Amplifying the Impact of the Fresh Fruit and Vegetable Program Beyond Schools: A Multisectoral Approach

Project Summary / Abstract: USDA‘s Fresh Fruit and Vegetable Program (FFVP) targets low-income schools, providing fresh fruit and vegetable (FV) snacks to elementary school children. Evidence shows that students who participate in the FFVP develop greater preferences for and consume more FV. Students also request more FV at home and at the store compared to their peers who attend non-participating schools, influencing parent/caregiver purchases and benefiting other members of the household. Promoting FFVP items in stores can capitalize on these healthy requests, prompting parents to act on them and purchase more FV. We have documented the eagerness of grocery stores, FFVP schools, and USDA’s Supplemental Nutrition Assistance Program- Education (SNAP-Ed) to form partnerships to promote FFVP items in stores. While FFVP’s current operations, confined to school settings and primarily focused on the student, limit its ability to have broader impacts, the program’s success demonstrates its potential to serve as a foundation for broader, multisectoral initiatives. By integrating efforts across education, public health, and food retail sectors, we can leverage the FFVP to reduce health disparities in FV consumption. To test this multisectoral approach, we propose to develop and test a novel Public-Private Partnership (PPP) consisting of three sectors -- Arizona’s FFVP, Bashas’ Food City stores (a regional grocery store chain), and SNAP-Ed. The PPP will coordinate efforts of the schools offering FV snacks through FFVP while also promoting these items in grocery stores. We hypothesize that our multisectoral approach can expand and amplify positive health impacts on underserved students and their families beyond what can be achieved in school settings alone. We will test the PPP in a cluster-randomized trial, randomly assigning 16 schools selected for FFVP by the Arizona Department of Education (ADE) to FFVP+ (intervention, 8 schools) or FFVP-only (active control, 8 schools) conditions, with a third observational non-FFVP (passive control group) group sampled randomly from similar schools that were not selected for FFVP (8 schools). Conducted across two phases, we will first test the feasibility of implementing a PPP and then use a confirmatory cluster-randomized trial design to evaluate the effectiveness of the intervention on students and their caregivers’ consumption as well as establish the sustainability of the PPP by estimating the cost-benefit to grocery stores. Evidence of the effectiveness of a PPP could support a scalable model for amplifying the positive impact of the FFVP program on schools, families, communities and grocery stores.