Under-consumption of fruits and vegetables is particularly problematic among children of lower socioeconomic status.  To address this concern, the USDA Fresh Fruit and Vegetable Program (FFVP) distributes free fruits and vegetable snacks outside of school mealtimes in schools with high proportions of low-income students. FFVP aims to increase student intake of fruits and vegetables while helping children learn more healthful eating habits. An important goal of the FFVP is to create a healthier school environment. Abt Associates Inc., and our partner the Atkins Center for Weight and Health at University of California, Berkeley, conducted the evaluation under coract the USDA Food and Nutrition Service.

Methodology:  We conducted a rigorous impact evaluation of FFVP, using a regression discontinuity design in which schools were ranked by the percentage of students eligible for free/reduced-price school lunches (the primary criteria for selecting schools to participate in FFVP).  The analytic sample included 4,696 students in 214 schools within 2.5 percentage points of the funding cutoff in each of 16 randomly-selected states (half the schools were above the funding cutoff and participating in FFVP; half were below the funding cutoff and not participating in the program). We conducted in-person surveys in 2011 with students in these schools, including diary-assisted 24-hour recall interviews to assess nutritional outcomes.  In addition, we conducted web surveys with school principals and school food authority (SFA) directors to assess outcomes at the school level.

Results:  Average daily fruit and vegetable consumption among students in schools participating in FFVP was approximately one-third of a cup per day higher on days when the program was offered than in non-participating schools, an increase of 15 percent over fruit and vegetable consumption levels in the absence of FFVP. Students in FFVP schools also had more positive general attitudes towards fruits and vegetables. There was no statistically significant difference in total energy intake across FFVP and non-FFVP schools, although statistical power for this outcome was limited. In addition, schools participating in FFVP provided nutrition education activities (e.g. classes, demonstrations, hands-on-learning, videos) more often than schools not participating in the program (2.4 days/week compared to .7 days/week).