Brief Summary of Minutes of Annual Meeting

Accomplishments: 

Short-term Outcomes: 

• A rigorously-tested, valid and reliable tool to evaluate the success of the Expanded Food and Nutrition Education Program, which reaches thousands of low-income caregivers of young children nationwide each year.
• Impact statement templates for EFNEP coordinators to communicate the impacts of EFNEP education to stakeholders, such as legislators.
• A valid and reliable infant feeding behaviors questionnaire that EFNEPs can use to measure the success of infant feeding education provided to expecting and new parents via EFNEP.

Outputs: 

Presentations

Aragon MC, Baker S, Barale K, Leschewski A. 2021. A Cost-Benefit Analysis of EFNEP in WA and CO using BMI. 2021 National EFNEP Coordinators Conference. (March 10, virtual).

Olson B, Uribe LLM. 2021. The Development of the Infant Feeding Evaluation Items. Annual State EFNEP Coordinators’ Post Conference: Strengthening Your EFNEP Toolbox. (March 16 & 17 [offered twice]; Virtual Conference).

Grants Awarded

Leschewski A, Aragon MC, Sankavaram K, Baker S, Duffy N, Roe A, Sharma D. 2021. A Cost- Benefit Analysis of EFNEP Utilizing Biomarkers of Chronic Disease Risk. USDA NIFA AFRI-Program Priority Area A1344 Diet Nutrition and the Prevention of Chronic Diseases. Funding request: $963,386.

Duffy NO, Aragon MC. June 1, 2020 - September 30, 2021. Testing the Spanish Translation of the EFNEP Food and Physical Activity Questionnaire: Phase Two. University of Florida, Department of Family, Youth and Community Sciences. Funding request: $5,000.

Publications

Gills SMH, Auld G, Hess A, Guenther PM, Baker SS. 2021. Positive Change in Healthy Eating Scores Among Adults with Low Income After Expanded Food and Nutrition Education Program Participation. Journal of Nutrition Education and Behavior. 53(6):503-510.

Murray EK, Baker SS, Betts NM, Hess A, Auld G. 2020. Development of a National Dietary Behaviors Questionnaire for EFNEP Adult Participants. Journal of Nutrition Education and Behavior. 52(12):1088-1099.

Leschewski A, Aragon MC, Baker S, Weatherspoon D, Barale K, Auld G, Acquah-Sarpong R. 2021. EFNEP Generates Economic Value Through BMI Improvement: A Cost-Benefit Analysis. Journal of Nutrition Education and Behavior. (Under Review).

Barale K, Aragon, MC, Yerxa K, Auld G, Hess A. Development of Reliable and Valid Questions to Assess Food Resource Management Behaviors in Adults with Limited Income Journal of Nutrition Education and Behavior. (accepted for publication).

Products

Six videos were created to support infant feeding education, based on work affiliated through Hatch funding with NC3169. There are six videos, available in  English and Spanish (12 videos total).  Available at: https://mediaspace.wisc.edu/channel/Feeding%2BMy%2BBaby%2BVideos/225760533

Activities: Despite the ongoing COVID-19 pandemic, research activity has continued and progress towards this multistate group’s goals has been made.

• Cognitive interviews were conducted with low-income adults to ensure that our developed scales were understandable by EFNEP’s target population.
• EFNEP coordinators were interviewed to determine how 24-hour recall practices differed among the implementing institutions.
• Spanish-speaking nutrition, physical activity, food safety, and food resource management experts were consulted to provide feedback on a Spanish translation of the Food and Physical Activity Questionnaire, to provide a standardized evaluation instrument to a substantial portion of EFNEP’s target audience.

Milestones: 

1. Dietary Assessment and Behavior (DAB)
   
   24-Hour Dietary Recall (24HDR): Researchers completed the proposed Phase 1 study, by conducting interviews with 56 EFNEP Coordinators to examine their programs’ current practices, plus their and paraprofessionals’ knowledge, training, and administration (individual or groups) of the 24HDRs. Currently, this project is in Phase 2, which consists of conducting in-depth interviews with paraprofessionals to understand their processes of administering 24HDR, the training they received, and their barriers to successful 24HDR data collection. Findings from this evaluation will help identify the gaps in 24HDR training and offer recommendations on the best 24HDR training practices and 24HDR training protocols for EFNEP paraprofessionals who work in a group or individual setting.

Automated Self-administered 24-hour Diet Recall (ASA24): No research progress was made this fiscal year on this portion of the proposed work due to the retirement of one of the lead researchers, and a change of position with the other. However, a new, actively participating NC3169 member is leading others in an effort to develop another EFNEP ASA24-related project for the anticipated submission of a new EFNEP Research multi-state Proposal to be submitted for the next project period (2024-2029).

Food and Physical Activity Questionnaire (FPAQ): Internal consistency measurements of the FPAQ subscales will be conducted using Federal Fiscal Year 2021 program data over the next year. A team of researchers have developed impact statement templates related to FPAQ for EFNEP coordinators to communicate the impacts of EFNEP to stakeholders, e.g., legislators. The researchers conducted 4 focus groups with communications personnel (n=13) at land grant universities to refine the impact statements for maximum effect.

Spanish Translation of FPAQ: A first round of expert reviews were completed for the Spanish FPAQ, to ensure accurate translation. Eleven experts in nutrition, physical activity, food safety, and food resource management, all of whom are bilingual in Spanish and English, were selected for this review.

Retrospective Pretest FPAQ: This project has progressed under leadership of a doctoral student, of which this is her dissertation project, and her faculty advisor. After adapting the protocol to be administered via Zoom, cognitive testing of the retrospective FPAQ questions is underway in NJ, GU, CO, TN, and MD, to test the face validity of the retrospective FPAQ (i.e., whether low-income adults understand the difference in temporality between the retrospective pretest question, and its corresponding posttest question).

Infant Feeding Questions: This work was completed in Federal Fiscal Year 2020.

1. Quality of Life (QoL)
   
   The QoL workgroup has identified items for a quality of life assessment tool for low-income adults who receive EFNEP lessons. Validity and reliability testing is underway and will continue into the next year to ensure the tool is appropriate for assessing quality of life changes in our target population.
   
   The face validity of the tool, i.e., the ability for the target audience to properly understand the questions’ constructs, is being assessed through qualitative cognitive interviews with low-income adults in several states (KS, ME, ID, CA, and potentially others).
   
   The construct validity (i.e., how accurate the tool assesses the intended psychological constructs) and temporal reliability (i.e., how consistently participants complete the tool over multiple administrations when they are not exposed to an intervention) will be assessed concurrently using a multistate sample of low-income adults during the next year. Both of these measurements are quantitative assessments and will require participants to complete the group’s QoL assessment twice, and a series of other validated QoL instruments once.
   
   
2. Cost-Benefit Analysis (CBA)
   
   A team of researchers from the CBA workgroup have received funding through the Agriculture and Food Research Initiative to expand on previous pilot studies conducted in CO and WA, which found a demonstrable cost benefit of EFNEP lessons for low-income participants and chronic disease risk, based on measured bioindicators like body mass index, blood pressure, and glycosylated hemoglobin.
   
   A cost-benefit analysis of EFNEP lessons using behavioral changes from the FPAQ and 24-hour diet recall to assess chronic disease risk is also being planned. Over the next year, the CBA workgroup plans to adapt a protocol developed at the University of Idaho to conduct such a cost-benefit analysis using national FPAQ and diet recall data from Federal Fiscal Year 2021.

1. Gills SMH, Auld G, Hess A, Guenther PM, Baker SS. 2021. Positive Change in Healthy Eating Scores Among Adults with Low Income After Expanded Food and Nutrition Education Program Participation. Journal of Nutrition Education and Behavior. 53(6):503-510.
2. Murray EK, Baker SS, Betts NM, Hess A, Auld G. 2020. Development of a National Dietary Behaviors Questionnaire for EFNEP Adult Participants. Journal of Nutrition Education and Behavior. 52(12):1088-1099.
3. Leschewski A, Aragon MC, Baker S, Weatherspoon D, Barale K, Auld G, Acquah-Sarpong R. 2021. EFNEP Generates Economic Value Through BMI Improvement: A Cost-Benefit Analysis. Journal of Nutrition Education and Behavior. (Under Review).
4. Barale K, Aragon, MC, Yerxa K, Auld G, Hess A. Development of Reliable and Valid Questions to Assess Food Resource Management Behaviors in Adults with Limited Income Journal of Nutrition Education and Behavior. (accepted for publication).