Nutrition Policy Institute partnered with local health departments to evaluate school-based CalFresh Healthy Living, finding that it improved student diet during COVID-19, contributing to improved community health and wellness.

The Issue

In March 2020 schools across California halted in-person instruction in an effort to protect students and staff against COVID-19 and embarked on “distance learning.” In spring 2021, over half of California's public schools, and disproportionately those serving low-income students, remained in full-time distance learning.

Distance learning had a substantial impact on student food security and dietary intake. Many students lost access to the consistent nutrition provided by school meal programs. Additionally, students may have had increased access to less healthy foods in the home environment, and/or experienced increases in snacking behaviors and eating/drinking out of boredom. For these reasons, continuance of public health programs that operate largely in the school environment, such as the California Department of Public Health's CalFresh Healthy Living (CFHL) program, were essential to addressing health impacts and widening disparities from school closures. When schools shuttered, local health departments (LHDs) administering CFHL had to swiftly adjust their approach to classroom direct education and school-wide policy, system, and environmental (PSE) change strategies as they prepared to deliver and evaluate their school-based interventions from afar. Likewise, evaluators at Nutrition Policy Institute (NPI) needed to devise new methods to enable and support evaluation of this valuable program.

How UC Delivers

To address the need to continue delivery of high quality CFHL programming, LHDs migrated nutrition and physical activity education from delivery in-person to delivery online. Curricula were delivered live via online platforms like Zoom or Google Classroom, or pre-recorded via websites like YouTube. Popular PSE change approaches, like improving school wellness policies or implementing a school garden had limited impact on students if not attending school. With limited or nonexistent in-person school-student interaction, LHDs opted to initiate more feasible and timely PSEs like modifying food distribution practices to ensure students had access to healthy meals.

Students participate in a taste test survey

While LHDs focused on modifying interventions, NPI evaluators were busy adapting evaluation methodology for students learning outside the classroom. A key component of this evaluation involved measuring student eating and physical activity behavior using the Eating and Activity Tool for Students (EATS). Pre-COVID-19, a hardcopy survey was administered to students before and after annual CFHL interventions. In Fall 2020, NPI launched an online version of EATS and provided technical assistance to schools to support virtual administration. Survey questions were also added to capture the unique impact of school closures on students' eating and physical activity behaviors.

The Impact

In 2020-21, pre/post EATS data were collected from 1,087 students from 47 CFHL intervention schools and 846 students from 17 comparison schools- schools where no programming occurred. During this time, intervention students reported a greater increase in frequency of consumption of fruit (by 0.16 times/day; p-value=0.032) and vegetables (by 0.45 times/day; p-value<0.001) than comparison students. Research suggests that higher fruit and vegetable intake protects against the development of cardiovascular and other chronic diseases.

Our findings suggest that LHD-led CFHL programs played a role in protecting student fruit and vegetable consumption during COVID-19 school closures and exemplifies how school-based CFHL may safeguard students' access to and consumption of nutritious food. California's health departments and their school partners proved that even with program adaptations, this important work continued to positively impact student health and wellbeing. Nutrition Policy Institute contributes to UC ANR's public value of Healthy People and Communities through their leadership and support of CFHL evaluation. Efforts by NPI help California communities understand the importance of CFHL programming for their children and families.

Students paint a mural

Acknowledgments

This study was conducted as part of a contract with the California Department of Public Health with funding from the United States Department of Agriculture (USDA) Supplemental Nutrition Assistance Program-- SNAP. These institutions are equal opportunity providers and employers.  

Youth participant from the Great Tomato Challenge

A social media campaign aims to improve health of residents at low-income housing sites by encouraging vegetable intake through container gardening

Great Tomato Challenge Family

The Issue 

In the U.S., vegetable intake is lowest among adults with low income. Eating the recommended daily amount of vegetables is important for overall health. Gardening has a role in promoting vegetable consumption. CalFresh Healthy Living, University of California Cooperative Extension (CFHL, UCCE) Butte Cluster and UC Master Gardeners, kicked off their second annual “Great Tomato Challenge” in 2022, a social media contest for Community Housing Improvement Program (CHIP).CHIP is a non-profit corporation that serves Butte, Glenn, Yuba and Colusa Counties by assisting low-income residents with quality, affordable housing. The goal of the “Great Tomato Challenge” event is to promote container gardening at apartment complexes through a workshop and social media contest.

How UC Delivers

The 1.5 hour Fresh from the Garden curriculum workshops took place at 5 CHIP sites, having been advertised in English, Spanish, and Hmong language flyers. Over 40 adults learned how to harvest, store, and prepare fresh tomatoes. Those who opted to sign up for the social media challenge received a tomato plant and agreed to submit photos, drawings, and recipes accessed on the CFHL, UCCE Butte Cluster Facebook page.

UC Master Gardeners partnered with CFHL, UCCE Butte Cluster to provide Facebook Live sessions to answer any questions participants had about growing their tomato plant. CFHL, UCCE Butte Cluster Educators translated questions and answers into Spanish and Hmong. 

Three winners were selected from the 36 contestants from the following categories: best photo of you and your tomato plant; best tomato drawing; and best recipe photo. Winners received a colander, whole wheat spaghetti noodles, and a jar of locally-sourced pasta sauce.

The Impact 

Eighteen participants completed an "Intent to Change" Survey for the workshop. Thirty-eight percent reported that they would: “eat more than 1 kind of vegetable each day more often within the next week.” One participant wrote “This workshop helps my family to be healthier.” Gardening has a role in promoting greater vegetable intake and variety among families with low income which improves overall health.

CalFresh Healthy Living, UCCE Butte Cluster will continue this challenge annually and is considering starting an additional annual challenge, using the same model, for a cool-season vegetable such as beets.

Tomato recipe

A child's drawing of a tomato fruit

UCCE partners with a school site to promote health and wellness and develop student leaders. As a result of the program, 92% of students reported gaining skills in teaching others.

The Issue

Studies show that school gardens support student health through increased physical activity, increased consumption of healthy foods, and decreased body mass index. School gardens are also associated with positive emotions and social interactions. Additionally, school gardens have the potential to improve students' leadership skills and teamwork abilities. CalFresh Healthy Living, UCCE (CFHL,UCCE) in Santa Barbara County partners with schools to gather stakeholders, create plans, fundraise, and build, maintain and teach in school gardens. One partnering school, Hapgood Elementary, has a flourishing garden that has been expanded and maintained over several years.

How UC Delivers

As COVID-19 restrictions at schools began to ease, UCCE garden nutrition educator Abbi Marrs reached out to the student leadership class to see if there was interest in developing leadership skills related to nutrition and food production in their school garden. Over 30 student leaders expressed interest in learning more about the garden. With the support of the school administration, UCCE staff met with the students to provide support and training related to growing food, composting, garden maintenance, and teaching in the garden. Throughout these trainings, UCCE staff worked with the youth to make decisions related to what they wanted to do with their new skills to support the garden. One group decided to focus on building more awareness of their garden by providing school garden tours. Another group decided to focus on supporting school and family health by providing garden enhanced nutrition education lessons in the garden.

UCCE staff supported youth by facilitating school garden training, helping write scripts for the garden tours, training in Teams With Intergenerational Support (TWIGS) curriculum, and practicing presentations. On April 15th, 2022, 26 youth delivered a garden tour to other youth, teachers, families, and community members. The mayor and city staff were invited to attend, and youth had the opportunity to share their garden and how it impacts their learning and health. In addition, 10 lessons were taught to 211 students in grades TK-6th.

Additionally, eight student leaders shared their garden experience while presenting at the 2022 California Agriculture in the Classroom Conference in September. Student leaders worked with UCCE staff to develop a presentation focused on the responsibilities of a garden student leader. The topics included: how the garden youth leader program started, garden jobs, composting, working with hydroponic towers, working with food service staff, safe harvesting practices, and how to teach garden-based and nutrition education lessons. During the presentation, student leaders shared their favorite parts of working in the garden. Some answers included teaching younger students about the garden, learning healthy recipes, and learning more about gardening in general. Student leaders then delivered a condensed version of the “Pest or Pal” lesson from the TWIGS garden-based curriculum to over fifty attendees. The presentation concluded with question-and-answers and students answered questions such as the biggest challenge they faced working in the garden, their favorite foods to grow, and how working in the garden has helped develop them as leaders.

Student leaders at California Ag in the Classroom Conference

The Impact

Youth leaders completed the Youth Leader Retrospective survey at the end of the school year (n=26). This survey asks participants to reflect on changes they see in themselves due to their participation in programming. Questions ask about behavior changes related to safely preparing and cooking healthy foods, leadership skills gained, and support received from adult facilitators.

For healthy behaviors, students agreed or strongly agreed, due to their participation in the UCCE Student Leaders Garden Committee: I wash my hands frequently (100%), my family has purchased healthier foods (92%), my family has prepared healthier foods (88%).

For leadership skills, youth retrospectively rated their ability before and after the program using a 4-point scale from No Ability to Excellent Ability. Improvement was observed in all leadership skills assessed, including the ability to work as a team member, speak before a group, teach others, and plan programs. The biggest change was observed in their ability to teach others. Prior to the program, only 1 (4%) youth reported an Excellent Ability, and 11 (42%) reported Good Ability. After the program, 11 (42%) rated themselves as having Excellent Ability and 13 (50%) rated themselves Good Ability. In addition, 0 youth rated themselves as No Ability after participating in the program, compared to 5 (19%) before the program.

For program support, youth agreed or strongly agreed with the following statements: There were dedicated adults who supported me as a youth leader (100%), I received ongoing training and support throughout the program (88%), The program made sure I had everything I needed to be successful as a youth leader (100%).

As a result of the garden tours, the Lompoc City Council adopted a school garden resolution that states the importance of school gardens to student health and the commitment of the city to support school gardens. Youth attended the council meeting and their school was gifted an apricot tree and the principal hosted a tree planting ceremony with students and family members. UCCE plans to work with student leaders next school year with 6th grade student leaders taking on the responsibility of training 5th grade student leaders. This peer to peer model will create a solid foundation for garden program sustainability for years to come. Lastly, when asked about the student youth leader the city mayor stated:

“I am so impressed with the students and the garden at Hapgood! Their passion for growing food was evident as the young scholars taught us about composting and what each part of the plant contributes to in its growth. I want to thank the UC CalFresh Education Program, all the parents and volunteers as well as the staff at Hapgood for supporting such an awesome learning experience in how our food grows.”- Lompoc City Mayor 

Through this partnership, CFHL, UCCE in Santa Barbara contributes to improved food security and health for the local community, and guides students to become effective public leaders.  

Student leaders presenting at a City Council meeting

School Garden Proclamation

CFHL, UC partners with San Mateo and Santa Clara county schools to increase structured and non-competitive physical activity opportunities for school-aged youth through the CATCH curriculum, contributing to improved community health and wellness.

The Issue

Since students returned to school and in-person learning, school administration witnessed a decline in student's social skills and physical activity abilities from previous years. Principals and teachers expressed concern that anti-social behavior was prevalent and believed it was a result of the isolation caused by the COVID-19 pandemic. One principal in Santa Clara County shared an observation that “students were having a difficult time making friends” and “many students would spend time by themselves, rather than engage with classmates.” School staff also noted that students were not getting the recommended 60 minutes of daily play during the pandemic.

In Spring 2022, CFHL, UCCE educators supported schools as they were dealing with low school staffing levels and students struggling to re-enter the classroom. Re-learning some of the skills associated with interacting and socializing, and then ramping up physical activity in the post-pandemic world was needed.

How UC Delivers

After hearing about the challenges facing schools, CFHL, UCCE developed an active recess program to help schools address supervision and staffing issues while engaging students in physical activity. School administrators and teachers were excited about this program and hoped structured recess games would engage their students physically and help them learn to interact cooperatively.

CFHL, UCCE educators attended school recess regularly, on a once- or twice-a-week basis, bringing CATCH games with them. At some elementary schools, CFHL educators reached all of the students with their games, from kindergarten to 5th grade, and at some school sites, educators focused on providing activities to just Kindergarteners. Games helped build a range of skills, from locomotor skills and coordinating with others, to developing balance, catching, and hand-eye coordination skills.

In San Mateo and Santa Clara County, CFHL, UCCE educators supported recess CATCH games with an array of equipment, from hula hoops, beanbags, frisbees, polyspots, scarves, and more! Students were welcome to join in for games such as dragon's tail, fruit salad, scarf and bean bag toss. Students were welcome to use the supplies to enrich their own play and it was common to see students building castles with cones, and juggling. These games were welcomed by the students, from K-5, with cooperation, laughter, and the request that CFHL, UCCE educators come the next day to play some more! This feeling was expressed by the Sunshine Gardens Principal, who stated “I only wish they were here every day!"

The principal at Sunshine Gardens went further to say that the games “allowed students to build skills and confidence and set goals”. At Castlemont Elementary,the principal saw that “more students were actively engaged”, a sentiment that was echoed at Pescadero Elementary, where a school leader noted that students were much more active during recess after the implementation of the active recess project.

The Impact

CFHL, UCCE Educators collected active recess evaluations to document CATCH adoption across four sites, reaching 795 students. Principals across sites reflected that the games were more cooperative than competitive, which encouraged more participation. The principal at Bowers Elementary also liked that the games “were structured so that they helped develop cooperative skills”. Pescadero leadership saw CFHL, UCCE involvement as both helpful and important, and all four participating schools requested continuing active recess work in the 2022-23 school year.

Recess interventions have been shown to increase the amount of physical activity children get and when children regularly engage in physical activity, it can lead to improved cognition, fitness, heart health and mental health outcomes. Teachers and staff remarked on the value of CFHL, UCCE bringing physically and mentally engaging collaborative games and activities to their students. CFHL, UCCE educators are looking forward to the opportunity to continue supporting active recess in the 2022-23 school year. Educators and School sites are inspired to build on last year's success and there is a plan to provide CATCH trainings to teachers and staff to support additional physical activity policy, systems, and environmental changes in the new school year. In this way, CFHL UCCE programming contributes to UC ANR's public value of Healthy People and Communities.

Student Playing at Active Recess