habits, promoting physical activity, and reducing television viewing (Gortmaker et al., 1999). Evaluation of the intervention involved comparing obesity prevalence and behavioral changes among students in five intervention and five control schools in the Boston area.

Sports, Play and Active Recreation for Kids (SPARK)—A school-based intervention designed to improve the quantity and quality of physical education, the evaluation involved seven elementary schools in southern California in a 3-year study (McKenzie et al., 1997). The SPARK program involves enhancements to the PE curriculum, implementation of a self-management curriculum, and teacher inservice training programs. Outcomes assessed included changes in student BMI and physical activity levels.

Stanford Adolescent Heart Health Program—Designed to reduce cardiovascular disease risk factors in high school students, the intervention consisted of 20 50-minute classroom sessions on physical activity, nutrition, smoking, and stress (Killen et al., 1988). The evaluation of the intervention compared the results of 10th-grade students in four high schools in northern California on behavioral changes and physiological variables including BMI.

Stanford S.M.A.R.T. (Student Media Awareness to Reduce Television)—Designed to motivate children to reduce their television watching and video game usage, the intervention was evaluated in two elementary schools in California (Robinson, 1999). Students in the intervention third- and fourth-grade classrooms participated in an 18-lesson, six-month curriculum and families could use an electronic television time manager. The primary outcome measure was BMI; other physiologic variables and behavioral changes were also assessed.

Recent and Ongoing Pilot Program

Several pilot programs have been developed at the school, district, state, and federal levels to explore strategies to increase fruit and vegetable consumption among students in school. The committee is not aware of any published outcome evaluation of these studies but the programs are described here to illustrate current approaches that may warrant continued funding and more systematic analysis. The most recent and perhaps largest effort to increase the availability and consumption of fresh fruits and vegetables was implemented by USDA during the 2002-2003 school year (Buzby et al., 2003). One hundred schools in four states (Indiana, Iowa, Michigan, and Ohio) and seven schools in New Mexico’s Zuni Indian Tribal Organization participated in the pilot program, which distributed fruit and vegetables free to participating schools. Schools could choose when and how to distribute the produce to students. The program requested, however, that the fruits and vegetables be made available to students outside the regular school meal periods. Due to limited funding, no

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