Food Education Program Research Articles

Validity and Reliability Assessment of a Food and Physical Activity Questionnaire for Adolescents From Low-Income Communities

ObjectiveDevelop and validate an evaluation questionnaire for sixth-12th grade Expanded Food and Nutrition Education Program (EFNEP) participants. DesignFive-step process: domain concept prioritization, question generation, question pretesting, reliability testing, and criterion validity testing. SettingCommunity sites in 4 states and New Jersey EFNEP secondary program data. ParticipantsNineteen sixth-12th graders were interviewed; secondary data included 164 ninth-12th graders. Variables MeasuredContent, face, and criterion validity; internal reliability. AnalysisIterative template analysis to gauge conceptual understanding; exploratory factor analysis with orthogonal Varimax rotation, interitem correlations, and Cronbach α; Spearman correlations and Bland-Altman plots against the Physical Activity Questionnaire for Adolescents and Youth Risk Behavior Survey questions. ResultsFourteen questions with acceptable face validity were developed. One item (handwashing) had a ceiling effect and was removed. Eleven of the remaining 13 items were loaded onto 4 factors. The remaining 2 items were kept because of conceptual relevance. The questionnaire demonstrated acceptable reliability and validity overall, but subscale Cronbach α values ranged from 0.53–0.75. Conclusions and ImplicationsThis 13-item questionnaire was presented to national EFNEP program leaders and was implemented by EFNEP in October 2023. Further research could establish temporal reliability and gold standard criterion validity estimates with a multistate sample of sixth through 12th graders.

Relato de Experiência: Implementação de Ações de Educação Alimentar e Nutricional com Estudantes Universitários

The transition to higher education is a phase marked by intense changes in lifestyle, including eating habits. University students' diets are affected by factors such as lack of time, academic pressures, work, and financial issues, often resulting in the choice of quick, ultra-processed foods. Lack of time and stress are aspects that hinder the maintenance of a healthy diet, leading to inadequate eating practices (SANTOS, 2014). Additionally, there is a significant relationship between psychological aspects and eating behavior. Conditions such as anxiety, depression, and eating disorders can directly influence individuals' nutritional status (FRANÇA et al., 2012). Since students face both academic and emotional challenges, the intersection between Nutrition and Psychology becomes an essential tool for promoting healthier eating habits and improving quality of life. This report describes the experience of implementing a Food and Nutrition Education (FNE) program with students from the Psychology course at the University Center of Brasília (UniCEUB), aiming to improve their eating habits and encourage reflection on their food choices. Furthermore, the importance of Health Surveillance in monitoring and promoting food and nutritional security among students will be addressed.

Knowledge and practices of vegetable consumption in Accra and greater Lomé: nutritional, health and environmental sustainability

In Accra and Greater Lomé, research into the harmful effects of food transitions focuses scarcely on the levels of knowledge and good practices (LKGP) of vegetable consumers. However, these foods play a key role in the nutritional, health, socio-economic and ecological sustainability of cities. This research aims to assess the health, nutritional, ecological and socio-economic sustainability of LKGP linked to vegetable consumption in these conurbations. A quantified multi-criteria evaluation approach was adopted. The respondents (394), selected via judgmental sampling, were equally distributed between the two cities. Data were collected using a Food Frequency Questionnaire administered by Kobocollect. The overall average rate of good vegetable consumption knowledge and practices in Accra and Greater Lomé is low (37.43%). This result stems from the low LKGP for daily vegetable consumption (24.62%), their inclusion in the main daily meals (33.50%) and consideration of their nutritional composition (30.86%). The target population is unaware of the health, nutritional and ecological drawbacks of poorly preserved vegetables (66.93%) and adopts inappropriate waste management practices when handling them (65.91%). The average proportions of access to vegetable procurement technology (47.08%) and sustainable food education (11.29%) were also low. The research results, unfavorable to the achievement of the SDGs in Accra and Greater Lomé, call for an inclusive, integrated and continuous sustainable food education program.

The Role of Food and Nutrition education in improving Dietary Habits

To find out whether teens' involvement in a non-profit organization's Food and Nutrition education program resulted in a change in the quantity of food they ate. Fifty-five low-income teenagers participating in an NGO received a six-month nutritional intervention that included six visits with dietitians and strategic communication and relationship initiatives. At baseline and after the intervention, body weight, height, BMI, nutrition and eating behaviors questionnaire, one day recall and diet quality evaluation of the Digital Food Guide's Diet Quality Index were collected. Dietary pattern improvement required a 5-point rise in the Digital Food Guide's Diet Quality Index. Food labels were better understood and daily and weekend eating habits. Fruits, vegetables, dairy goods, legumes, and milk consumption increased (adequate components). However the intake of whole grains and nuts was low while that of items that should be eaten in moderation was high. The effort altered the eating habits of teenagers, making it a practical and affordable way to promote health, avoid illness. The diet quality index in the digital meal guide has also proven useful for analyzing dietary changes and directing future counseling and nutritional intervention efforts.

The Impact of the COVID-19-Related Transition to Remote Learning on the Expanded Food and Nutrition Education Program (EFNEP) Outcomes

The Impact of the COVID-19-Related Transition to Remote Learning on the Expanded Food and Nutrition Education Program (EFNEP) Outcomes

Impact of Intergenerational Shokuiku (Food and Nutrition Education) Programs on Alleviating Loneliness in Japanese Communities across Ages.

As loneliness is a risk factor for mental and physical health problems in various age groups, this study aimed to explore the impact of the intergenerational Shokuiku (food and nutrition education) program (IGSP) on loneliness in a Japanese community. This single-arm intervention study conducted between 2022 and 2023 included children (n = 21), guardians (n = 16), university students (n = 3), and older adults (n = 6). The IGSP was a one-day program that included participants making and eating their own bread, butter, and sorbet. Loneliness was measured using the Five-item Loneliness Scale for Children (Five-LSC; Japanese) and the three-item UCLA Loneliness Scale (Japanese; for adults) with other direct questions. Social capital, including civic participation, social cohesion, and reciprocity, was assessed using a self-administered questionnaire. The Five-LSC score significantly decreased post-intervention (p = 0.04). There was a significant increase in adults who reported not feeling lonely (p = 0.001). However, the UCLA Loneliness Scale scores did not show any significant changes. A positive change in social cohesion, including community contribution (p = 0.001) and attachment (p = 0.002), was observed among adults. This study suggests that IGSPs have a positive impact on loneliness in children and a partly positive one in adults. These findings emphasize the potential of intergenerational programs to reduce loneliness in communities.

Expanded Food and Nutrition Education Program Generates Economic Value Through Body Mass Index Improvement: A Cost-Benefit Analysis

Prior economic evaluations of the Expanded Food and Nutrition Education Program (EFNEP) perform cost-benefit analyses (CBA) reliant on self-reported behavioral data and unvalidated criteria for disease prevention. This study aims to conduct a CBA of Colorado and Washington EFNEP using an objective biomarker, Body Mass Index, to monetize program benefits. A longitudinal study of a convenience sample of EFNEP participants was conducted utilizing a single-group pretest-posttest design. Results indicate Colorado and Washington EFNEP generates $9.23 of benefits per $1.00 of costs and demonstrate the feasibility and value of using biomarkers in economic evaluations of nutrition education interventions delivered through Extension.

Evaluation of a pilot food education program delivered for children in grade four attending a school located in a disadvantaged area in greater Melbourne

Primary school aged children (aged 4-12 years) in Australia consume approximately 40% of daily energy from energy-dense, nutrient poor foods and fewer than 5% meet the recommended guidelines for vegetables and fruit (ABS 2018). Poor eating habits in children can track into adulthood increasing the risk of non-communicable diseases later in life (Nicklaus 2013). Children spend a large amount of time at school where they are provided with social contexts which influence behaviour development (FAO, 2022) and thus are ideal settings for teaching children about food and nutrition (FAO, 2022; WHO 2017). This pilot study was designed in response to a call to action from a local primary school in southeast Melbourne facing disadvantage. Anecdotally, the school reported poor food literacy with many students bringing unhealthy lunches. The school asked us to design, pilot, and evaluate a student education program enabling healthier lunches among these children. The aim of the study was to explore the effectiveness of a 4-week food and nutrition education program delivered to grade 4 students within a disadvantaged area targeting, children’s food-related knowledge, behaviours and self-efficacy (confidence) to pack a healthy lunch. The program delivered weekly 1-hour interactive sessions over four weeks (October-November 2022). Topics included healthy eating, designing healthy lunches and food safety and were delivered using interactive games, activities, quizzes and food tasting. Students completed an online survey measuring their knowledge, self-efficacy and behaviour (e.g. foods packed in their lunchbox) pre- and post- program. A comparative analysis of the pre- and post-survey responses was performed using McNemar Tests in SPSS version 29.0. Sixty students completed both the pre- and post-surveys. A significant increase (p<0.001) in knowledge of recommended daily serves of fruit (pre 43%, post 80%) and vegetables (pre 17%, post 54%) was observed. There was also a significant (p<0.001) increase in student’s ability to identify ‘sometimes food’. No changes were observed in identification of ‘everyday food’, sources of protein and sources of dairy food or safety knowledge. Children’s confidence to make healthy food swaps significantly increased from pre- to post- program (27%45%, p = 0.035). We observed significant increases in children’s food and nutrition related knowledge for some topics and confidence to make healthy food swaps following completion of the program. A program of longer duration may be beneficial to observe additional improvements in knowledge as well as behaviour change, including foods packed in school lunches.

Abstract P256: Rationale, Development, and Implementation of a Multidisciplinary Digital Lifestyle Health Education Program for Older Adults With Cardiovascular Disease and Osteoarthritis

Introduction: Cardiovascular disease (CVD) is the leading cause of death worldwide. Globally, osteoarthritis (OA) affects 654 million. In 2018, of the 1.2 million Australians who had CVD, half also had arthritis, with the most common form in Australia being OA. Ongoing pain and physical limitations from OA can affect lifestyle choices, contributing to the shared risk factor profile of CVD and OA (physical inactivity, overweight/obesity, poor diet, high medication use). This contributes further to the burden of both diseases including reduced 6-minute walk (6MW) performance, which is directly related to increased CVD mortality. This project outlines the rationale for and development of a multidisciplinary digital lifestyle health education program for the treatment and secondary prevention of CVD and its common comorbidity of OA. Methods: This study is a cross-sectional analysis of older adults in Sydney. Class was classified based on the Australian socioeconomic index for areas. Conditions were defined according to Australian national guidelines. Medical history, body mass index (BMI), waist measurement, muscle strength, and 6MW measurements were assessed. Differences between those with and without OA were determined via one-way analysis of variance. Simple linear regressions assessed potential relationships. Results: In a cohort of 532 adults; n=341 (64.1%) had diagnosed CVD; 48.4% of which had OA (mean age 66±12 years; 73.3% female). Socioeconomic index was deemed high. In the OA cohort mean BMI and waist were above healthy heart recommendations according to the World Health Organisation. There were no significant differences between those with OA and those without for cardiovascular risk factors of body weight, BMI, waist measurement, blood pressure, 6MW, or muscle strength. However, in those with CVD and OA, the relationship between age and 6MW was stronger and age accounted for more of the variance in performance (r=-0.44; r 2 =0.19; p<0.001) than those without OA (r=-0.37; r 2 =0.17; p<0.001), indicating a greater reduction in walking ability in those with OA as they get older. Conclusion: With 6MW performance being related to CVD mortality, interventions are needed to improve health and fitness in this cohort. International guidelines for CVD and OA recommend treatment should prioritise lifestyle changes, including a healthy diet, regular physical activity, and interventions that address all risk factors. Lifestyle LIFEMAP will assess the efficacy of a widely translatable multidisciplinary digital evidence-based 10-module lifestyle, food, exercise, medication, and park prescription education program for adults with the comorbidity of CVD and OA. We expect this program to improve knowledge, and healthy lifestyle choices, thereby improving physical activity and health outcomes in this highly vulnerable population.

Impact and process evaluation of a primary-school Food Education and Sustainability Training (FEAST) program in 10-12-year-old children in Australia: pragmatic cluster non-randomized controlled trial

BackgroundEnvironmentally sustainable food initiatives accompanying nutrition education, such as the Food Education and Sustainability Training (FEAST) program, have gained traction in school settings. The aim of this trial was to conduct an impact and process evaluation of FEAST, to evaluate its effect on children’s fruit and vegetable (F&V) intakes, and secondary outcomes: F&V variety consumed, nutrition knowledge, food preparation/cooking skills, self-efficacy and behaviours, food waste knowledge and behaviours, and food production knowledge.MethodsFEAST was a 10-week curriculum-aligned program, designed to educate children about healthy eating, food waste, and sustainability, while teaching cooking skills. It was implemented by classroom teachers, face-to-face and online, during COVID-19 school closures, in Australia in 2021. A custom designed survey was used to collect baseline and post-intervention data from students. Generalised linear mixed models (GLMM) estimated group differences in pre-post changes for primary and secondary outcomes. Surveys were also administered to students and teachers to evaluate intervention implementation.ResultsTwenty schools participated and self-selected to be either intervention schools (n = 10) or wait-list control (WLC) schools (n = 10). A total of 977, 5th and 6th grade children participated in the trial with a mean age of 11.1 years (SD ± 0.7). The FEAST intervention, compared to WLC, did not result in significant increases in primary outcomes nor secondary outcomes. The process evaluation revealed FEAST was well-received by students and teachers, but COVID-19 school closures hindered implementation fidelity with a less intense program delivered under the constraints of pandemic lockdowns.ConclusionsThis is the first cluster non-randomized controlled trial designed to independently evaluate FEAST in the primary-school setting. No evidence was found for improved F&V intakes in children, nor secondary outcomes. However, the positive process evaluation results suggest that further trials of the program are warranted. If implemented as originally designed (pre-pandemic), with increased duration and complemented by supporting school policies, such programs have the potential to improve children’s daily F&V intakes, cooking skills and food waste behaviours. This would support the Australian curriculum and contribute to: health promotion within schools and sustainable schools initiatives, the national agenda to reduce food waste and sustainable development goals.Australian and New Zealand Clinical Trials Registry[ACTRN12620001347954]- Registered prospectively on 14/12/2020.

Using Mobile Technology for Family-Based Prevention in Families with Low Incomes: Lessons from a Randomized Controlled Trial of a Childhood Obesity Prevention Program

Researchers are increasingly using web-based technologies to deliver family-based, prevention programming. Few studies have examined the success of such approaches for families with low incomes. The purpose of this study was to describe the level of in-class and online engagement in a childhood obesity prevention program for parents with low incomes, to examine the demographic correlates of parent engagement, and to examine dosage effects on parental feeding outcomes as a function of online exposure. All participants attended in-class nutrition education classes (Eating Smart · Being Active) as part of the Expanded Food and Nutrition Education Program (EFNEP) in Colorado and Washington State (classes were offered in English and Spanish). Participants in this analysis were 168 parents from a larger cluster randomized controlled trial who had been randomly assigned to also receive a newly developed, mobile-based version of an efficacious, feeding-focused, childhood obesity prevention program. Results showed that despite high levels of in-person attendance (70%), participants only accessed 47% of the videos (online content). Older parents and parents of girls showed higher levels of in-person attendance; currently employed parents showed lower levels. Online engagement varied as a function of ethnicity and acculturation: non-Hispanic parents accessed the most videos, low-acculturated Hispanic parents accessed the second most, and highly acculturated Hispanic parents accessed the least. In contrast, low-acculturated Hispanic parents showed the highest in-person attendance. For all but one outcome, significant online program effects were found only for parents who accessed at least half of the videos. Implications for mobile-based, family-based prevention programs for parents with low incomes are considered.ClinicalTrials.gov Identifier: NCT03170700; Registration Date: March 08, 2017.

Effects of a short food education program implemented at school canteens on children’s acceptance of plant-based food: A quasi-experimental study

Dietary transition toward more plant-based foods is needed to improve nutritional quality and reduce the carbon footprint of the food systems. Since 2018, the French school meals guidelines have imposed a weekly vegetarian meal, yet children may not like all of them. This study aimed to evaluate the effects of a short sensory-based food education program (SFEP) developed in collaboration with school canteen staff on children’s acceptance of plant-based food and eating traits. Two school canteens were selected as intervention group and two others as control group. Two plant-based foods were selected as targets (green cabbage and red beans) and two SFEPs were conducted: SFEP1 on cabbages and SFEP2 on pulses. Liking of the vegetarian dishes was collected through connected scoring devices. Knowledge about cabbages and pulses, willingness to taste and identification of green cabbage and red beans, attitudes toward food, and food neophobia by self-completed paper questionnaires. A total of 660 elementary school children (between 6 and 11 years old) participated in the study: 338 in the control group and 322 in the intervention group. After SFEP1, knowledge about cabbages increased, but liking, willingness to taste and identification did not. After SFEP2, knowledge about pulses, willingness to taste and identification of red beans increased, but liking did not. No effect of the SFEPs was observed on attitudes toward food nor on food neophobia. This intervention had positive effects on children’s knowledge for both cabbages and pulses, and on willingness to taste and identification but for red beans only.

Does feeling what you eat change how you eat? Implications of an intervention to promote consciousness of eating experiences.

This work aims to understand the experience of participating in the Food and Nutrition Education Program workshops with Sensory and Cognitive Exercises (PESC) and measure its impact on eating behavior. The PESC consists of four workshops with exercises stimulating perception and reflection on bodily sensations triggered in eating situations. It was developed to promote consciousness of eating experiences in women who reported difficulty in controlling their body weight and who increased over 5% of their body weight in the previous year. This is a mixed-methods study designed as a controlled trial. The intervention group (n = 19) was evaluated before the first workshop (T0) and after the last workshop (T1) and the control group (n = 18), which did not participate in the workshops, was evaluated twice (T0 and T1), with an interval of 3 to 4 weeks. At T0 and T1, it was applied the Intuitive Eating Scale (IES-2) and the Three Factor Eating Questionnaire (TFEQ-R21). In T1, the intervention group also participated in a qualitative interview. After participating in the PESC, the intervention group showed an increase in the IES-2 total score (95% Confidence Interval = (0.10, 0.39)) and a decrease in the emotional eating scale score (95% Confidence Interval = (-16.03; -3.85)). The interviews' analysis revealed the participants' self-observation process, which led to the perception of their practices, priorities, intentions, eating difficulties, and the connection between these aspects and environmental issues. The following themes were considered: Food management/control, Body dissatisfaction, Reflection/re-signification, and Different ways of being in familiar contexts. The results allow us to infer that, after participating in the PESC, the intention to manage food intake became more effective, less susceptible to oscillations imposed by the external environment, and more supported by internal resources.

Impact on weight loss and body composition of a food education intervention associated with Liraglutide treatment to address obesity

Introduction: clinical practice guidelines recommend considering pharmacological treatment of obesity only as a complement to lifestyle modification. Drugs alone are usually ineffective in the long term after discontinuation, so pharmacological weight loss strategies should always be accompanied by lifestyle modifications. Objective: to analyze the changes in weight, body mass index and body composition by means of electrical bioimpedance after a 32-week treatment with liraglutide in patients with obesity, associated or not with a food education program. Materials and methods: the study involved 68 patients who were randomly divided into 2 groups. One group received treatment with liraglutide 3.0 mg/day along with individual dietary education, and the other group was treated with liraglutide 3.0 mg/day and standard medical follow-up for 32 weeks. The data collected were weight (kg), height (m) (Seca® brand), body mass index (kg/m2) and body composition using multifrequency bioimpedance (SECA 112® brand). The variables were analyzed at the beginning and at the end of the treatment. Results: after 32 weeks of treatment, both study groups lost weight significantly. The group treated with liraglutide and individual dietary education had a reduction of 8.77 kg (9.08 %) (p < 0.001) and the group treated with liraglutide without education had a reduction of 3.55 kg (3.45 %) (p < 0.001). The BMI of the participants treated with liraglutide and education decreased by -4,04 kg/m2 (10.35 %) (p < 0.001) and in the group without education it decreased by -3.22 kg/m2 (8.30 %) (p = 0.003). In the educated group, fat mass decreased by -7.65 kg (15.89 %) (p < 0.001), although skeletal muscle mass also decreased by -1.62 kg (6.8 %) (p < 0.001). In those treated with liraglutide without education, a reduction in fat mass and skeletal muscle mass was also observed - fat mass by -4.72 kg (9.43 %) (p < 0.001) and skeletal muscle mass by -0.17 kg (0.70 %) (p < 0.001). Differences were also observed between groups, observing a greater reduction in weight, BMI, fat mass and skeletal muscle mass in the group with liraglutide and education compared to the group without education, although these differences were not statistically significant. Conclusions: dietary education associated with liraglutide treatment may contribute to increasing weight and fat mass losses. However, it was also associated with an unwanted loss of skeletal muscle mass, probably related to the greater intensity of weight loss, which will have to be reversed in future therapeutic approaches. Habit modification through multidisciplinary treatment, including nutritional education, combined strength and resistance exercise, and cognitive-behavioral therapy, could be an effective way to treat obesity and maintain weight, body composition, and adherence to a lifestyle.

Participant Perspectives on the Impact of a School-Based, Experiential Food Education Program Across Childhood, Adolescence, and Young Adulthood

ObjectiveExplore participant perceptions of involvement in an experiential food education program during elementary school and the scope and extent of program influence on food decisions. DesignFocus groups with current participants and program alumni. SettingWashington, DC. ParticipantsThirty-nine elementary school students and 39 program alumni ranging from middle school through university students. Phenomenon of InterestParticipant perceptions of program impact from childhood into adolescence and young adulthood. AnalysisInductive thematic analysis. ResultsNine emergent themes were identified, spread over 3 categories of program impact: immediate, beyond the classroom, and sustained. Immediate program impact themes came from all participants and included enjoyment, hands-on learning, and fostering connection. Beyond the classroom, older elementary students and alumni expressed perceived shifts in individual and family food intake, involvement in household food practices, and desire for fresh food options at school. Themes of sustained program impact among alumni participants were an appreciation for fresh food, openness to trying new foods, and confidence to make informed food decisions. Conclusions and ImplicationsFindings provide a deeper understanding of participant perspectives on the impact of participation in a school-based experiential food education program and a basis for further research on the role of early exposure to food education in influencing food decisions as children grow older.

Contextual Factors Influencing the Adoption of Physical Activity Direct Education and Policy, Systems, and Environmental Change Initiatives by Virginia EFNEP and SNAP-Ed Staff

ObjectiveTo explore factors influencing the adoption of direct education programs and policy, systems, and environmental (PSE) change initiatives focused on physical activity for Supplemental Nutrition Assistance Program-eligible audiences by Virginia Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education (SNAP-Ed) staff. MethodsOnline survey with Expanded Food and Nutrition Education Program and SNAP-Ed peer (paraprofessional) educators (n = 28) and SNAP-Ed agents (master of science level) (n = 9) in Virginia. Descriptive statistics were computed for sociodemographic characteristics and responses to questions on the basis of Likert-type scales. Exploratory factor analyses were run to identify the underlying structures of the different variables. ResultsThe main factors for peer educators were related to substituting nutrition programs or content for physical activity programs. Other factors included staff qualifications and expectations about leading vs teaching physical activities. For PSEs, the top factors were the capacity to reach many community members, attract new partners and stakeholders, and personal interest in the PSE. Conclusions and ImplicationsThe results provide insight into potential barriers and motivators for adopting physical activity education and PSEs within community-based initiatives and can be used to inform program planning and staff training. Additional research is warranted to examine other factors influencing the adoption and implementation of physical activity programs and PSEs.

Sensory-Informed Evaluation Method for Use With Peer Educators of Nutrition Education Programs

ObjectiveDetermine acceptance of unfamiliar recipes and investigate the practicality of a hybrid (remote and in-office) method of evaluating recipes. MethodsPeer educators from the University of Georgia's Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education programs used a hybrid home-use test method to evaluate 8 recipes before and after preparation and tasting. We collected perceived and actual measures of recipe acceptance. The main outcomes included overall liking and preparation behaviors, analyzed using nonparametric approaches. ResultsNo significant differences (P > 0.05) were found between prepreparation and postpreparation overall liking or preparation behaviors for each recipe, supporting the practicality of the method. Liking of recipe preparation exceeded 7 out of 9 for all recipes, but ratings for recipe preparation willingness and perceived program participant ratings decreased after tasting. Conclusions and ImplicationsAlthough tasting new recipes is necessary to determine specific modifications, a hybrid recipe evaluation format is practical for introducing new recipes to peer educators when resources are limited.

Development and Evaluation of Impact Statements for the Expanded Food and Nutrition Education Program (EFNEP)

Extension professionals often communicate program outcomes to external stakeholders using impact statements. We developed and evaluated four impact statements for the Expanded Food and Nutrition Education Program (EFNEP). We drafted the statements after conducting literature reviews for core content areas of EFNEP that include diet quality, food resource management, physical activity, and food safety. Subsequently, we evaluated the statements by facilitating expert panels made up of subject matter experts and communication professionals (n=14) from 12 Land-grant Universities. These impact statements aim to support EFNEP and other Extension professionals when communicating program value with key external stakeholders.

24-Hour Dietary Recall in the Expanded Food and Nutrition Education Program: Perspective of the Program Coordinator.

The purpose of this study was to determine how the 24-hour dietary recall (24HDR) is administered and how the Expanded Food and Nutrition Education Program (EFNEP) peer educators and other staff are trained on the data collection and entry process, from the EFNEP coordinators' perspectives. This cross-sectional, quantitative study utilized an online survey to collect information from EFNEP coordinators representing 61 of 76 EFNEP programs. While 56% of the programs collected the 24HDR data starting with the first thing eaten the previous day, 49% of them started collecting data at the time of class, going backwards. Most programs, i.e., 72%, reported using a multiple-pass method; however, only one-third of them reported using the standard five-pass method. Almost all programs, i.e., 97%, reported one peer educator collecting data from a group of 2-12 clients. All programs reported collecting the 24HDR data in a group setting, with about one-third of the programs also collecting data one-on-one. Most programs, i.e., 57%, reported spending ≤4 h on the initial training of staff in how to collect 24HDR data, and 54% of them reported that the peer educators entered the data themselves. This study found that the methods used to collect answers, train the staff, and enter the 24HDR data varied across EFNEP programs and that there is a need to standardize or revise the collection of 24HDR data.

Conducting 24-Hour Dietary Recalls in Group Settings with Adults Having Low-Income: Perspectives of EFNEP Peer Educators.

The Expanded Food and Nutrition Education Program (EFNEP) is a federally funded program that teaches nutrition education to adults and youth with low-income. EFNEP is funded throughout the United States including federal territories. The purpose of EFNEP is to provide nutrition education. Evaluation for adult programs includes pre/post surveys and pre/post 24-h diet recalls (24HDR). A validated standard of dietary measures, 24HDR are useful when collected as designed: one-on-one by a trained professional. In EFNEP, 24HDR are collected in group settings by EFNEP peer educators who often have not received a college degree or any formal education in nutrition. The purpose of this study was to explore attitudes and behaviors of EFNEP peer educators regarding how they collect diet recalls in a group setting, their perceptions of how adult participants feel about the recalls, and the benefits and challenges of using recalls. Online interviews were conducted with EFNEP peer educators across the U.S. Peer educators recognized the importance of collecting the recall data but identified several challenges such as time, resources, and participant reluctance to complete the recall. Program evaluation through methods like the 24HDR is important to measure outcomes and inform program improvements but also needs to include how evaluation can benefit participants and minimize data collection burden. Future research needs to examine the validity of collecting recalls in a group setting compared to other measures of diet quality.