Effects of a School-Based Gardening, Cooking, and Nutrition Cluster Randomized Controlled Trial on Unprocessed and Ultra-Processed Food Consumption.

BACKGROUND: School-based gardening and nutrition education interventions report improvements in dietary intake, notably through fruit and vegetables. However, gardening, cooking, and nutrition randomized controlled trials are limited in evaluating dietary quality, and none have examined processed food consumption to date. OBJECTIVES: The study examined the effects of Texas Sprouts (TX Sprouts), a gardening, cooking, and nutrition education intervention, compared with control on unprocessed and ultra-processed food (UPF) consumption in predominately low-income Hispanic children. METHODS: TX Sprouts was a school-based cluster randomized controlled trial that consisted of 16 elementary schools randomly assigned to either the TX Sprouts intervention (n = 8 schools) or control (delayed intervention; n = 8 schools) over 3 y (2016-2019). TX Sprouts schools received an outdoor teaching garden and 18 1-h lessons taught by trained educators throughout the school year. Dietary intake data via 2 24-h dietary recalls were collected on a random subsample (n = 468) at baseline and postintervention. All foods and beverages were categorized using the NOVA food classification system (e.g., unprocessed, processed, ultra-processed). Generalized linear mixed effects modeling tested changes in percent calories and grams of NOVA groups between the intervention and control estimates with schools as random clusters. RESULTS: Of the sample, 63% participated in the free and reduced-price lunch program, and 57% were Hispanic, followed by non-Hispanic White (21%) and non-Hispanic Black (12%). The intervention, compared to the control, resulted in an increase in consumption of unprocessed foods (2.3% compared with -1.8% g; P < 0.01) and a decrease in UPF (-2.4% compared with 1.4% g; P = 0.04). In addition, Hispanic children in the intervention group had an increase in unprocessed food consumption and a decrease in UPF consumption compared to non-Hispanic children (-3.4% compared with 1.5% g; P < 0.05). CONCLUSIONS: Study results suggest that school-based gardening, cooking, and nutrition education interventions can improve dietary intake, specifically increasing unprocessed food consumption and decreasing UPF consumption. This trial was registered at clinicaltrials.gov as NCT02668744.

The Association Between Home or Community Garden Access and Adolescent Health.

Little is known about the influence of home or community garden (HCG) access on adolescent health. The objective of this study was to determine the association between adolescent self-rated health, nutrition knowledge, attitudes, and intake with HCG access. Urban high school students (n = 401) completed a questionnaire prior to a nutrition education intervention. Point biserial correlations and one-way analyses of variance evaluated garden access and health variables. Garden access differed by race ( P < .001), and students with HCG access consumed more vegetables than students who did not ( P = .003) and rated themselves as healthier ( P = .034). Findings suggest that garden access is associated with higher adolescent vegetable consumption and higher self-rated health. Future research should investigate adolescent levels of engagement in HCGs.

School-based gardening, cooking and nutrition intervention increased vegetable intake but did not reduce BMI: Texas sprouts - a cluster randomized controlled trial.

BACKGROUND: Although school garden programs have been shown to improve dietary behaviors, there has not been a cluster-randomized controlled trial (RCT) conducted to examine the effects of school garden programs on obesity or other health outcomes. The goal of this study was to evaluate the effects of a one-year school-based gardening, nutrition, and cooking intervention (called Texas Sprouts) on dietary intake, obesity outcomes, and blood pressure in elementary school children. METHODS: This study was a school-based cluster RCT with 16 elementary schools that were randomly assigned to either the Texas Sprouts intervention (n = 8 schools) or to control (delayed intervention, n = 8 schools). The intervention was one school year long (9 months) and consisted of: a) Garden Leadership Committee formation; b) a 0.25-acre outdoor teaching garden; c) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school-year; and d) nine monthly parent lessons. The delayed intervention was implemented the following academic year and received the same protocol as the intervention arm. Child outcomes measured were anthropometrics (i.e., BMI parameters, waist circumference, and body fat percentage via bioelectrical impedance), blood pressure, and dietary intake (i.e., vegetable, fruit, and sugar sweetened beverages) via survey. Data were analyzed with complete cases and with imputations at random. Generalized weighted linear mixed models were used to test the intervention effects and to account for clustering effect of sampling by school. RESULTS: A total of 3135 children were enrolled in the study (intervention n = 1412, 45%). Average age was 9.2 years, 64% Hispanic, 47% male, and 69% eligible for free and reduced lunch. The intervention compared to control resulted in increased vegetable intake (+ 0.48 vs. + 0.04 frequency/day, p = 0.02). There were no effects of the intervention compared to control on fruit intake, sugar sweetened beverages, any of the obesity measures or blood pressure. CONCLUSION: While this school-based gardening, nutrition, and cooking program did not reduce obesity markers or blood pressure, it did result in increased vegetable intake. It is possible that a longer and more sustained effect of increased vegetable intake is needed to lead to reductions in obesity markers and blood pressure. CLINICAL TRIALS NUMBER: NCT02668744 .

"Sow, Grow, Know, and Show": The Impact of School Gardens on Student Self-Perception in the Mississippi Delta.

This research evaluates the impact of participation in school garden programs on fifth grade student garden knowledge, self-perception, and standardized test scores in the Mississippi Delta. We collected pre and posttest participant data for two years, compared garden participants' standardized test scores with non-participants, and conducted participant observation and interviews in three school gardens for eight months during the 2017-2018 school year. While no effect on standardized test scores could be determined, students increased garden knowledge and reported feeling positive about their future, teamwork, and leadership ability. These results were supported by observations of student joy, confidence, leadership, and teamwork.

Sustainability via Active Garden Education (SAGE): results from two feasibility pilot studies.

BACKGROUND: Low physical activity (PA) and fruit and vegetable (F&V) consumption in early childhood are continued public health challenges. This manuscript describes outcomes from two pilot studies for Sustainability via Active Garden Education (SAGE), a program designed to increase PA and F&V consumption among 3 to 5 year old children. METHODS: SAGE was developed using community-based participatory research (CBPR) and delivered to children (N = 89) in early care and education centers (ECEC, N = 6) in two US cities. Children participated in 12 one-hour sessions that included songs, games, and interactive learning activities involving garden maintenance and taste tests. We evaluated reach, efficacy, adoption, implementation, and potential for maintenance of SAGE following the RE-AIM framework. Reach was evaluated by comparing demographic characteristics among SAGE participants and residents of target geographic areas. Efficacy was evaluated with accelerometer-measured PA, F&V consumption, and eating in the absence of hunger among children, parenting practices regarding PA, and home availability of F&V. Adoption was evaluated by the number of ECEC that participated relative to the number of ECEC that were recruited. Implementation was evaluated by completion rates of planned SAGE lessons and activities, and potential for maintenance was evaluated with a parent satisfaction survey. RESULTS: SAGE reached ECEC in neighborhoods representing a wide range of socioeconomic status, with participants' sociodemographic characteristics representing those of the intervention areas. Children significantly increased PA during SAGE lessons compared to usual lessons, but they also consumed more calories in the absence of hunger in post- vs. pre-intervention tests (both p < .05). Parent reports did not suggest changes in F&V consumption, parenting PA practices, or home F&V availability, possibly due to low parent engagement. ECEC had moderate-to-high implementation of SAGE lessons and curriculum. Potential for maintenance was strong, with parents rating SAGE favorably and reporting increases in knowledge about PA and nutrition guidelines for young children. CONCLUSIONS: SAGE successfully translated national PA guidelines to practice for young children but was less successful with nutrition guidelines. High adoption and implementation and favorable parent reports suggest high potential for program sustainability. Further work to engage parents and families of young children in ECEC-based PA and nutrition programming is needed.

Grüt: A Gardening Sensor Kit for Children.

Food waste is one of the main problems in our society. This is mainly caused by people's behaviors and attitudes, which influence the whole food chain, from production to final consumption. In fact, food is generally perceived as a commodity by adults, who transmit this behavior to children, who in turn do not develop any consciousness about food's source. One way to reduce the problem seems to be by changing consumers' attitudes, which develop during the early years of childhood. Research has shown that after attending school garden classes, children's food-related behavior changes. Growing crops is not always easy--it can't be done in the domestic space, and this lead to a loss of the long term positive effects. This paper presents a project that tries to teach children how to grow their own food indoors and outdoors, mixing real and virtual reality, connecting something natural like a plant to the Internet of Things (or IOT, a network of physical objects virtually connected to each other and to the web). The use of sensors related to an app makes this process more fun and useful for educational purposes. The aim of the project is to change children's attitude towards food, increasing their knowledge about production and consumption, in order to reduce waste on a long term basis. The research has been developed in collaboration with Cisco NL and MediaLAB Amsterdam. The user testing has been executed with Dutch children in Amsterdam.

School Gardens: Cultivating Food Security in Nova Scotia Public Schools?

PURPOSE: A small but growing body of peer-reviewed research suggests that school gardens can play a role in building community food security (CFS); however, to date little research exploring the role of school gardens in supporting CFS is available. This paper begins to address this gap in the literature. METHODS: A qualitative, exploratory, single-case study design was used. The focus of this case study was the school food garden at an elementary school in the River Valley, Nova Scotia, school community. RESULTS: Results provide useful information about potential CFS effects of school gardens in addition to the environmental effects on school gardens important to their effectiveness as CFS tools. Findings suggest children gained food-related knowledge, skills, and values that support long-term CFS. A local social and political landscape at the community, provincial, and school board level were key to strengthening this garden's contributions to CFS. CONCLUSIONS: We support Dietitians of Canada's nomination of school gardens as an indicator of CFS with theoretical and practical evidence, underscore the importance of a supportive environment, and need for further research in this area. Health professionals and community organizations provide critical support, helping to weave gardens into a greater movement towards building CFS.

Sustenance and sustainability: maximizing the impact of school gardens on health outcomes.

OBJECTIVE: School garden programmes have become popular action-oriented learning environments in many countries, often driven by converging priorities of environmental sustainability and healthful diets. Many of these programmes have assessed the impact on dietary intake, specifically fruit and vegetable intake, and related dietary behaviours, such as knowledge, preference, motivation, intention and self-efficacy to eat and prepare fruit and vegetables. The objective of the present study was twofold: (i) to review published garden-based programmes conducted in schools targeting dietary intake and/or determinants of dietary behaviour in children; and (ii) to identify similar strategies and components employed by these garden-based programmes. DESIGN: The review included thirteen studies that have examined the impact of garden-based programmes conducted in school, either during school hours or in after-school settings, on dietary behaviours in children (kindergarten through 8th grade students). RESULTS: Three of the reviewed studies did not have a comparison or control group and simply evaluated within-group changes after a garden intervention. None of the reviewed studies were randomized, but were assigned based on school's interest and timing of new school gardens being built. Out of the eleven programmes that examined dietary intake, six found that the programme resulted in increased vegetable intake, whereas four showed no effect. Seven of the eight studies that measured preference found that the programmes resulted in increased preference for vegetables. Gardening programmes also resulted in improved attitudes towards, willingness to taste, identification of and self-efficacy to prepare/cook fruit and vegetables. Similar strategies/components employed by the majority of the programmes included: 'hands on' curriculum, incorporation of a cooking component, providing the instructors, parental and stakeholder support, food provision and using the garden as the focal point for media promotion. CONCLUSIONS: Some of the garden programmes resulted in increased vegetable intake, which has positive implications for both environment sustainability and health-related outcomes. Further, the majority resulted in some improvement in behaviour determinants more generally. However, more research is warranted to understand how to achieve long-term improvements in dietary behaviours and how to sustain the garden-based programmes in schools.

Sustainability and public health nutrition at school: assessing the integration of healthy and environmentally sustainable food initiatives in Vancouver schools.

OBJECTIVE: To describe the development and application of the School Food Environment Assessment Tools and a novel scoring system to assess the integration of healthy and environmentally sustainable food initiatives in elementary and secondary schools. DESIGN: The cross-sectional study included direct observations of physical food environments and interviews with key school personnel regarding food-related programmes and policies. A five-point scoring system was then developed to assess actions across six domains: (i) food gardens; (ii) composting systems; (iii) food preparation activities; (iv) food-related teaching and learning activities; and availability of (v) healthy food; and (vi) environmentally sustainable food. SETTING: Vancouver, Canada. SUBJECTS: A purposive sample of public schools (n 33) from all six sectors of the Vancouver Board of Education. RESULTS: Schools scored highest in the areas of food garden and compost system development and use. Regular integration of food-related teaching and learning activities and hands-on food preparation experiences were also commonly reported. Most schools demonstrated rudimentary efforts to make healthy and environmentally sustainable food choices available, but in general scored lowest on these two domains. Moreover, no schools reported widespread initiatives fully supporting availability or integration of healthy or environmentally sustainable foods across campus. CONCLUSIONS: More work is needed in all areas to fully integrate programmes and policies that support healthy, environmentally sustainable food systems in Vancouver schools. The assessment tools and proposed indicators offer a practical approach for researchers, policy makers and school stakeholders to assess school food system environments, identify priority areas for intervention and track relevant changes over time.

The Cleveland-Cuyahoga County Food Policy Coalition: "we have evolved".

Several pieces of legislation passed in Cleveland, Ohio, from 2007 to 2011, focused on improving the city's food environment through urban agriculture initiatives. We used qualitative, case study methods, including interviews with 7 key informants, to examine the policy development process and investigate the role of the Cleveland-Cuyahoga County Food Policy Coalition in developing and implementing 4 pieces of legislation. In this article, we focus on 2 pieces of legislation: zoning designation of an urban garden and allowance of small farm animals and bees on residential property. Five key themes emerged: impetus for policy came from community needs; education and raising awareness helped mitigate barriers; a cultural shift took place among policy makers; social connections and individual champions were needed; and concerns over food access and health influenced policy decisions. Legislative actions are important tools to influence the nutrition environment, as long as they are based on local needs and context.

The Impact of School Gardening on Cree Children's Knowledge and Attitudes toward Vegetables and Fruit.

PURPOSE: School-based interventions may increase children's preferences for vegetables and fruit (V&F). This Canadian study measured changes in Indigenous First Nations schoolchildren's V&F knowledge, preferences, and home consumption following the implementation of a gardening and V&F snack program. METHODS: At baseline, 7 months, and 18 months, children in grades 1-6 (i) listed at least 5 V&F they knew, (ii) tasted and indicated their preferences towards 9 vegetables and 8 fruit using a 6-point Likert scale, and (iii) indicated their home consumption of 17 V&F. RESULTS: At all 3 time points, 56.8% (n = 66/116) of children provided data. Children listed a greater number of V&F at 18 months (4.9 ± 0.1) than at baseline (4.5 ± 1.0) or 7 months (4.7 ± .07) (F(1.6,105.6) = 6.225, P < 0.05). Vegetable preferences became more positive between baseline (37.9 ± 9.3) and 7 months (39.9 ± 9.2), but returned to baseline levels at 18 months (37.3 ± 8.7) (F(1.6,105.8) = 4.581, P < 0.05). Fruit preferences at 18 months (42.7 ± 3.0) were greater than at baseline (41.1 ± 4.3) and at 7 months (41.9 ± 5.1) (F(1.7,113.3) = 3.409, P < 0.05). No change in V&F consumption occurred at home. CONCLUSIONS: Despite improvements in V&F knowledge and preferences, home consumption of V&F did not occur. Complementing school-based programs with home-based components may be needed to influence V&F intake of children.

Edible gardens in early childhood education settings in Aotearoa, New Zealand.

ISSUE ADDRESSED: This paper aims to explore the presence and role of edible gardens in Aotearoa/New Zealand Early Childhood Education Services (ECES). METHODS: Participant ECES providers were identified from the Ministry of Education database of Early Childhood Education Services (March 2009). These include Education and Care and Casual Education and Care, Kindergarten, Home-based Education and Care services, Playcentres, Te Kohanga Reo. A structured, self-administered questionnaire was sent to the Principal or Head Teacher of the service. RESULTS: Of the 211 ECES that responded (55% response rate), 71% had edible gardens, incorporating vegetables, berry fruit, tree fruit, edible flowers and nut trees. Garden activities were linked with teaching across all strands of the New Zealand early childhood curriculum. In addition, 34% provided guidance on using garden produce and 30% linked the garden with messages on fruit and vegetable consumption. Most gardens were established recently (past 2 years) and relied on financial and non-financial support from parents, teachers and community organisations. Barriers included a lack of funding, space, time and staff support. CONCLUSIONS/IMPLICATIONS: Study findings suggest that gardens are already being used as a versatile teaching tool in many ECES settings. Most gardens are new, with a need to support the sustainability and workforce development among teachers and parents in order to be able to maintain these resources for future generations. SO WHAT?: Given the inherent links between gardening and healthy food and exercise, there seem to be extensive opportunities for health promotion aligned with the edible garden movement.

Effects of a School-Based Nutrition, Gardening, and Cooking Intervention on Metabolic Parameters in High-risk Youth: A Secondary Analysis of a Cluster Randomized Clinical Trial.

Importance: Although school-based gardening programs for children have consistently been shown to improve dietary behaviors, no cluster randomized clinical trial (RCT) has evaluated the effects of a school-based gardening intervention on metabolic outcomes. Objective: To evaluate the effects of a school-based gardening, nutrition, and cooking intervention (Texas Sprouts) on changes in metabolic outcomes in elementary schoolchildren. Design, Setting, and Participants: This study was a secondary analysis of a cluster RCT, conducted over 3 years from 2016 to 2019, at low-income elementary schools with majority Hispanic students in the greater Austin, Texas, area. Data were analyzed from January to August 2022. Interventions: Texas Sprouts was 1 school year long (9 months) and consisted of (1) Garden Leadership Committee formation; (2) a 0.25-acre outdoor teaching garden; (3) 18 student gardening, nutrition, and cooking lessons taught by trained educators throughout the school year; and (4) 9 monthly parent lessons. The delayed intervention was implemented the following academic year and received an identical intervention. Main Outcomes and Measures: The following measures were obtained at baseline and postintervention (9 months): demographics via survey; measured height, weight, and body mass index parameters; and glucose, insulin, homeostatic model assessment of insulin resistance, and a lipid panel via an optional fasting blood draw. Results: Sixteen elementary schools were randomly assigned to either Texas Sprouts intervention (8 schools) or to delayed intervention (control, 8 schools). A total of 3302 children (aged 7-12 years) were enrolled in Texas Sprouts, and fasting blood samples were obtained from 1104 children (or 33% of those enrolled) at baseline. The final analytic sample included 695 children (307 boys [44.17%]; mean [SE] age, 9.28 [0.04] years; 480 Hispanic children [69.02%]; 452 [65.03%] eligible for free or reduced lunch) with complete demographic data and baseline and postintervention (9-month) fasting blood draws. Compared with control schools, children from Texas Sprouts schools had a 0.02% reduction in mean hemoglobin A1c (95% CI, 0.03%-0.14%; P = .005) and a 6.40 mg/dL reduction in mean low-density lipoprotein cholesterol (95% CI, 3.82-8.97 mg/dL; P = .048). There were no intervention effects on glucose, insulin, homeostatic model assessment of insulin resistance, or other lipid parameters. Conclusions and Relevance: In this cluster RCT, Texas Sprouts improved glucose control and reduced low-density lipoprotein cholesterol in high-risk youth. These findings suggest that elementary schools should incorporate garden-based interventions as a way to improve metabolic parameters in children. Trial Registration: ClinicalTrials.gov Identifier: NCT02668744.

School Gardening and Health and Well-Being of School-Aged Children: A Realist Synthesis.

School environments can create healthy settings to foster children's health and well-being. School gardening is gaining popularity as an intervention for healthier eating and increased physical activity. We used a systematic realist approach to investigate how school gardens improve health and well-being outcomes for school-aged children, why, and in what circumstances. The context and mechanisms of the specific school gardening interventions (n = 24) leading to positive health and well-being outcomes for school-aged children were assessed. The impetus of many interventions was to increase fruit and vegetable intake and address the prevention of childhood obesity. Most interventions were conducted at primary schools with participating children in Grades 2 through 6. Types of positive outcomes included increased fruit and vegetable consumption, dietary fiber and vitamins A and C, improved body mass index, and improved well-being of children. Key mechanisms included embedding nutrition-based and garden-based education in the curriculum; experiential learning opportunities; family engagement and participation; authority figure engagement; cultural context; use of multi-prong approaches; and reinforcement of activities during implementation. This review shows that a combination of mechanisms works mutually through school gardening programs leading to improved health and well-being outcomes for school-aged children.

An evaluation of the California Instructional School Garden Program.

OBJECTIVE: California Assembly Bill 1535 awarded $US 15 million to California public schools to promote, develop and sustain instructional school gardens through the California Instructional School Garden Program (CISGP). The present study was designed to assess the effectiveness of the CISGP at assisting schools in implementing, maintaining and sustaining an academic school garden programme, determine how schools utilized the funding they received and assess the impact of the California state budget crisis on the CISGP. DESIGN: A mid-term evaluation was used to assess the degree to which schools achieved their instructional garden-related goals. SETTING: California. SUBJECTS: Only schools that applied for the CIGSP grant as part of a school district and also provided a contact email and had a unique contact person were included in the study (n 3103, 80·6 %). RESULTS: In general, many schools reported not achieving their predicted goals with regard to the CISGP grant. Only 39·4 % of schools reported accomplishing all of their garden-related goals. Over one-third (37·8 %) of schools reported that their school gardens were negatively affected by the California budget deficit. CONCLUSIONS: The difference between predicted and actual utilization of the CISGP grants may be due to a combination of the effects of budget shortfall and insufficiency of the grant award amount.

Impact of a community gardening project on vegetable intake, food security and family relationships: a community-based participatory research study.

This community-based participatory research project used popular education techniques to support and educate Hispanic farmworker families in planting and maintaining organic gardens. Measures included a pre- post gardening survey, key informant interviews and observations made at community-based gardening meetings to assess food security, safety and family relationships. Thirty-eight families enrolled in the study during the pre-garden time period, and four more families enrolled in the study during the post-garden period, for a total of 42 families enrolled in the 2009 gardening season. Of the families enrolled during the pre-gardening time period there were 163 household members. The mean age of the interviewee was 44.0, ranging from 21 to 78 years of age. The median number of occupants in a household was 4.0 (range: 2-8), Frequency of adult vegetable intake of "Several time a day" increased from 18.2 to 84.8%, (P < 0.001) and frequency of children's vegetable intake of "Several time a day" increased from 24.0 to 64.0%, (P = 0.003). Before the gardening season, the sum of the frequencies of "Sometimes" and "Frequently" worrying in the past month that food would run out before money was available to buy more was 31.2% and the sum of these frequencies dropped to 3.1% during the post garden period, (P = 0.006). The frequency of skipping meals due to lack of money was not statistically significantly different before and after the gardening season for either adults or children. Analysis of text responses and key informant interviews revealed that physical and mental health benefits were reported as well as economic and family health benefits from the gardening study, primarily because the families often worked in their gardens together. A community gardening program can reduce food insecurity, improve dietary intake and strengthen family relationships.

Food and the body politic.

Americans are in the midst of a food-consciousness revival: on television, in the mouth of the First Lady, in endless articles celebrating urban agriculture can be found a sudden enthusiasm for the politically and, perhaps, spiritually curated dinner table. In this special section, writers explore the perilous state of food and food politics in America and a wide range of responses on the Left. Marion Nestle, in her essay on the farm bill, describes how the existing policy disaster came to be, along with the relationship between Reagan-era deregulation and the obesity epidemic. Mark Engler describes both the successes and coopting of the strands of left-wing responses­buying organic, eating local, and agitating for fair trade­and asks, "What's a radical to eat?" Laurie Woolever uncovers the kind of labor exploitation endemic to the elite dining experience. Karen Bakker Le Billon compares American to French school lunches, unpacking the relationship between food and citizenship. Juliana DeVries explores vegetarianism and the politics of everyday life.

School Garden Benefits: Health Promotion and Environmental Conservation.

Garden-based learning promotes environmental awareness, health, and wellness across the school community and beyond. In this article, we review the literature on the benefits of school gardening and describe firsthand experiences for garden success. By sharing lessons learned, our aim is to inspire school nurses to join forces with like-minded teachers and staff or take the lead to build capacity in their school for gardening and a green culture dedicated to the conservation of natural resources.

Developing and Evaluating Newsletters for Parent Engagement in Sustainability via Active Garden Education (SAGE).

Physical activity and nutrition preschool programming must involve parents in positive long-term healthy habits. This paper describes parent outreach in the Sustainability via Active Garden Education (SAGE) study. Newsletters were sent home with children to promote family opportunities to increase physical activity and fruit and vegetable intake. The content was generated via a community advisory board participatory process. Messages linked SAGE curriculum topics with home and community activities. Parents rated frequency of receipt, helpfulness, satisfaction, and use of content. Most participants were Hispanic (>78%) and women (>95%). Most reported receiving newsletters; nearly all reported that they were helpful. Favorite newsletter components included recipes, pictures of their children and seasonal produce spotlights. Most reported doing physical activities from the newsletters (51.9%). Few reported doing featured physical activity (8.9%) and fruit and vegetable (12.7%) community activities. Newsletter outreach methods are a simple strategy to add value to preschool-based interventions promoting healthy families.