The goal of this integrated project is to assess whether EFNEP is a cost-effective nutrition education intervention that generates sustained improvement in chronic disease biomarkers. This project will be unique in its use of objective biomarkers, instead of self-reported behaviors, to quantify the economic benefits generated by EFNEP through chronic disease prevention. A paired location untreated control group quasi-experimental design will be employed, with biomarkers (BMI, blood pressure, HbA1c) measured for 500 adults across four representative state EFNEP programs (CO, FL, MD, WA). Biomarkers will be measured pre-EFNEP, 6-months-post-EFNEP and 1-year-post-EFNEP. Analytical techniques will include cost-benefit, bivariate, and multivariate analyses.
According to the CDC, 60% of US adults have a diagnosed chronic disease. This indicates the need for focused efforts to change modifiable risk factors including diet and exercise. The Expanded Food and Nutrition Education Program (EFNEP) aims to prevent chronic diseases by educating and encouraging vulnerable populations to adopt a healthy diet and physical activity. Addressing the program priority area Diet, Nutrition and the Prevention of Chronic Diseases, the long-term goal of this integrated project is to assess whether EFNEP is a cost-effective nutrition education intervention that generates sustained improvement in chronic disease biomarkers. This project will be unique in its use of objective biomarkers, instead of self-reported behaviors, to quantify the economic benefits generated by EFNEP through chronic disease prevention. Project research objectives include analyzing EFNEP's sustained impact on chronic disease biomarkers and developing and applying a biomarker-based cost-benefit analysis methodology. Extension objectives are to develop an online cost-benefit analysis tool and webinar for nutrition education program evaluation. Education objectives are to provide graduate students with experiential learning opportunities in data collection and analysis. A paired location untreated control group quasi-experimental design will be employed, with biomarkers (BMI, blood pressure, HbA1c) measured for 500 adults across four representative state EFNEP programs (CO, FL, MD, WA). Biomarkers will be measured pre-EFNEP, 6-months-post-EFNEP and 1-year-post-EFNEP. Analytical techniques will include cost-benefit, bivariate, and multivariate analyses. Project results will expand the EFNEP knowledge-base, allowing for program content and delivery modifications that maximize the impact of taxpayer dollars allocated to chronic disease prevention.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
500
Subjects will participate in nine hands-on EFNEP lessons to teach nutrition, healthy lifestyle choices, physical activity, food preparation, food safety, and food resource management.
Colorado State University
Fort Collins, Colorado, United States
NOT_YET_RECRUITINGUniversity of Florida
Gainesville, Florida, United States
RECRUITINGUniversity of Maryland
College Park, Maryland, United States
RECRUITINGWashington State University
Pullman, Washington, United States
RECRUITINGChange in Height from Baseline to 6 Months Post Intervention
Height (m) is measured using a portable stadiometer.
Time frame: Change in height measurement from baseline to 6 months post intervention
Change in Height from Baseline to 12 Months Post Intervention
Height (m) is measured using a portable stadiometer.
Time frame: Change in height measurement from baseline to 12 months post intervention
Change in Weight from Baseline to 6 Months Post Intervention
Weight (kg) is measured using a portable scale.
Time frame: Change in weight measurement from baseline to 6 months post intervention
Change in Weight from Baseline to 12 Months Post Intervention
Weight (kg) is measured using a portable scale.
Time frame: Change in weight measurement from baseline to 12 months post intervention
Change in Systolic and Diastolic Blood Pressure from Baseline to 6 Months Post Intervention
Systolic and Diastolic blood pressure are measured using an OMRON Silver blood pressure monitor
Time frame: Change in Systolic and Diastolic blood pressure measurements from baseline to 6 months post intervention
Change in Systolic and Diastolic Blood Pressure from Baseline to 12 Months Post Intervention
Systolic and Diastolic blood pressure are measured using an OMRON Silver blood pressure monitor
Time frame: Change in Systolic and Diastolic blood pressure measurements from baseline to 12 months post intervention
Change in HbA1c from Baseline to 6 Months Post Intervention
HbA1c is measured using A1CNow monitor.
Time frame: Change in HbA1c measurement from baseline to 6 months post intervention
Change in HbA1c from Baseline to 12 Months Post Intervention
HbA1c is measured using A1CNow monitor.
Time frame: Change in HbA1c measurement from baseline to 12 months post intervention
Change in EFNEP Adult Questionnaire Responses Baseline to 6 Months Post Intervention
The EFNEP Adult Questionnaire includes questions regarding food and physical activity behaviors.
Time frame: Change in EFNEP Adult Questionnaire Responses Baseline to 6 Months Post Intervention
Change in EFNEP Adult Questionnaire Responses Baseline to 12 Months Post Intervention
The EFNEP Adult Questionnaire includes questions regarding food and physical activity behaviors.
Time frame: Change in EFNEP Adult Questionnaire Responses Baseline to 12 Months Post Intervention
Change in 24-Hour Dietary Recalls Baseline to 6 Months Post Intervention
24-hour dietary recalls will be administered to capture change in food and beverage intake.
Time frame: Change in 24-Hour Dietary Recalls Baseline to 6 Months Post Intervention
Change in 24-Hour Dietary Recalls Baseline to 12 Months Post Intervention
24-hour dietary recalls will be administered to capture change in food and beverage intake.
Time frame: Change in 24-Hour Dietary Recalls Baseline to 12 Months Post Intervention
Participant Demographics Baseline
A range of participant demographics will be collected including sex, age, race/ethnicity, public assistance receipt, pregnancy status, and breastfeeding status.
Time frame: Baseline.
Participant Demographics Post Intervention
A range of participant demographics will be collected including public assistance receipt, pregnancy status, and breastfeeding status.
Time frame: Immediately Post Intervention.
Participant Demographics 6 Months Post Intervention
A range of participant demographics will be collected including public assistance receipt, pregnancy status, and breastfeeding status.
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Time frame: 6 Months Post Intervention
Participant Demographics 12 Months Post Intervention
A range of participant demographics will be collected including public assistance receipt, pregnancy status, and breastfeeding status.
Time frame: 12 Months Post Intervention
Participant Health Status Baseline
A Health Questionnaire will be used to identify whether participants have a health condition, take medication(s) for a health condition, and smoke.
Time frame: Baseline
Participant Health Status 6 Months Post Intervention
A Health Questionnaire will be used to identify whether participants have a health condition, take medication(s) for a health condition, and smoke.
Time frame: 6 Months Post Intervention
Participant Health Status 12 Months Post Intervention
A Health Questionnaire will be used to identify whether participants have a health condition, take medication(s) for a health condition, and smoke.
Time frame: 12 Months Post Intervention