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The National School Lunch Program is a healthy lunch option for students, yet participation is suboptimal and fruit and vegetable waste remains high. The study intervention consisted of adding school-lunch vending machines and mobile carts, school-lunch outreach to teachers, and cafeteria redesigns. The objectives were to determine the impact on school-lunch participation, perceptions and fruit and vegetable consumption. This three-year quasi-experimental study included 24 middle and high schools of which half received the intervention and half served as controls. Daily meal participation data were available through electronic point-of-sale records. Student and teacher surveys (20,905 and 1,941, respectively) assessed consumption and perceptions. Mixed effects linear and logistic regression models were used to assess differences between intervention and control groups in outcomes. No significant differences in overall lunchtime fruit and vegetable consumption or student lunch participation were observed between control and intervention groups. There was a decrease in participation among teachers at intervention compared to control schools (0.5% difference, P <.001). Among students eligible for free or reduced price meals (FRPM), the intervention was modestly effective (2.2% difference in participation, P <.001). Compared to students at control schools, students at intervention schools had a significantly greater increase in agreement that school meals make them feel full (0.129, P =.007) and that adults at their schools encourage them to eat school-lunch (0.116, P =.008). Compared to control schools, teachers in intervention schools had a greater increase in odds of agreement that school meals are healthy (2.83, P =.037). The intervention did not have a positive effect on overall lunchtime fruit and vegetable consumption or lunch participation but had a modest effect on student and teacher perceptions of school-lunch and FRPM student lunch participation. Additional innovations are needed to improve school-lunch participation and student dietary intakes. 2015-68001-23236. [ABSTRACT FROM AUTHOR]