University of Maryland Extension Food Supplement Nutrition Education (UME FSNE)


The ReFresh curriculum is a direct education intervention designed to encourage students to consume more fruits, vegetables, whole grains, and low-fat or fat free dairy products and to be more physically active. Composed of a series of 8 nutrition education units, ReFresh is designed for implementation in fourth and fifth grade classrooms throughout the school year from October through May. Lessons align with Common Core courses such as math and language arts and offer opportunities for taste testing, discussion, and reflection. Throughout the ReFresh curriculum, the following behaviorally-focused messages are emphasized:

  • Make half your plates fruits and vegetables
  • Make at least half your grains whole grains
  • Increase physical activity
  • Maintain calorie balance

Target Behavior: Healthy Eating

Intervention Type: Direct Education

Intervention Reach and Adoption

ReFresh targets fourth and fifth grade students and their families in public and private schools and out of school sites in both rural and urban areas, such as summer camps and other after school programs which serve low-income children.

Setting: School

Age: Elementary School, Parents/Mothers/Fathers

Race/Ethnicity: All

Intervention Components

ReFresh utilizes direct education with youth participants, as well as tastings to build taste preference for a variety of fruits and vegetables. Additionally, supplemental tools, including follow-up lessons/activities and journals, extend the scope and reach of the nutrition education lessons. Parental involvement is encouraged through the use of newsletters, which link parents to what their children are learning in the classroom. Teachers are also directly trained to administer the curriculum in the classroom and are supported by UME- FSNE throughout the school year.  A cafeteria component complements the classroom-based education and reaches the broader school environment.

Intervention Materials

All materials needed for the implementation of the curriculum are available online.

The ReFresh promotion flyer:

The ReFresh Curriculum can be accessed via the following link:

The ReFresh Toolkit can be accessed via the following link:

Evidence Summary

ReFresh is a research-tested intervention that has demonstrated positive associations between program participation and individual-level nutrition-related indicators (taste preference, consumption, self-efficacy, trying new foods). Impacts have been demonstrated across varying intervention conditions as well (i.e., no intervention (control); cafeteria improvements only; cafeteria improvements and ReFresh nutrition education) with the greatest changes occurring within the schools that implemented multilevel approaches.

  • After participating in ReFresh, 9 out of 10 (87%) students report consuming at least one fruit the previous day while 7 out of 10 (74%) consume at least one vegetable during the same time period.
  • Youth who participate in ReFresh make healthy choices regarding their lunchtime meals. 96% of students report regularly eating fruit with lunch, while 79% report regularly consuming vegetables at their lunchtime meal.
  • Youth who participate in ReFresh report significant increases in their preferences for fruits and whole grain foods—98% report liking fruit and 92% report liking whole grain foods after participating in the curriculum.
  • When cafeteria improvements (structuring food choices, promoting healthy foods, improving interactions between cafeteria staff and students, etc.) are combined with ReFresh education in the classroom, youth are more likely to select healthy food options, specifically fruits and vegetables.
  • Youth who participate in ReFresh within schools that also implement cafeteria improvements report eating fruits and vegetables more frequently and in greater quantities than do those in schools without nutrition education and/or cafeteria improvements.
  • Within schools that implement both cafeteria improvements and ReFresh classroom-based lessons, youth report significant increases in their self-efficacy to prepare fruits and vegetables at home and to select fruits and vegetables in the school cafeteria.

Classification: Research-tested

Evaluation Indicators

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

Readiness and Capacity – Short Term (ST) Changes – Medium Term (MT) Effectiveness and Maintenance – Long Term (LT) Population Results (R)
Individual ST1, ST3 MT1, MT3
Environmental Settings
Sectors of Influence


Evaluation Materials

The ReFresh Toolkit includes a section for evaluation (pg. 15) with a student survey, food service staff survey, student-staff interactions observation form, and a cafeteria nutrition environment observation form.

Additional Information

Website: The ReFresh website ( includes a ReFresh overview, promotional flyer, and more.

Contact Person:
Carol Miller (Training Coordinator)
Food Supplement Nutrition Education (FSNE) – University of Maryland Extension
Phone: 410-715-6903 (office line); 443-283-1116 (direct line)