Brief Summary of Minutes of Annual Meeting

SHORT-TERM OUTCOMES:

OUTPUTS:

Training Resource:

Utah ASA24 Training for Nutrition Education Programs, Online Training and In-Person Curriculum. Available at https://extensioncourses.usu.edu/product/utah-asa24-training-for-nutrition-education-programs/

Presentations:

Baker, S. (October, 2019). Baker, S., Aragon, C., Mullins, J., Procter, S. Rooted in Communities: The Scholarship, Practice and Engagement of EFNEP Engagement Scholarship. Engagement Scholarship Consortium Conference. Denver, CO.

Durwood, C., Baker, S., Chidambaram, V., Franck, K., Kramer, H., McGirr, K., Savoie, K., Smith, J., Weir, C., Yerxa, K., Guenther, P. (July 2019) Exploratory Test of ASA24 to Collect 24-Hour Recalls in the Expanded Food and Nutrition Education Program. Society of Nutrition Education and Behavior Conference. Orlando, FL.

Franck, K., Stephenson, L., & Salie, J. (July 2019). Web-based training videos to promote changes in policies, systems and environments for nutrition educators. Paper presentation at the Society for Nutrition Education and Behavior conference in Orlando, FL

Gills, S.M.H., Baker, S., Guenther, P.M., Hess, A., Auld, G. (June 2019) Positive Change in Healthy Eating Index-2005 Scores of Low-Income Adults After Participation in the Expanded Food and Nutrition Program (EFNEP). ASN Annual Conference. Baltimore, Maryland.

Keenan, P., Baker, S., Auld, G., Li, C., Aragon, C., Franck, K., Owens Duffy, N. (July 2019). Measure What You Teach: How EFNEP Rooted Its New Impact Assessment in Research. (Plenary Session). Society of Nutrition Education and Behavior Conference. Orlando, FL

Auld, G., Procter, S, Roe, A., Yerxa, K. EFNEP Quality of Life Cognitive Interview Training Webinar: AES 3169. September 18, 2019. Note; Includes a YouTube Video demonstrating QoL cognitive interview.

ACTIVITIES:

Virtual Meeting held Spring 2019, scheduled for Spring 2020.

Continuing and New Leadership - three co-chairs identified for next year (2019-2020): Catalina Aragon (Washington State), Janet Mullins (University of Kentucky), and Beth Olson (University of Wisconsin).

MILESTONES:

1. Dietary Assessment and Behavior - 
   
   Food and Physical Activity Questionnaire (FPAQ) - Testing of Spanish FPAQ plans have been developed with revised methodology based on literature reviewed. Looking for FPAQ expert reviewers, native Spanish speakers, in one of five content domains. Applied for and received a mini-grant that has allowed hiring a graduate student and gift card purchase. Timeline: expert review completed soon, by end of 2020 should have the 3.0 version ready to share. Data would be available 2023. Discussion around timing of project and WebNEERS followed. Will use full 32 question tool for expert review.

   24HR Participant Focus Groups – Work has been submitted to JNEB. Title: Qualitative Assessment of the EFNEP Group-Delivered 24-hour Dietary Recall. Reviewers are being sought – discussion around reviewers from non-participating members of this group.
   
   ASA24 - Exploratory study of what could happen with use of ASA24 in field (use of end of RNECE funds). Study conducted in three states (ME, CO, TN) with 10 educators. 37 participants entry, 30 at exit. Quantitative and qualitative (interviews and focus groups) data collected. Results: very similar between paper and pencil (P&P) tool and ASA24 use.  Results overall very positive. Educator preference – evenly split. Qualitative themes – accuracy noted; group size was concern – both positive and negative; barriers identified. Duration of recalls was tested. Total calories reported in both methods was identical; total food items reported was also similar.  Proposed full pilot study of ASA24, with external funding needed for extensive work to recruit and collect data from comparison group. Carrie believes NIH grant might be most appropriate. Heather Eicher-Miller from Purdue has submitted an RO1 grant on use of ASA24 (she is with SNAP-Ed there). IN, TX, UT, FL in this submission. Discussion followed around concerns of both SNAP-Ed and EFNEP in same study. The proposal is under review but should be reviewed this month.

   Infant Feeding Behavior Assessment Tool - Excessive weight can begin as early as infancy. Inappropriate infant feeding practices play a role in an infant’s weight trajectory, and therefore education for caregivers is crucial.  Curricula provided by EFNEP educators and others working with low-income families with infants includes nutrition education for the feeding of their infants, including topics such as breast- and formula-feeding, when and how to introduce healthy foods, and guiding infants to develop their own feeding skills.  There has been little valid evaluation of this education.  The NC2169 Infant Feeding workgroup used best practices to develop evaluation and conducted preliminary research that indicates this evaluation gives meaningful results. In NC3169, validation was completed, resulting in content validity, test-re-test reliability, and a measure of construct validity-known groups technique. When made available in WebNEERS, this evaluation will provide educators the ability to select appropriate evaluation for their infant feeding education, and the EFNEP program leadership the ability to assess and improve program efforts with this population of parents nationwide.  Healthy infant feeding is expected to improve health not only in infancy, but into childhood and beyond; resulting in an improved quality of life and increased productivity in these families.
   
   
2. Quality of Life - 

   Quality of Life (QoL) – Review of QoL of cognitive interview training and discussion of efforts to this point, we want to do in the future. Participants’ improvement seen mostly in “being,” and educators in “belonging.” Since no existing tool captures EFNEP’s effects, this work deemed needed. Now need to do cognitive interviews to examine what details of tool could be most useful. CO, TN, KS, ME, AR, NJ, ID – seven states will be doing this phase. Why does QoL matter? Relationship in QoL literature to self-sufficiency? Bring out these factors into research, policy brief about this topic.

3. Cost Effectiveness Analysis - 
   

   Using the new biometric CBA, which uses BMI, the ratio is much improved (2.29 per dollar spent previous method to 2.85 per dollar spent now) Colorado findings: 4.87 to 6.12 now. Findings showed that 30 – 35% showed BMI decrease. These are conservative numbers, but trends are very positive. Reviewed methodology of project, which compares to previous CBA studies. This did use Behavior Checklist questions, not new FPAQ questions, and looks at 6 mos. post-data as well. Indirect benefits – looked at savings in lost earnings vs. healthcare savings (direct benefits). Much higher indirect benefits seen with use of biometric methods. Next steps discussed, asked group to be sure literature cited is most current and representative. Is JNEB best place for this initial finding to be published? A policy brief will be created for EFNEP professionals. Funding sources are needed – foundations, grants. Discussed next paper looking beyond the indicator of BMI – blood pressure, A1C. Are the small changes cumulative, with simultaneous impact? Third paper will address this. Discussion around publishing strategies and steps – is this a public health focused paper rather than a methodological paper?

    

Publications:

• Fuller, S., Phelps, J.A., Baker, S., Boeckner, L., Garrard-Foster, D., Walsh, J. Qualitative Assessment of the EFNEP Group-Delivered 24-hour Dietary Recall. Journal of Nutrition Education and Behavior, under review.
• Moore, C., Sweet, C., Harrison, J., & Franck, K. Validating responses to a food safety survey with observations of food preparation behaviors among limited resource audiences. Journal of Food Protection, in press.
• Moore, C. J., Lindke, A., & Cox, G. O. Using sensory science to evaluate consumer acceptance of recipes in a nutrition education intervention for limited resource populations. Journal of Nutrition Education and Behavior, in press.
• Sneed, C. T., & Franck, K. Back to the basics: Are traditional educational methods still effective in a high-tech world? Journal of Extension, in press.
• MacMillan Uribe, AL, Olson BH. Development and Evaluation of the Infant Feeding Education Questionnaire for the Expanded Food and Nutrition Program. Journal of Nutrition Education and Behavior, October 9, 2019. https://doi.org/10.1016/j.jneb.2019.09.006
• Franck, K., & Sneed, C. Are we listening to our limited-resource audiences? Engaging parents and caregivers with nutrition messaging in Extension programs. Journal of Human Sciences and Extension, 7(3), 52-67, 2019.
• Spruance L, Atoloye A, Douglass D, Zimmerman TP, Guenther PM, Franck K, Henson T, Moore CJ, Wood G, Durward, CM, 2019, Pilot test of an online ASA24 training with EFNEP educators, SAGE Open 9 (2), p. 2158244019844074. Article, Refereed Journal, Published, 03/15/2019.
• Kirkpatrick SI, Guenther PM, Douglass D, Zimmerman T, Kahle LL, Atoloye A, Marcinow M, Savoie-Roskos MR, Dodd KW, Durward CM. The provision of assistance does not substantially impact the accuracy of 240hour dietary recall completed using the Automated Self-administered 24-hour Dietary Assessment Tool among women with low incomes. Journal of Nutrition 149(1);114-122. Article, Refereed Journal, Published, 01/02/2019.
• Brewster PJ, Durward CM, Hurdle JF, Stoddard GJ, Guenther PM. The Grocery Purchase Quality Index-2016 performs similarly to the Healthy Eating Index-2015 in a national survey of household food purchases. Journal of the Academy of Nutrition and Dietetics 119:45–56. Article, Refereed Journal, Published, 01/2019.
• Kirkpatrick S, Guenther P, Douglass D, Subar A, Zimmerman T, Kahle L, Atoloye A, Marcinow M, Savoie Roskos M., Dodd K, Durward C. Accuracy of 24-hour recalls completed by women with low incomes using the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24). Current Developments in Nutrition 2(11), https://doi.org/10.1093/cdn/nzy045. Abstract, Published, 11/2018.
• Guenther PM, Brewster PJ, Durward CM, Hurdle JF, The Grocery Purchase Quality Index-2016 performs similarly to the Healthy Eating Index-2015 in a national survey of household food purchases. Current Developments in Nutrition 2(11), https://doi.org/10.1093/cdn/nzy045. Abstract, Published, 11/2018.