Annual/Termination Reports:

[06/12/2007]

Report Information

Participants

Garry Auld -Colorado State University; Audrey Adler  Rutgers University; Susan Baker - Colorado State University; Stephanie Blake  USDA, EFNEP Program Specialist; Nancy Betts  Oklahoma State University; Helen Chipman  USDA, CSREES, EFNEP Program Leader; Shirley Gerrior  USDA; Mary Gray - USDA Deputy Administrator Families, 4-H, and Nutrition, CSREES; Gail Hanula  University of Georgia; Deb Kennan - Rutgers University; John Kirby - Administrative Advisor, USDA, South Dakota State University; Wanda Koszewski, University of Nebraska Lincoln; Lily Liang  USDA; Joyce McDowell  Ohio State University; Amy Mobley  Purdue University; Rachel Novotny  University of Hawaii; Sandy Procter - Kansas State University; Hanley Roy, Louisiana State University; Barbara Sutherland University of California Davis; Pat Tschida  University of Hawaii; Cynthia Tuttle  USDA, Nutrition and Consumer Sciences; Susan Welsh  USDA, CSREES; Wells Willis USDA (retired) Program Leader, EFNEP; Siew Sun Wong - Utah State University

Brief Summary of Minutes

History and Purpose of NCDC 211

- Mary Gray gave a brief overview for why this research committee was established.

- S. Baker noted the project grew from Extension and EFNEP Coordinators interest in evaluation.

- S. Blake provided US EFNEP demographic data for 2002 to 2006. Gray comment  household income of +50% of participants are equal to or less than poverty guidelines.

- John Kirby introduced Multi-state project procedures. Goal is to underpin EFNEP to research and bring convergence of Extension and research. First draft by Dec., 2007; review by March 2008; rewrite by July 2008; and funding starts October 2008.

- D. Kennan said we are uniquely positioned so that several are trained researchers and have both research and Extension appointments.

- D. Novotny noted that there is variability in understanding intent of multi-state projects among Deans and Extension Directors. Any clarification of principles or guidelines to give states and other multi-state committees would be valuable.


Q: Can any EFNEP dollars be used for staff time to support this project. A: Funds are for direct education of clients. A discussion would be appropriate between state and federal level EFNEP program leaders. Clarification is being sought.

Q: In the initial proposal how do we describe long term? A: state vision and describe immediate and intermediate goals. Vision and substantive information are important.


- S. Welsh If it were not for national data base, EFNEP would not be positioned as a premier nutrition education program. Reliability and validity of evaluation tools and self reporting are why the evaluation has been criticized by some.


Be sure to CRIS search.


Q: How did we get the 24 hour recall and the Behavior Checklist? A: W. Willis - Federal guidelines state that our nutrition programs should support the Dietary Guidelines. Also, following food safety guidelines of USDA was also important. Committee came up with multiple questions and strategies to measure something that was part of the curriculum.


Q: What questions have been validated? A: Jean Anliker and Jim Hershy did lots of internal validation. Ruby Cox was also involved. Lydia Medeiros from OSU Extension found top food borne illnesses in literature and then traced to behaviors, and then she did analysis of subset of questions that adequately measure the behaviors. That study needs to be included.


{Much discussion about reliability and validity of current EFNEP tools (recall and behavior check list), but since eventual focus moved away from this, details of discussion not included here}


- We must have good science as a foundation for understanding why EFNEP works. Is the reason EFNEP works, the paraprofessional model, the curriculum, etc? We have a system that is accepted from a political standpoint.


Q/comment: Why does EFNEP work? What is it that works? What is the underpinning of EFNEP? How do we evaluate that? We have to focus. If we are all using different methods, we will not be able to do a multistate cost benefit analysis.
A: No one is challenging the program. Why does it work? What would make it better?


Q: Instead of looking at dietary recall (DR) and behavior checklist (BCL), lets learn the behaviors that are difficult to access. Then, lets go back through literature and establish/identify what needs to be done, perhaps pilot in different ways.


Determine underpinnings (what contributes to its success) of EFNEP: a) Psycho-social b) biological & if we paint the picture broad enough, we can relate to the multi-state project and have increased opportunities for funding.


- Report from Survey about EFNEP Adult Curricula, Wanda Koszewski
(response rate was 51 of 56). Most states still deciding what curriculum they will use in 2008. Will re-survey in August.


Q: Which of these do make the bigger differences? When we talk to practitioners at the local level, peer teachers say cooking. Researchers say give me the statistics to support this. Another Q is shopping. How much biological support for that? What should be in the curriculum? There are no biological markers for teaching people to eat breakfast.


Q: How do we validate the BCL? How do we assess non dietary intake successes in relation to food safety, diet quality, and food money management?
Comment: How can we capture the qualitative data in terms of data outcomes?
Comment: High correlation between comments of participants with BCL outcomes.


Comment: As EFNEP leader, what is most valuable tool to me? BCL is the most
valuable. Get more bang for the buck with BCL than with 24 hour recall. (General consensus around this point by participants)


Q: Does EFNEP improve dietary quality? BCL asks those questions.
Comment: The hypothesis may need to be broader. Look at how agriculture, health and food literacy connect. EFNEP is a program that brings agriculture and health and food literacy together.


Comment: If simple cooking techniques are taught to low income homemakers, will they cook more meals at home? The inference is that those who cook at home are eating at home more often (decreased meals out of home means fewer calories, less fat, less money spent on food if prepare it at home).


Susan W: What piece of data has had the greatest impact in raising the awareness of EFNEP and its increased funding  it has been the F&V component.


Wells: Part of EFNEP success that it is multi-disciplinary. Teaches many skills  shop, prepare, store  all of those things together. Remember the broader picture.


Helen: EFNEP has holistic approach. If we break it up, do we destroy the holistic concept? It is the same idea as food versus nutrients.


John: The hypothesis is that a fully integrated education program will result in better outcomes than a compartmentalized program.


Susan W: The first objective is a lit review which shows the holistic nature of the program; the second step would be to break off smaller sub topics, e.g, improving/evaluating the tools for measuring behavior changes.


John: The outcome is what we are interested in. We want to get to end point, and then determine the underpinnings of your program.


- Hypothesis: EFNEP improves quality of life
Education alters behavior
Food Security
Food Safety
Food Resource Management
Physical Activity


What is the definition of quality of life?
Objectives of EFNEP are: http://www.csrees.usda.gov/nea/food/efnep/pdf/program-policy.pdf


EFNEP changes self-efficacy, knowledge and skills which leads to behavior changes which leads to improved nutrition and quality of life


EFNEP Guidelines
a. Improved diet, nutritional welfare of family
b. Increase knowledge of human nutrition
c. Increase ability to select and buy food that satisfies nutritional need
d. Improve practices in food production, preparation, storage, safety, and sanitation
e. Increased ability to manage food budgets
f. Physical activity


{Beginning of focus by group around eventual writing objectives}

1. Define Quality of life affected by EFNEP (use literature review, mining qualitative data, asking people direct focused interviews, including expert thinking)
a. Outcomes could be:
i. website and
ii. published paper after one or two years.
iii. Have a one page flyer to take to legislators.


2. Define effective measures of diet quality (these measures would also be used for other components of quality of life)
a. Qualitative
b. Quantitative
c. Biological
d. Psycho-social
e. Environmental


3. Does EFNEP result in improved diet quality?


DAY 2

Discussion: What is quality of life? We need to define the phrase for we have new ethnic and racial audiences and a group of professionals with expertise to help us define from perspectives of professionals, paraprofessionals, participants, etc.


Discussion Quality of life may be defined differently by different groups.


Discussion: If we can define quality of life for respective ethnic groups, we will know better how to reach the audience.


Wells - One of the reasons EFNEP has been successful is that food is something we do everyday. Participants begin to get a feeling of control over food and food resources. That seems to be why EFNEP has broader impacts. Those same skills carry over into other parts of life.


Helen: Hoping that we can be deliberate of the conceptual whole rather than go down one track. The pieces are connected. We need to keep coming back to the conceptual whole. What are we really trying to do? Improve the quality of life through EFNEP.


Discussion: What happens if diet quality is not the highest priority? When we review what we are teaching, diet quality is evident on the list of responses.
" Participants
" Others in participant sphere of influence
" Paraprofessionals
" Professionals


TASKS
1. Define Quality of Life as it relates to EFNEP(overview)
" Identify legislated program mandate/policies.
" Include in introduction how EFNEP is flexible enough to meet changing needs of low income families (acute to prevention of diseases; always focus upon food)
" Refer to Healthy Eating Index
" Refer to Dietary Guidelines and to Food Guidance system (MyPyramid)
" Use Wells annotated bibliography and Debs student thesis


2. Look at tools currently used in EFNEP to assess DQ. How do we determine effective measures? Are our current methodologies the best way(s) to assess behavior change? What does the literature say about the methodologies and the tools to assess DQ  limitations? Are we measuring what we want to measure?

i. Do the measures, tools, and methodologies show behavior change?
ii. What education theories are used to measure DQ
iii Use current BCL and 24 hour recall as baseline
iv How does the tool interface with Quality of Life

b. Methods for testing will flow from research literature review


Q: Should Objective 3 be to plan an evaluation of EFNEP based upon outcomes of #1 and #2? yes


Discussion of possible questions:
What is it about EFNEP that results in improved quality of life and DQ?
Which tools are most effective in measuring DQ?
How does EFNEP cause impact?


Need to evaluate tools to see which is most effective. When looking at #2 can pilot testing occur? In the process of identifying pros and cons, could there be testing. #3 is an evaluation of how the tools work to measure DQ. How does measure reflect improvement in DQ of EFNEP?


How collectively will #1 and #2 play out in #3? Do we have a potential rewording of #3?


UPDATE
Objective 3: Which measures of DQ are most sensitive and least burdensome for assessing the impact of EFNEP?


Discussion: Objective is to develop a strategy for tracking long term effectiveness.

Willis discussion: Does improved diet quality increase the quality of life? How applicable is this model to other parts of quality of life?


ADMINISTRATIVE Component of NC211

1. Who will lead our writing group 
a. Susan and Garry are co-chairs for proposal writing (unanimous assent)
b. Joyce is recorder/secretary

2. Co- chair Leadership of DQ group will be Barb and Nancy
Leadership of Quality of Life Measures: Wanda and TBD Family Life specialist

3. Submission of objectives:
a. Issues and Justification (Appendix H)
i. Extent of problem, consequences if research is not done
ii. Explain why the project should be conducted by multiple states
iii. Address national or regional issues
iv. Probable impacts from successfully completing the works

b. Accountability is a key issue, account for time and efforts and how many contacts with others

4. Garry: Options for governance of AES Multi-state Research Projects
" Each participant on this committee must work within own state to acquire approval and funding  are you resourced to participate?
" Being on the writing team does not ensure that you are on the project team
" IRB approval  handled by each respective state
" Projects ideally start on October 1, 2008.
" Publications: Will have to be decided after approved

5. Telephone conference calls
c. 3 p.m. EST of 2nd Wednesday in May, June, July and August, 2007
i. Call 970-491-1205
ii. Possibly the subcommittees will meet on Saturday p.m. at SNE  Susan Baker will confirm dates and time at May telephone conference call

Accomplishments

<br /> Identified broad objectives for proposal<br /> Created writing teams for each objective<br /> Scheduled monthly conference calls<br /> Established timelines for summer writing<br />

Publications

Not applicable

Impact Statements

1. Activities  writing; identification of other possible tools, e.g., Quality of Life Questionnaire

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