What Social, Program, and Behavioral Factors Influence the Healthy Eating Index for EFNEP and SNAP-Ed Adult Participants?

Abstract

The main objectives of this article were to determine the demographic factors, the program related factors and the behavioral factors that influence Michigan Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education outcomes. Secondarily, we sought to understand the trends and changes in Healthy Eating Index (HEI) scores across the differing baseline score groups. The data were collected by nutrition instructors in a pretest, posttest design to capture change in healthy eating habits through changes in HEI scores. The participants were all low-income program participants during the years of 2011 and 2012, living in Michigan. Findings show that eating habits improved most in households with weekly per-person income within $100 to $500, and with Caucasian females living in cities or suburbs. Improvements were also greater with those who took part in the Expanded Food and Nutrition Education Program, where the participants exhibited higher baseline frequency of planning meals before grocery shopping, comparing prices, and budgeting enough money for food and food related purchases. Overall, the average change in HEI scores increased by 2.3 points, however, the variability between the participants' changes was high, suggesting that more targeted program lessons might increase program efficacy, especially for those participants with high baseline HEI scores.

Effectiveness of an Adult Food Literacy Program

“…More needs to be known about the impact on participants who start with high food literacy as evident in their self-reporting of the frequency of planning, selection, preparation and eating behaviours. Programs may operate to reinforce or confirm for participants that they are doing the right thing [51].…”

Identifying Participants Who Would Benefit the Most from an Adult Food-literacy Program

“…Food literacy skills are developed over a person’s life and must be adapted to changing circumstances, such as moving out of home, changing household size (e.g., the birth of children), economic circumstances (e.g., changing income levels) and lifestyle factors (e.g., diagnosis of a lifestyle-related disease such as diabetes or high blood pressure). People with high food literacy attend food literacy programs [63], which suggests that programs operate more subtly to reinforce or remind participants to use their food literacy skills. The reasons that participants gave for attending FSA demonstrated that learning new ideas about cooking was the second most popular response.…”

The Effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) on Diet Quality as Measured by the Healthy Eating Index

“…31 The HEI has been previously utilized to measure EFNEP outcomes. 18,32 The relationship between EFNEP participation and diet quality has been measured 18,20,32,33 ; however, approaches have varied. Additionally, some studies explored the effect of socioeconomic factors on diet quality of EFNEP participants 32 while others focused on evaluating specific curriculum.…”

“…18,32 The relationship between EFNEP participation and diet quality has been measured 18,20,32,33 ; however, approaches have varied. Additionally, some studies explored the effect of socioeconomic factors on diet quality of EFNEP participants 32 while others focused on evaluating specific curriculum. 20 Outcome variables also differed from one study to the other, with some assessing total HEI 32 and others focusing on nutrient intake.…”

“…Additionally, some studies explored the effect of socioeconomic factors on diet quality of EFNEP participants 32 while others focused on evaluating specific curriculum. 20 Outcome variables also differed from one study to the other, with some assessing total HEI 32 and others focusing on nutrient intake. 33 Finally, the effectiveness of EFNEP curricula delivery in Maine has never been formally analyzed utilizing the HEI.…”