Located in rural Kentucky, the state with the highest adolescent overweight rate in the nation, the proposed project examines the feasibility of using a farm to school program as a health intervention. Farm to school projects have the potential to increase student consumption of fruits and vegetables, thus decreasing the risk of obesity, by linking local farms to school cafeterias and classrooms and combining curriculum on nutrition and food production with experiential education such as farm field trips and school gardens;currently, however, there are no known empirically-based examinations of this promising, ecologically oriented approach to stemming overweight and obesity. A multidisciplinary team, including an anthropologist, a clinical nutritionist, a biostatistician, a behavioral epidemiologist, and a public health nutritionist, will partner with school personnel and farmers in a Community Based Participatory Research program designed to develop, implement and assess a farm to school programs as an obesity prevention intervention for preadolescent elementary students. A factorial design will allow us to discern the relative impact of each component of this ecologically- oriented, multi-component intervention.
The Specific Aims of this project are 1) Utilize formative research to develop a farm to school project to prevent childhood obesity in rural Kentucky;2) Demonstrate feasibility of implementing and evaluating a farm to school program;3) Establish financial feasibility and sustainability of farm to school programs as a dietary and health intervention in elementary schools;4) Identify individual and interacting effects of each component of the intervention on fruit and vegetable consumption;5) Examine the impact of the intervention on knowledge, attitudes and beliefs about food and nutrition;and 6) Identify individual and interacting effects of intervention components on BMI. During Phase I, the developmental phase, key informant interviews and focus groups will be conducted to gain insights into the most useful components of a farm to school program for school personnel, parents, children, and farmers. During this phase we will work with school administrators and food service personnel, teachers, area farmers, students, and parents in program development. Research team members will collaborate closely with community members in curriculum development, farmer recruitment, selection of produce. During Phase II, we will administer the intervention, using a group-randomized trial in one rural school. Outcome measures include photographic assessment of cafeteria consumption and BMI measures, which are complemented with extensive process evaluation. Upon project completion, we will apply and expand the findings of this ecologically oriented, CBPR project to create a large scale R01 project capable of reducing childhood obesity in a way enriching and acceptable to the community.

Public Health Relevance

Project narrative Kentucky has the highest rate in the nation for adolescent obesity. Schools offer an excellent environment to address this epidemic through interventions which address the problem simultaneously in the classroom, the cafeteria, and the community. The proposed project works with one Kentucky elementary school and its surrounding community to institute and test the impact of a Farm to School program that brings locally grown produce into the cafeteria, teaches about nutrition and farming in the classroom, and provides experiential education through field trips to farms, farmer visits to classrooms, and class gardening projects. The success of the intervention is evaluated by stakeholder assessments, measuring what students eat in the cafeteria, and measuring what effects the program has on student weight.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-HDM-G (02))
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Esposito, Layla E
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University of Kentucky
Public Health & Prev Medicine
Schools of Public Health
United States
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