The Role of Farm to School Programs in Promoting Healthy School Food Environments in the United States: A Scoping Review of Child‐Level Outcomes*

BACKGROUND: Most children and adolescents in the United States fall short of the Dietary Guidelines for Americans, with disparities by race and ethnicity, socioeconomic status, and geography. As K-12 students consume much of their daily nutrition from school meals, this scoping review sought to document reported impacts of Farm to School (F2S) programs on child-level food-related outcomes and discuss their potential to advance nutrition and health equity within school settings. METHODS: A literature search was conducted in PubMed, Scopus, Google Scholar, and Google search engine to identify publications evaluating F2S programs on health and food-related outcomes. Eligible English-language articles published from 2018 to 2024 were included, relevant data was extracted from each publication, and key themes were synthesized using content analysis. FINDINGS: Eight studies met the inclusion criteria. Most interventions were multicomponent and assessed student-level outcomes, including nutrition knowledge, food attitudes, and fruit and vegetable selection and consumption. Findings suggest F2S programs support healthier eating behaviors and positive food-related attitudes among students, particularly those with multiple F2S components. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: F2S programs are a Policy, Systems, and Environmental (PSE) strategy for promoting healthier school food environments. CONCLUSIONS: F2S programs can promote healthy dietary behaviors and perceptions among students while providing an avenue to support equity in school nutrition. Implementation barriers, including funding and local food availability, require further attention to improve equitable F2S adoption and sustainability.