Farm to elementary school programming increases access to fruits and vegetables and increases their consumption among those with low intake.

Abstract Objective To assess the effectiveness of Wisconsin Farm to School (F2S) programs in increasing students' fruit and vegetable (FV) intake. Design Quasi-experimental baseline and follow-up assessments: knowledge and attitudes survey, food frequency questionnaire (FFQ), and lunch tray photo observation. Setting Wisconsin elementary schools: 1 urban and 8 rural. Participants Children, grades 3–5 (n = 1,117; 53% male, 19% non-Caucasian). Intervention(s) Farm to School programming ranging from Harvest of the Month alone to comprehensive, including school garden, locally sourced produce in school meals, and classroom lessons. Main Outcome Measures Knowledge, attitudes, exposure, liking, willingness; FFQ-derived (total), and photo-derived school lunch FV intake. Analysis t tests and mixed modeling to assess baseline differences and academic-year change. Results Higher willingness to try FV (+1%; P P P ≤ .001) (n = 4,451 trays), both with increasing prior F2S program exposure and across the year. There was no effect on overall dietary patterns (FFQ; n = 305) but FV consumption increased among those with the lowest intakes (FFQ, baseline very low fruit intake, +135%, P P ≤ .05). Conclusions and Implications Farm to School programming improved mediators of FV consumption and decreased the proportion of children with unfavorable FV behaviors at school lunch. Longer-term data are needed to further assess F2S programs.