Abstract
<h3>Background</h3> Farm to School programs (FTSP) have been promoted as part of the Healthy, Hunger-Free Kids Act (HHFKA) to improve school children's access of nutritious, local food. <h3>Objective</h3> We investigate the prevalence of FTSP in K-12 schools before and after the implementation of the HHFKA. We also examine differences in prevalence of FTSP by school-level (elementary vs middle/high school), proportion of students enrolled from various race/ethnicity groups and proportion of students eligible for free or reduced-price meals (FRPM). <h3>Study Design, Setting, Participants</h3> A secondary analysis of data collected between 2010–2017 from 148 schools participating in the New Jersey Child Health Study (NJCHS) was analyzed. Schools were located in 4 low-income high minority cities in NJ: Camden, New Brunswick, Newark, and Trenton. <h3>Measurable Outcome/Analysis</h3> Schools' personnel answered surveys at 3 time points between 2010-2017 and reported on their schools' participation in the FTSP for the year of the survey and the previous year. Bivariate and multivariate analyses were conducted to examine FTSP prevalence rates for each year of data collection and for time periods categorized as before and after the implementation of the HHFKA. Differences in prevalence rates were compared by school characteristics. <h3>Results</h3> Across all years, on average significantly (<i>P</i> < 0.001) more elementary schools (21%) participated in the FTSP compared to middle/high schools (8%). Based on multivariate logistic regression analysis, compared to 2010, the odds of FTSP participation were 4-5 times higher in 2016 (<i>P</i> = 0.008) and 2017 (<i>P</i> = 0.003). Adjusted estimates show that across K-12 schools, participation increased from 7% in 2010 to 26% and 27% in 2016 and 2017, respectively. No differences were observed in FTSP participation by other school demographics. <h3>Conclusion</h3> Elementary schools are more likely to participate in FTSP and rates of participation in the program across K-12 schools have increased significantly in recent years.
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