EFNEP: Assessing the Evaluation Tools and Impact of the Program
Lambea, Maria Carmen
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. Department of Human Nutrition Honors Theses; 2007
The Expanded Food and Nutrition Education Program (EFNEP) is a federally funded program to assist people with limited resources in developing knowledge and skills about food and nutrition. The program targets youth and low-income families with children. EFNEP programs exist throughout counties in all 50 states and US territories. It has been shown to be an effective program in improving food practices and dietary intake. EFNEP is evaluated by the changes in the baseline questionnaires and post-intervention questionnaires filled out by the participants. Two of the questionnaires which are pertinent to my research are the EFNEP Behavior Checklist (BC) and 24 hr recall. The BC is a 10 question form asking participants about recent food related behaviors. The 24 hr recall is a detailed record of the foods eaten by the participant in a 24 hr time period. The 24 hr recall allows for an analysis of the nutrient intake of the individual. There are 11 counties in Ohio which have EFNEP programs. This research will use the data subsets from all 11 counties, for the 2005 and 2006 fiscal years. The Ohio EFNEP program is facilitated through The Ohio State University Extension, Department of Nutrition. Funds for the research are provided through the Ohio EFNEP program budget. The goal of this research is to determine which questions on the BC are sensitive enough in evaluating EFNEP, and which are not. Sensitivity was assessed through determining the association of the food behaviors (BC) and actual behavior (dietary intake) interpreted from nutrient analysis. This will create a framework for further research on which questions need to be changed to accurately assess food behaviors as reported in the 24 hr recall. The advantage of using the BC is that it is shorter, less expensive, and easier to apply than a 24 hr recall, making it faster to administer and more understandable for the participants to take. Statistical analysis was performed using a Paired T-Test of the mean scores from the pre- and post- BC and pre- and post- 24 hr recall to determine changes upon completion of the program. To determine the correlation of the BC and 24 hr recall, a one-way analysis of variance (ANOVA) was applied. The Ohio EFNEP has been successful in bringing about positive changes in participants in both food behaviors and diet. Although changes are positive, the diets of participants at exit are still below DRI/Food Guide Pyramid recommendation for many of the nutrient and food groups. Many nutrition related BC questions had a significant relationship with the 24 hr recall. Questions from the core 10 BC as well as Additional BC questions were related to specific nutrients, adding value to ability of the BC to assess diet. However, there were also BC questions that did not show the expected relationship to the nutrient addressed in the question. Select questions of the BC may be useful to discriminate between the groups of participants consuming the lower and higher amount of select nutrients relative to their self-reported food behaviors. The BC must be continuously evaluated to improve the evaluation tools used to assess EFNEP. Although it is able to measure change in the participants, when used alone the core 10 BC and additional questions from this research would not be able to completely assess diet independent of 24 hr recall.