Abstract
The overall purpose of this study is to assess whether the Expanded Food and Nutrition Education Program (EFNEP) is a cost-effective nutrition education intervention that generates sustained improvement in chronic disease biomarkers.
This study utilizes a paired longitudinal quasi-experimental design with two parallel arms (untreated control versus EFNEP) and four waves of data collection (baseline pre-test, immediate post-test, six-months-post-test, 12-months-post-test). Chronic disease biomarkers (BMI, blood pressure, HbA1c) will be measured for 500 adults (250 control; 250 EFNEP) across four state EFNEP programs (Colorado, Florida, Maryland, Washington). Difference-in-differences analysis will be used to identify the impact of adult EFNEP on chronic disease biomarkers. The estimated impacts will then be incorporated into a biomarker cost-benefit analysis to assess the economic value generated by adult EFNEP through chronic disease risk reduction.
Protocol finalization was a primary focus during Year One. This included creation of standard operating procedures, data collection and entry protocols, biometric data collection forms and handouts, health questionnaires, data entry forms, demographic forms, data collection scripts, participant and partner recruitment flyers and scripts, data collection reminder postcards, Spanish translation and backtranslation of project documents, and IRB approval. Data collection training videos were developed and a two-part data collection training sequence was held for data collectors. Project personnel also published a pilot study introducing the biomarker cost-benefit analysis methodology to be used in this project. Partner site and participant recruitment began in Fall 2022 and is ongoing. To date, 12 sites have been enrolled in the study with pre-test data collection completed for 64 participants. Assessment of outcome measures, including biomarkers, food behaviors and intake, and demographics, will begin following completion of the 6-month-post data collection.
Project results will provide objective estimates of the economic value generated by EFNEP through chronic disease risk reduction and provide insight to support coordinators’ efforts to enhance programming and accurately demonstrate the economic value generated by the program to policymakers and stakeholders.
2022-69015-36283
This work is supported by the USDA National Institute of Food and Agriculture.