Maryland SNAP-Ed Program - University of Maryland Extension


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 eight 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 that 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:

Intervention Costs

Materials available at no cost.

Evidence Summary

The ReFresh curriculum was developed, piloted, and evaluated through a Team Nutrition grant to the Maryland State Department of Education in partnership with Maryland SNAP-Ed. The intervention was research-tested during the initial grant period. Results demonstrated positive associations between program participation and individual-level nutrition-related indicators (taste preference, consumption, self-efficacy, trying new foods). Impacts were 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

At the conclusion of the research period, ReFresh was integrated into Maryland SNAP-Ed’s comprehensive evaluation strategy, which tracks individual preference data and environmental changes across all youth sites, independent of specific curricula used. 

Since FY18, youth education sites have used the Kids Food and Activity Questionnaire to collect pre and post-program data. This questionnaire tracks individual behavior change among youth participating in any of Maryland SNAP-Ed’s programs, including ReFresh. The questionnaire was modified from the Kids’ Activity and Nutrition Questionnaire developed by the University of Arizona SNAP-Ed Evaluation Team, published here 

LeGros TA, Hartz VL, Jacobs LE. Reliability of a Kids’ Activity and Nutrition Questionnaire for School-Based SNAP-Ed Interventions as Part of a Tiered Development Process. Journal of Nutrition Education and Behavior. 2017;49:125-129. 

Additional Information

Website: The University of Maryland Extension SNAP-Ed program’s Teacher Toolkit ( includes the ReFresh curriculum, resource guide, social media content, and more.

Contact Person:
Chrissa Carlson (Healthy School Community Coordinator)
Maryland SNAP-Ed Program – University of Maryland Extension
Phone: 410-715-6903 (office line); 443-283-8447 (direct line)