the role of social cognitive theory in farm-to-school-related activities: implications for child...

GE N E R A L AR T I C L E

The Role of Social Cognitive Theoryin Farm-to-School-Related Activities:Implications for Child Nutrition*LINDA BERLIN, PhDa,b KIMBERLY NORRIS, PhDc JANE KOLODINSKY, PhDd,e ABBIE NELSON, MSf

ABSTRACTBACKGROUND: Farm-to-school (FTS) programs are gaining attention for many reasons, one of which is the recognition thatthey could help stem the increase in childhood overweight and obesity. Most FTS programs that have been evaluated haveincreased students’ selection or intake of fruits and vegetables following the incorporation of FTS components. However, thewide range of activities that are typically part of FTS programs make it difficult to pinpoint which components have the greatestpotential to improve students’ health behaviors. Within the field of nutrition education, theory-based interventions that targetthe key underlying factors influencing health behavior offer the most promise.

METHODS: We review existing research on dietary health impacts and implications of 3 key FTS-related activities and explorethe component activities of FTS in terms of their potential to address the key constructs of social cognitive theory (SCT)—whichis a current best practice in the field of nutrition—suggesting that FTS programs incorporating a diverse set of activities appearto be most promising.

RESULTS: We find that components of FTS programs incorporate many of the key theoretical constructs in SCT, and show thatFTS programs have great potential to facilitate movement toward desired dietary changes. However, it is unlikely that a set ofactivities in any one current FTS program addresses multiple constructs of the theory in a systematic manner.

CONCLUSION: More intentional inclusion of diverse activities would likely be beneficial. Future research can test theseassertions.

Keywords: nutrition and diet; school food services; health educators; school health instruction.

Citation: Berlin L, Norris K, Kolodinsky J, Nelson A. The role of social cognitive theory in farm-to-school-related activities:implications for child nutrition. J Sch Health. 2013; 83: 589-595.

Received on April 3, 2012Accepted on August 12, 2012

The farm-to-school (FTS) movement gained tractionduring the 1990s, and then flourished over

the next decade, resulting in an estimated 2,000programs in nearly 9,000 schools across the countryby 2008.1 Lacking a precise definition, FTS programsare characterized as linking farmers and K-12 schoolswith the primary purposes of contributing to nutritiousmeals and education for youth and better incomesfor farmers who market locally. Additional goalsinclude enhancing youth’s appreciation and awareness

aExtension Assistant Professor, ([email protected]), Department of Nutrition and Food Sciences, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405-0086.bDirector, ([email protected]), Center for Sustainable Agriculture, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405-0086.cAssociate Agent, ([email protected]), Food Supplement Nutrition Education, University of Maryland, 10632 Little Patuxent Parkway, Suite 435, Columbia, MD 21044.dProfessor and Chair, ([email protected]), Community Development and Applied Economics, University of Vermont, 109 Carrigan Drive, Burlington, VT 05405.eDirector, ([email protected]), Center for Rural Studies, University of Vermont, Morrill Hall Rm. 202, Burlington, VT 05405.fDirector, ([email protected]), Vermont Food Education Every Day, NOFA-Vermont, PO Box 697, 14 Pleasant Street, Richmond, VT 05477.

Address correspondence to: Linda Berlin, Extension Assistant Professor, ([email protected]), Department of Nutrition and Food Sciences, University of Vermont, 109 CarriganDrive, Burlington, VT 05405-0086.

*Indicates CHES continuing education hours are available. Also available at http://www.ashaweb.org/continuing_education.html

of agriculture, food, and nutrition, strengtheninglocal economies, and furthering youth’s sense ofconnectedness to the community.2,3

As a result of FTS programs’ diverse purposes andgrassroots nature, the types of activities they encom-pass vary considerably from program to program. Thisvariety may be due to a view that FTS efforts appearto be best designed from the ground up. Despite thisdiversity, most FTS programs serve locally producedfoods in the school cafeteria,4,5 often highlightingfresh or processed fruits and vegetables (eg, kale,

Journal of School Health • August 2013, Vol. 83, No. 8 • © 2013, American School Health Association • 589

squash, tomato sauce), dairy and meat products,eggs, beans, and other value-added items (eg, pesto,granola, cider). In addition to locally sourced foodserved in the cafeteria, components of FTS activitiescommon to many programs include taste tests, lessonson healthful food choices, farm visits, school gardens,recycling activities, and composting systems.

The rapid expansion of FTS has been part of abroader food system relocalization movement in theUnited States. Other facets of this movement, whichmay or may not happen in communities with FTSprograms, have included the revival of farmers’ mar-kets, development of direct marketing relationshipsbetween farmers and restaurant operators, forma-tion of CSAs or ‘‘community supported agriculture,’’and numerous other connections among producers,processors, distributors, and consumers of food.2 Pro-ponents of the food relocalization movement oftencite improved food quality and safety, small-scale foodproduction, biodiversity, resource protection, commu-nity well-being, democratic participation, and regionalpalates.6 Despite their long list of attributes, the con-cepts of ‘‘local’’ and ‘‘regional,’’ as they apply to foodsystems, are no more precisely defined than is the term‘‘farm-to-school.’’

FTS programs are gaining attention for theirpotential to help stem the increasingly prevalent trendof childhood overweight and obesity. A comparisonof National Health and Nutrition Examination Survey(NHANES) data over more than 30 years (1976-1980and 2009-2010) shows that the prevalence of obesityhas increased for children aged 6-11 years, from 6.5%to 18.0%; and for those aged 12-19 years from 5.0%to 18.4%.7,8 Increased consumption of fruits and veg-etables has been recognized as a successful strategy forreducing overweight and obesity,9 and is of particularinterest here because greater access to produce isoften a core component of FTS efforts.10 In fact, theCenters for Disease Control and Prevention (CDC)has identified FTS programs as an effective approachto improving student health through healthier schoolmeals as well as nutrition and eco-literacy involvinghands-on and out-of-doors experiences.11

Many FTS programs that have been evaluated haveincreased students’ selection or intake of fruits and veg-etables following the incorporation of FTS componentssuch as including locally grown produce into schoolmeal selections, creating school gardens, and provid-ing classroom-based nutrition education.10 Of 5 studiesthat also examined FTS participants’ dietary behavioroutside of school, 4 found increases in the selection orintake of fruits and vegetables by the children. Anotherstudy of primary data from 7 school-based nutritionintervention studies—not necessarily incorporatingcomponents of FTS programs—showed a net increaseof 0.45 servings of fruits and vegetables per student.12

While there are few specific FTS programevaluations, many of the individual activities thatare sometimes part of FTS programs such as schoolgardens have been researched outside of the FTScontext. These identify public health implications,including impacts on nutrition knowledge, foodpreference, and dietary behaviors. The followingsections review existing research on the dietary healthimpacts and implications of three key FTS-relatedactivities. Then, we explore the component activitiesof FTS in terms of their potential to address thekey constructs of social cognitive theory (SCT)—ahealth behavior change theory on which nutritioninterventions are commonly based—suggesting thatFTS programs incorporating a diverse set of activitiesappear to be most promising in this regard.13

LITERATURE REVIEW

Research and evaluations that examined theimpacts of food-related activities in the school settingare included in this review if they are typical ofthe types of activities that are conducted within aFTS context. Because FTS does not have a precisedefinition, not all activities reviewed here werenecessarily linked in the school setting to a definedFTS program. Much of the research cited here wasidentified through a 2009 review by Joshi et al,1

and augmented with additional research publishedafter that report. The 3 broad areas of focus includeclassroom-based nutrition education activities, schoolgardens, and food interventions such as school lunchmenu changes and taste tests.

Component One: Nutrition Education Interventionsfor Children

One of the most explicit goals of FTS is to improvechildhood nutrition. Programs may attempt to increaseknowledge and awareness, change attitudes, improveskills, or alter behaviors, to positively impact healthmeasures. Despite great interest in this goal, researchspecifically designed to identify how FTS nutritioneducation components influence child nutritionhas been limited. Furthermore, it is challenging tocompare results across the few studies that have beendone, due to the diverse array of approaches that fallunder the broad definition of FTS.10

Studies show benefits of combining experientialnutrition education with that based in the class-room. Classroom-based nutrition education programsyielded increases in fruit and vegetable consumptionamong students, from 0.20 to 0.99 servings.14,15 Astudy of classroom-based nutrition education andhands-on gardening activities for fourth grade studentsshowed that compared with a control group, boththese activities ‘‘significantly improved the nutrition

590 • Journal of School Health • August 2013, Vol. 83, No. 8 • © 2013, American School Health Association

knowledge of the students,’’ as long as 6 months afterthe intervention. Furthermore, while both activitiesincreased students’ preferences for certain vegetables,the garden-based nutrition education did so for agreater number of vegetables.16

Component Two: School GardensA review of 11 studies showed that garden-

based nutrition interventions have varying impacts onyouth’s produce consumption. Of the featured studies,conducted between 1990 and 2007, 5 were school-based, involving children ages 5-15. Of the 4 studiesthat looked at actual changes in fruit and vegetableintake, 3 found evidence of increased intake. Of the 6studies that considered fruit and vegetable preferences,2 showed increased preferences. Of the 3 studies thatexamined willingness to taste fruits and vegetables, 2reported increased willingness to taste.17

More recent research has provided clearer evidencethat garden-based education improves youth’s appre-ciation of fresh produce. Garden education programshave been shown to improve attitudes toward fruitsand vegetables for second to fifth graders.18 In addi-tion, a 12-week pilot intervention for fourth to sixthgraders through a summer YMCA program showedincreases in the variety of fruits and vegetables ‘‘evereaten,’’ as well as improvements in vegetable prefer-ences and requests for fruits and vegetables at home.19

A 28-week study of second graders in a school settingshowed that youths involved in gardening in addi-tion to classroom-based nutrition education were morelikely to choose and consume vegetables in the cafe-teria, as compared with a control group and anothergroup who only received classroom-based nutritioneducation. The group that participated in gardeningactivities also showed improved nutrition knowledgeand taste ratings compared with the control group.20

Although these studies’ results are promising,their limitations—including small sample sizes, lackof long-term follow-up, convenience samples, andfrequent absence of control groups—prevent firmoverall conclusions about school gardens’ impactson youth’s consumption of and preferences for freshfruits and vegetables.

Component Three: School Lunch Option, Taste Tests,and Farm Connections

School-based interventions to improve nutritionoften incorporate some combination of taste testsin the classroom or cafeteria, more healthful foodchoices available in the cafeteria, and connectionsbetween children and local farmers. Given prominentgoals to improve children’s suboptimal intake of fruitsand vegetables, such as those put forth in the mostrecent Child Nutrition Reauthorization Act, much

of the recent research on the impact of school foodinterventions focuses on produce consumption.

Seven studies featured in a review of FTS programevaluations showed that participation in FTS programsincreased cafeteria offerings of fruits and vegetables.Subsequently, participating students chose more fruitsand vegetables than they did before their participationin the programs.1 One study in this review reportedthat on days when the salad bar was available, approx-imately 85% of students selected fruits and vegetables,compared to 35% choosing fruits and vegetables whenonly hot lunch was available. Between 80% and 90%of the salad bar produce that students selected wasunprocessed, compared to only 10% to 20% of thehot lunch fruits and vegetables they chose.21 Similarstudies in Compton, California, showed that studentschoosing foods from FTS salad bar lunches selectedbetween 90% and 140% of United States Departmentof Agriculture (USDA)-recommended daily servingsof fruits and vegetables, while students choosing hotlunch selected just 40% to 60% of the recommendedservings. For comparison, both groups took close tothe recommended amounts of proteins and grains; thissuggests that gains in fruit and vegetable consumptionmay be a unique contribution of school lunch saladbars.22

Across the nation, salad bar lunches consistentlyoffer nearly twice the servings of fruits and vegetablesthat hot lunches provide.21 In Oregon, FTS salad barprograms raised the average servings of fruits andvegetables taken by students from 1.24 to 2.26.23 InLos Angeles schools, students self-reported eating anaverage 4.09 daily servings of fruits and vegetableswhen participating in salad bar lunch programs, com-pared to 2.97 daily servings prior to the introductionof the salad bar. Students selecting the salad baralso reported consuming fewer total daily calories,cholesterol and fats.24 Pennsylvania parents reportedthat their children opted for healthier foods at homewhen participating in FTS interventions, specificallynoting that they ate fewer foods high in fats and salt.25

FTS programs can be a boon to school lunchprograms’ revenue, as studies show that they typicallyincrease school meal participation rates between 4%and 16%.26-28 This is an important part of schoolfood services’ budgets, because they must cover partof their operating costs through sales of full-pricemeals. They are also reimbursed by the USDA permeal served for purchases of commodity foods, as wellas for serving free and reduced-price meals to eligiblestudents.29 One California school meal cost analysisshowed that participation rate increases of as little as8% can offset additional costs of labor related to anFTS salad bar program.27

Little research was identified describing how tastetests within FTS programs affect actual student dietarybehavior. Practitioners use taste tests to introduce


students to nutritious food choices, to educate studentsabout what makes food healthy, and to allow foodservice providers to assess the feasibility of servingnew foods.30 The link between taste tests and actualfood choice and intake has yet to be made.

Clinical research conducted in the United Kingdomdemonstrates that exposure to a vegetable through 8daily taste tests increased children’s preferences forthat vegetable more effectively than reward methods,when compared with control groups.31 Taste tests heldin a school setting in Burlington, Vermont, facilitatedthe integration of new, healthy food items into theschool lunch menus, including pesto pasta and pestopizza, chicken caesar salads, minestrone soup, andgranola-yogurt parfaits.32

School food service professionals interviewed in aset of case studies observed that students are morewilling to eat fresh fruits and vegetables if theyhave interacted with the farmer who grew them,through activities such as field trips to the farm orvisits by the farmer to the school.33 These qualitativeobservations warrant further research into the effectsthat educational interactions with farmers have onstudents’ consumption of fresh fruits and vegetables.

Overall, research has shown these are positive gainsfrom the implementation of FTS programs. However,given the variety of interventions across FTS programsand the grassroots efforts by communities to imple-ment them, FTS programs consist of interventions insearch of a theory that provides a conceptual frame-work upon which to build testable hypotheses. Giventhat FTS programs require resources to implement,having impact research to show the efficacy is animportant next step toward policy changes that mayhelp stem the rising tide of childhood obesity.

Farm-to-School and Behavior Change TheoryTheory-based interventions that target key factors

influencing health behavior are a current best practicein the field of nutrition education. The social ecologicalmodel is one relevant theory that describes 5 levelson which health-related behaviors and conditions areinfluenced: intrapersonal, interpersonal, institutional,community, and public policy.34,35 There are multipletheories that address how change might happen ateach of these levels of influence, some of which areparticularly suited for certain types of interventions.

Social cognitive theory, although primarily focusedon the interpersonal sphere of influence, alsoencompasses factors linked to the intrapersonal,institutional, and community levels. This theory isfrequently the framework around which youth-relatedfood and nutrition interventions are designed becauseof its: (1) emphasis on approaches that are importantto youth, such as positive reinforcement and (2)applicability to public health issues, as evidenced by its

recent applications in these fields.36-38 It is, therefore,a good fit for considering the factors associated withFTS impacting students’ food-related decision-makingand behaviors.

SCT addresses the relationship among 3 factors thathave to do with how people acquire and maintainhealth-related behaviors: the environment, personalcharacteristics, and personal experience. These 3factors operate in a reciprocal manner with eachinfluencing the others, and are translated into anumber of specific constructs which can help shapethe components of an intervention. For example,an intervention built on SCT might incorporate achanged environment (institutional and communitylevel), positive reinforcements for new behaviors(intrapersonal level), and opportunities to build orenhance behavioral capability (intrapersonal level),self-control (intrapersonal level), and self-efficacy,such as through modeling (interpersonal level).13,39

To understand how the key constructs of SCTrelate to FTS activities, the following list provides abasic outline of the constructs 39 and indicates howthey might apply to dietary behavior change thatincorporates more local, healthful foods:

• Behavioral capability: youth having the knowledgeand skills that are necessary to choose and consumea diet that incorporates local, healthful foods.

• Expectations: youth having beliefs about the likelyoutcomes of consuming a healthful diet that includeslocal foods.

• Expectancies: youth valuing the results of eating a dietconsisting of healthful, local foods.

• Locus of control: youth’s perception of who reinforcescontinued consumption of local, healthful foods.

• Reciprocal determinism: interaction between a youthand his or her environment that results inconsumption of more healthful, local foods.

• Reinforcement: a youth’s response related to the con-sumption of local, healthful foods that increase thechance of the behavior being repeated; reinforce-ment can be provided internally (by oneself) orexternally (by another);

• Self-control or self-regulation: youth gaining controlby monitoring and adjusting personal behaviors(consumption of local, healthful foods).

• Self-efficacy: youths’ confidence in their ability toconsume local, healthful foods.

• Emotional coping response: how youth deal with thesources of anxiety that surround their consumptionof local, healthful foods.

DISCUSSION

Vermont Food Education Every Day (VT FEED)provides a concrete example of how SCT can be incor-porated into FTS programs. Many FTS programs in


Vermont have been initiated or supported by VT FEED,which encourages and provides technical assistance toschools through its ‘‘3 Cs’’ model: classroom, cafeteria,and community. Schools with the most comprehen-sive programs—those that incorporate all 3 Cs in theirefforts to improve their food environments—wouldlikely touch upon the intrapersonal, interpersonal,and community spheres of influence addressed in thesocial ecological model and SCT. Although VT FEEDdid not intentionally design its interventions aroundhealth behavior-change theory, and no peer-reviewedresearch yet considers FTS programs in this light, therest of this paper explores how components of FTSprograms in Vermont do (or do not) address key con-structs of SCT, and discusses these programs’ likelihoodof influencing long-term health behavior change.

Table 1 provides a description of the typesof activities that are often incorporated into FTSprograms. It then describes whether each activity takesplace in the classroom, cafeteria, or community, andwhich, if any, of the constructs of SCT are addressedwhen the activity is carried out.

As noted previously, the activities incorporated intoeach FTS program are not consistent across programs,making it impossible to draw a conclusion about theextent to which the constructs of SCT are addressedthrough FTS. However, some generalizations can bemade from the content of Table 1.

First, the activities that are commonly part of FTSdo touch upon many of the theoretical constructsin SCT, and often an activity has the potential toaddress a number of constructs. Second, and mostimportantly, FTS programs are likely to modify thestudents’ food environment while simultaneouslyproviding opportunities for them to learn throughobservation of others (modeling) during activitiessuch as taste tests, eating in the cafeteria, gardening,and cooking.30 Together these approaches have greatpotential to facilitate movement toward desired dietarychange. However, more research is needed to test theseassertions.

Another question to guide further research iswhether there are any approaches covered in SCTthat could be integrated more consistently into FTSprograms. Specific questions to ask toward this endinclude: Is parental involvement in FTS programsadequate to reinforce key messages at home, andthereby help establish a stronger sense of control(‘‘locus of control’’) in students? How can empiricalevidence be used to assess the value of local foodsin nutrition education to justify use of the classroomsetting to develop expectations and expectancies? andAre students provided with positive reinforcementwhen they make nutritionally beneficial choices inthe cafeteria? Further research that explores the linksbetween FTS and behavior change theory will enablea closer examination of some of these questions. Ta

ble

1.M

atch

ing

Soci

alC

ogn

itiv

eTh

eory

toFT

SA

ctiv

itie

s

Act

ivit

yC

lass

room

,Caf

eter

ia,

orC

omm

unit

y?So

cial

Cog

nit

ive

Theo

ryC

onst

ruct

Prim

ary

Way

sth

eA

ctiv

ity

Hel

ps

Car

ryO

utth

eC

onst

ruct

s

Tast

ete

sts

Clas

sroo

mor

cafe

teria

Posit

ive

rein

forc

emen

ts;e

xpec

tanc

ies;

self-

effic

acy;

mod

elin

g/ob

serv

atio

nal

lear

ning

;em

otio

nalc

opin

gre

spon

se

Stud

ents

lear

nth

atea

ting

prod

uce

can

been

joya

ble.

This

incr

ease

sthe

chan

ceth

eyw

illtry

som

ethi

ngin

the

futu

re(‘‘e

xpec

tanc

ies’’

);ad

ults

who

parti

cipa

tein

tast

ing

activ

ities

are

able

togi

veyo

uth

kudo

sfor

tryin

gne

wfo

ods(

‘‘pos

itive

rein

forc

emen

t’’)a

ndm

odel

tast

ing

new

food

s(‘‘m

odel

ing’

’);yo

uth

who

tryan

dlik

ene

wfo

odsg

ain

confi

denc

eab

outt

heir

abilit

yto

tryne

wfo

odsi

nth

efu

ture

(‘‘sel

f-effi

cacy

’’);st

uden

tsw

hoar

efe

arfu

loft

ryin

gne

wfo

odsm

ayov

erco

me

this

anxie

tyw

hen

they

are

expo

sed

toth

epo

sitiv

ere

spon

seof

thei

rpee

rs(‘‘e

mot

iona

lcop

ing

resp

onse

’’)St

uden

tshe

lpde

sign,

build

,and

tend

scho

olga

rden

sO

utdo

or‘‘c

lass

room

’’Be

havi

oral

capa

bilit

y;re

cipr

ocal

dete

rmin

ismM

ore

know

ledg

ean

dsk

illsab

outg

arde

ning

incr

ease

sint

eres

tin

the

end

prod

uct(

‘‘rec

ipro

cal

dete

rmin

ism’’);

Lear

ning

new

gard

enin

gsk

illsbu

ildsa

bilit

ies(

’beh

avio

ralc

apab

ility)

Loca

lfoo

dsin

the

cafe

teria

Cafe

teria

Self-

effic

acy;

locu

sofc

ontro

l;rec

ipro

cal

dete

rmin

ismIn

crea

sed

avai

labi

lity

inth

eca

fete

riagi

vess

tude

ntst

hech

ance

totry

thin

gsin

depe

nden

tly(‘‘l

ocus

ofco

ntro

l’’);s

elec

ting

new

item

sin

the

cafe

teria

enab

lesy

outh

toex

perie

nce

succ

esst

hatc

anre

sult

ina

sens

eof

mas

tery

(‘‘sel

f-effi

cacy

’’)Nu

tritio

ned

ucat

ion

inth

ecl

assr

oom

Clas

sroo

mPo

sitiv

ere

info

rcem

ents

;exp

ecta

tions

;se

lf-ef

ficac

yM

ore

food

-rela

ted

know

ledg

ean

dsk

illsin

crea

sesi

nter

esti

nth

epr

oduc

e(‘‘e

xpec

tatio

ns’’);

teac

hers

are

able

toco

mm

end

stud

ents

fort

heir

gain

s(‘‘p

ositi

vere

info

rcem

ents

’’)w

hich

lead

sto

agr

eate

rsen

seof

abilit

yto

mak

ego

odfo

od-re

late

dde

cisio

ns(‘‘s

elf-e

ffica

cy’’)

Sala

dba

rtra

inin

gfo

rstu

dent

sCa

fete

riaBe

havi

oral

capa

bilit

y;St

uden

tsre

cogn

izeth

eyar

eca

pabl

eof

sele

ctin

ghe

alth

fulc

hoic

es(‘‘b

ehav

iora

lcap

abilit

y’’)

Loca

lfar

mvi

sits

Com

mun

ityRe

cipr

ocal

dete

rmin

ismM

ore

inte

ract

ion

with

the

farm

and

farm

erre

sults

inm

ore

inte

rest

inhe

alth

fulc

hoic

es(‘‘r

ecip

roca

lde

term

inism

’’)In

-cla

ssfo

odpr

epar

atio

nan

dsh

arin

gCa

fete

riaBe

havi

oral

capa

bilit

y;ex

pect

atio

ns;

Stud

ents

reco

gnize

they

are

capa

ble

ofpr

epar

ing

heal

thfu

lcho

ices

(‘‘beh

avio

ralc

apab

ility’’

);fo

odpr

epar

atio

nle

adst

oin

crea

sed

inte

rest

intry

ing

new

food

sand

hope

that

itw

illbe

tast

y(‘‘e

xpec

tatio

ns’’)

FTS,

farm

tosc

ho

ol.


FTS programs that incorporate a number of diverseactivities are apt to lead to positive dietary behaviorchange, in part because of their capacity to addressmultiple constructs of SCT. However, because mostFTS programs are locally driven and differ from placeto place,5 they do not necessarily combine multipleactivities using SCT or any theory as guidance. Forthis reason it is unlikely that many programs addressmultiple constructs in a systematic manner. Researchfocusing on the ability of individual FTS-programcomponents to bring about dietary changes throughthese constructs, as well as research on the synergisticeffects of combining components toward this end,will help to shape the intentional inclusion of diverseactivities in future FTS models and possibly contributeto the creation of a universal FTS best practicesframework to guide local efforts.

A clear need remains for further research on thenutrition and health impacts of students’ participationin FTS. Incorporation of SCT described here providesan opportunity to build a more robust body ofknowledge supporting FTS programs’ improvementof students’ diets.

IMPLICATIONS FOR SCHOOL HEALTH

The complex and diverse goals of FTS programsmakes it too easy to use a scattershot approachwhen identifying interventions that might contributeto important outcomes. Furthermore, the FTS focuson ‘‘local’’ food and community may translate into avalue being placed on grassroots efforts throughout theeducational components of the program rather thanan incorporation of best practices identified throughresearch or adopted from other locales. How then dopractitioners reconcile these seemingly opposite valuesof ‘‘grassroots’’ vs ‘‘best practices?’’

Perhaps the first step is to recognize that thesevalues are not necessarily mutually exclusive. Schoolcommunities can coalesce around the broad conceptof FTS, consider ways they might capitalize on localresources, and still take advantage of the documentedexperiences of other programs. School leaders mustrecognize that cafeteria-based changes may not beenough to result in positive nutrition-related behaviorchanges. Forming school committees that undertakeFTS planning which broadly considers the cafeteria,classroom and community as venues for educationand change would likely help to create strong,comprehensive programs. Teachers, school healthpractitioners, parents, and others should be membersof these committees. Researchers should continue tolook for best practices that are theoretically grounded,practical, and affordable, and educators should helppublicize the results of this research. As the FTSconcept spreads through communities across thenation, and these communities use scarce resources to

achieve their aspirations, it is incumbent on membersof each community to carefully consider the best,reasoned approach.

REFERENCES

1. Joshi A, Azuma AM. Bearing fruit: farm to school programevaluation resources and recommendations. National Farm toSchool Network. Center for Food & Justice, Urban & Envi-ronmental Policy Institute, Occidental College; 2009. Avail-able at: http://departments.oxy.edu/uepi/cfj/bearingfruit.htm.Accessed August 3, 2010.

2. Bagdonis JM, Hinrichs CC, Schafft KA. The emergence andframing of farm-to-school initiatives. Agric Human Values.2009;26(1-2):1-13.

3. Farm to School. 2009. Available at: http://www.farmtoschool.org. Accessed September 22, 2009.

4. Kloppenburg JJ, Hassanein N. From old school to reform school?Agric Human Values. 2006;23(4):417-421.

5. Schafft KA, Hinrichs CC, Bloom JD. Pennsylvania farm-to-school programs and the articulation of local context. J HungEnviron Nutr. 2010;5(1):23-40.

6. Hinrichs CC. The practice and politics of food systemlocalization. J Rural Stud. 2003;19(1):33-45.

7. Ogden CL, Carroll MD, Kit BK, Flegal KM. Centersfor Disease Control and Prevention. Prevalence of Obe-sity in the United States, 2009-2010. National Cen-ter for Health Statistics Data Brief #82; 2012. Avail-able at: http://www.cdc.gov/nchs/data/databriefs/db82.pdf.Accessed July 3, 2012.

8. Ogden CL, Carroll MD, Flegal KM. High body mass index forage among US children and adolescents, 2003-2006. JAMA.2008;299(20):2401-2405.

9. Lin BH, Morrison RM. Higher fruit consumption linked withlower body mass index. Food Rev. 2002;25(3):28-32.

10. Joshi A, Azuma AM, Feenstra G. Do farm-to-school programsmake a difference? Findings and future research needs. J HungEnviron Nutr. 2008;3(2/3):229-246.

11. Dietz WH. Benefits of farm-to-school projects, healthyeating and physical activity for school children. Testimonybefore the Committee on Agriculture, Nutrition & ForestryUnited States Senate, Washington, DC; 2009. Available at:http://www.cdc.gov/washington/testimony/2009/t20090515.htm. Accessed August 3, 2010.

12. Howerton MW, Bell BS, Dodd KW, Berrigan D, Stolzenberg-Solomon R, Nebeling L. School-based nutrition programs pro-duced a moderate increase in fruit and vegetable consumption:meta and pooling analyses from 7 studies. J Nutr Educ Behav.2007;39(4):186-196.

13. Bandura A. Social Foundations of Thought and Action: A SocialCognitive Theory. Englewood Cliffs, NJ: Prentice Hall; 1986:544.

14. Knai C, Pomerleau J, Lock K, McKee M. Getting children toeat more fruit and vegetables: a systematic review. Prev Med.2006;42(2):85-95.

15. Stables GJ, Young EM, Howerton MW, Yaroch AL, KuesterS, Solera MK. Small school-based effectiveness trials increasevegetable and fruit consumption among youth. J Am Diet Assoc.2005;105(2):252-256.

16. Morris JL, Zidenberg-Cherr S. Garden-enhanced nutritioncurriculum improves fourth-grade school children’s knowledgeof nutrition and preferences for some vegetables. J Am Diet Assoc.2002;102(1):91-93.

17. Robinson-O’Brien R, Story M, Heim S. Impact of garden-basedyouth nutrition intervention programs: a review. J Am DietAssoc. 2009;109(2):273-280.

18. Nolan G. The effects of nutrition education and gardeningon attitudes, preferences and knowledge of 2nd-5th graders


regarding fruits and vegetables. Texas A&M; 2006. Available at:http://repository.tamu.edu/bitstream/handle/1969.1/3254/etd-tamu-2005C-HORT-Nolan.pdf?sequence=1. Accessed August3, 2010.

19. Heim SL, Stang J, Ireland M. A garden pilot project enhancesfruit and vegetable consumption among children. J Am DietAssoc. 2009;109(7):1220-1226.

20. Parmer SM, Salisbury-Glennon J, Shannon D, StruemplerB. School gardens: an experiential Learning approach for anutrition education program to increase fruit and vegetableknowledge, preference, and consumption among second-gradestudents. J Nutr Educ Behav. 2009;41(3):212-217.

21. Feenstra G, Ohmart J. Yolo County Farm to School EvaluationReport for the California Farm to School Program. OccidentalCollege, Center for Food and Justice; 2004.

22. Feenstra G, Ohmart J. Yolo County Farm to School EvaluationReport Year 4 Annual Report. UC Sustainable AgricultureResearch and Education Program; 2005.

23. Abernethy Elementary, Portland Public Schools NutritionServices, Injury Free Coalition for Kids and Ecotrust. New onthe Menu, District wide changes to school food start in thekitchen at Portland’s Abernethy Elementary. A report by Aber-nethy Elementary, Portland Public Schools Nutrition Services,Injury Free Coalition for Kids and Ecotrust; 2006. Available at:http://www.ecotrust.org/farmtoschool/Abernethy_report.pdf.Accessed August 3, 2010.

24. Slusser WM, Cumberland WG, Browdy BL, Lang L, NeumannC. A school salad bar increases frequency of fruit and vegetableconsumption among children living in low-income households.Public Health Nutr. 2007;10(12):1490-1496.

25. Food Trust. Kindergarten Initiative Evaluation Report. TheFood Trust; 2007. Available at: http://s1038.sharedsite.net/files/publications_114.pdf. Accessed August 3, 2010.

26. Feenstra G, Ohmart J. Final Evaluation Report, Compton Farmto School Demonstration Project, July 1, 2004-June 30, 2005.UC Sustainable Agriculture Research and Education Program;2006.

27. Center for Food and Justice. Riverside Farm to SchoolDemonstration Project, Final Grant Report, December 1,2004-November 30, 2006. Occidental College, The CaliforniaEndowment; 2006.

28. Flock P, Petra C, Ruddy V, Peterangelo J. A salad bar featuringorganic choices: revitalizing the school lunch program.

Washington: Olympia School District; 2003. Available at:http://agr.wa.gov/marketing/smallfarm/saladbarorganicchoices.pdf. Accessed August 3, 2010.

29. Ralston K, Newman C, Clauson A, Guthrie J, Buzby J. TheNational School Lunch Program: Background, Trends, and Issues (No.61). Washington, DC: US Department of Agriculture EconomicResearch Service; 2008.

30. Vermont Food Education Every Day. Vermont Farm to School:A Guide for Using Local Foods in Schools. Food Works,Northeast Organic Farming Association of Vermont, andShelburne Farms; 2007.

31. Wardle J, Herrera ML, Cooke L, Gibson EL. Modifyingchildren’s food preferences: the effects of exposure and rewardon acceptance of an unfamiliar vegetable. Eur J Clin Nutr.2003;57(2):341-348.

32. Croom E, Nasrana R, Kolodinsky J. Growing Farms, GrowingMinds: The Burlington School Food Project, Year OneEvaluation. Center for Rural Studies; 2003.

33. Izumi BT, Alaimo K, Hamm MW. Farm-to-school programs:perspectives of school food service professionals. J Nutr EducBehav. 2010;42(2):83-91.

34. Bronfenbrenner U. The Ecology of Human Development: Experimentsby Nature and Design. Cambridge, MA: Harvard University Press;1979:330.

35. Centers for Disease Control and Prevention. Principles ofCommunity Engagement. Available at: http://www.cdc.gov/phppo/pce/. Accessed April 28, 2013.

36. Hawley L, Harker D, Harker M. A social cognitive approach totackle inactivity and obesity in young Australians. J Bus Res.2010;63(2):116-120.

37. Rinderknecht K, Smith C. Social cognitive theory in an after-school nutrition intervention for urban Native American youth.J Nutr Educ Behav. 2004;36(6):298-304.

38. Winters ER, Petosa RL, Charlton TE. Using social cognitivetheory to explain discretionary, ‘‘leisure time’’ physical exerciseamong high school students. J Adolesc Health. 2003;32(6):436-442.

39. Baranowski T, Perry CL, Parcel G. How individuals, environ-ments, and health behavior interact. In: Health Behavior andHealth Education: Theory, Research, and Practice. 3rd ed. San Fran-cisco, CA: Jossey-Bass Publishers; 2002:153-178.


the role of social cognitive theory in farm-to-school-related activities: implications for child...

Documents