Brief Summary of Minutes of Annual Meeting

The NC3169 Multi-State Research Project held its Annual Meeting on May 14–15, 2026, at the Texas A&M Research and Extension Center–Dallas in hybrid format. The three active working groups and five DAB sub-groups reported progress toward their objectives. Spanish FPAQ is preparing IRB applications for cognitive interviews and planning manuscripts on linguistic equity and curriculum adaptation. Youth Evaluation is prioritizing South Dakota data collection while managing recruitment challenges and pursuing multi-state IRB reliance. 24-Hour Diet Recalls is evaluating Chelsea Bishop Smith’s Texas A&M training tool against previously identified gaps. Curricula Content Analysis is finalizing dietary and physical-activity content analyses and developing educator/coordinator implementation surveys. Physical Activity is completing manuscript analyses and planning training resources. Quality of Life has completed cognitive interviews and refined its tool, with an AFRI grant pending (decision by August 30). Behavioral CBA is resolving 24-hour recall data-quality issues and will compare questionnaire-only, recall-only, and combined approaches toward a program CBA toolkit. Biomarker CBA completed six-month post data collection with preliminary BMI and HbA1c improvements and plans a manuscript and Excel CBA tool by summer. The group also discussed publication strategies, leveraging county-based academic partnerships to fund participant incentives, and adding impact-statement training to the mid-year meeting.

Objective 1. Analyze the economic value generated by adult EFNEP through chronic disease and condition risk reduction.

Behavioral CBA: Collaboratively developed the optimal nutrition behavior criteria used to assess chronic disease risk (Roe, Bastian, Fitzgerald, Scott-Pierce, Alfaro Hudak, Adedokun, MacMillan Uribe, Leschewski, Venkatesh, Hodge). National EFNEP data were obtained via FOIA request and required cleaning to remove outliers; a subgroup is documenting the cleaning process and drafting a journal article.

Biomarker CBA: Led development and publication of a biomarker-based CBA methodology framework (JNEB) and began programming an Excel-based CBA tool. Directed multi-state collection and analysis of biometric data (BMI, blood pressure, HbA1c) across four states (CO, FL, MD, WA) with co-PIs Susan Baker, Annie Roe, and Kylie Pybus. Resolved Research.WebNEERS data issues and disseminated the framework to academics, federal leaders, and policymakers via JNEB publications, an invited SNEB 2025 presentation and two posters, and a briefing to Western Region EFNEP coordinators.

Objective 2. Investigate the impact of EFNEP education on participants’ and educators’ quality of life.

Quality of Life: Completed cognitive interviews and began data analysis; developed a facilitated interview guide to capture participants’ perceived social support. Partnered with Western Region EFNEP to submit an AFRI grant to fund further validation and use of the quality-of-life questionnaire.

Objective 3. Improve the standardization and methodological rigor of EFNEP evaluation.

Youth Evaluation: Revised the protocol and secured new IRB approval, and developed standardized administrator training to support consistent, multi-site delivery.

Spanish FPAQ: Completed the cognitive-interview phase of the psychometric evaluation, analyzed data, and modified items based on participant responses; findings were accepted for poster presentation at SNEB 2026. Preparing materials for the test-retest and internal-consistency reliability phases.

Objective 4. Examine the content, implementation characteristics, and effectiveness of EFNEP curricula targeting adults’ nutrition- and physical activity-related behaviors.

Physical Activity Education Barriers: Completed peer-educator interviews nationwide; data analysis is underway toward a manuscript and a Northeast-region pilot testing resources and training tools.

Curricula Content Analysis: Finalized a comprehensive curriculum content-evaluation instrument and an AI-based version; analyzed the most widely used EFNEP adult curricula (>80% of FY2024 adult participants); developed a preliminary educator implementation and engagement survey.

Outputs:

Presentations

• Leschewski A, et al. Economic valuation framework presented via one invited presentation and two poster sessions at the 2025 Society for Nutrition Education and Behavior (SNEB) Annual Conference. (Biomarker CBA)
• Leschewski A, Roe A. Progress on Behavioral and Biomarker CBA presented to program coordinators at the Western Region EFNEP In-Person Annual Meeting. (Behavioral & Biomarker CBA)
• Bastian GE, Roe AJ, Fitzgerald N, Scott-Pierce M, Alfaro Hudak K, Adedokun O, MacMillan Uribe AL, Leschewski A, Venkatesh S, Hodge K. Developing a Diet-Related Cancer Nutrition Behavior Matrix to Inform EFNEP Cost-Benefit Analysis. Accepted as presentation, Nutrition 2026 (American Society for Nutrition Annual Conference), Washington, DC. (Behavioral CBA)
• Bastian G, Roe AJ, Venkatesh S, Hodge K, Fitzgerald N, Scott-Pierce M, Adedokun O, MacMillan Uribe AL, Alfaro Hudak K, Leschewski A. A Cardiometabolic Nutrition Behavior Matrix to Inform EFNEP Cost-Benefit Analysis. Accepted as poster presentation, SNEB Annual Meeting, 2026, Washington DC. (Behavioral CBA)
• Treviño V, Diaz Rios K, Romano D, Kairios R, Matias S, MacMillan Uribe AL. Face Validity Evaluation of the Spanish-Language EFNEP Adult Questionnaire. Accepted as poster presentation, SNEB Annual Meeting, 2026, Washington DC. (Spanish FPAQ)
• Fitzgerald N, Azar Atallah M. Progress updates presented at the monthly NC3169 meetings and at the Annual Meeting, May 14, 2026. (Curricula Content Analysis)
• Yaco S. “AI support for research and teaching” — AI-based content analyses presented at the Rutgers Emerging Technology Community meeting, February 25, 2026. (Curricula Content Analysis)
• Azar Atallah M, Yaco S, Bastian G, Diaz Rios K, MacMillan Uribe A, Puglisi M, Roe A, Scott-Pierce M, Venkatesh S, Fitzgerald N. Human versus AI: A Comparative Curriculum Content Analysis and Alignment with the 2020–2025 Dietary Guidelines for Americans. Accepted as oral presentation, SNEB Annual Meeting, 2026, Washington DC. (Curricula Content Analysis)
• Emilcar M, Puglisi M, Amin S. EFNEP Peer Educator Facilitators and Barriers to Teaching Physical Activity to Adult Participants. National EFNEP Coordinators Meeting, March 2026. (Physical Activity)
• Mayaki TB, Adedokun O, Scott-Pierce M, Fitzgerald N, Venkatesh S, Roe AJ, Bastian GE. Full-Scale Exploratory and Confirmatory Factor Analysis of the Food and Physical Activity Questionnaire. Accepted for poster presentation, SNEB 2026, Washington, DC. (Won the doctoral-level SNEB Higher Education Division Abstract Award, to be presented July 31, 2026.)

Publications (see below)

Graduate Students Trained/In Training

• One completed master’s thesis (University of Maryland) and one ongoing Applied Economics master’s student (South Dakota State University), trained in multi-site database management, data cleaning, and health-economics/cost-benefit modeling (Biomarker CBA).
• Maya Azar Atallah, PhD student (Advisor: Nurgul Fitzgerald), facilitating curriculum reviews and content analyses (Curricula Content Analysis).
• Maruth Emilcar, doctoral student (University of Rhode Island), trained in research recruitment, semi-structured interviews, and qualitative analysis (Physical Activity).
• One doctoral student (University of Arizona) mentored on an EFNEP curriculum study with CKD and kidney-transplant patients, April–June 2026 (Curricula Content Analysis).
• Two University of Idaho graduate students (Jolene Kendall, Jackie Davis) engaged in cognitive-interview coding and consensus review (Quality of Life).

Activities:

Behavioral CBA: Developed the nutrition behavior criteria from literature and professional guidelines (Dietary Guidelines for Americans, AHA, AICR); used SAS to visualize national EFNEP data.

Biomarker CBA: Tracked 453 adults across four states (BMI, blood pressure, HbA1c); performed data cleaning, entry, and QA in Research.WebNEERS; published the CBA methodology; began an Excel CBA tool; mentored two graduate students in database management, data cleaning, and health-economics modeling.

Quality of Life: Conducted cognitive interviews (Zoom/in-person), independently coded for comprehension, response-scale agreement, and preferred scale, then reached team consensus (Roe, Venkatesh, Yerxa, and U. Idaho students Kendall and Davis); began drafting a social-support interview guide.

Youth Evaluation: Revised the protocol to remove accelerometry after ActiLife license issues, submitted a new IRB application, and planned multi-site data collection; recruited a Sioux Falls, SD site and began outreach to additional states (first attempt rescheduled after low consent-form returns).

Spanish FPAQ: Completed two rounds of in-person cognitive interviews (n=26) with Spanish-preferring EFNEP-eligible individuals; catalogued item issues and revised items by consensus (Díaz Rios, Kairios, MacMillan Uribe, Matias, Onofrietti, Romano, Treviño); submitted an accepted SNEB 2026 abstract; began protocol, materials, and IRB for test-retest and confirmatory factor analysis, and identified incentive funding.

Physical Activity Education Barriers: Conducted 35 semi-structured peer-educator interviews (45–60 min, Zoom) covering implementation, engagement, environment, barriers, and needs; led by PI Sarah Amin (URI), doctoral student Maruth Emilcar, and Michael Puglisi (UConn); analyzed in Dedoose with dual coding and a social-ecological thematic analysis.

Curricula Content Analysis: Convened a researcher/practitioner committee (Bastian, Diaz Rios, MacMillan Uribe, Puglisi, Roe, Scott-Pierce, Venkatesh, Azar Atallah, Yaco, Fitzgerald) to review content and instruments; partnered with a Rutgers emerging-technologies librarian to apply AI methods; doctoral trainee M.A.A. led reviews and analyses under Fitzgerald.

Milestones:

Behavioral CBA: Framework developed; caught up from last year’s delay and moving to data analysis.

Biomarker CBA: Data collection nearly complete (453 tracked at baseline, 213 retained through 12 months). An ~8-month delay from Research.WebNEERS data-migration and quality issues pushed back preliminary pre-to-6-month analyses and student thesis timelines; field collection was also affected by participant immigration concerns and honoraria-processing delays. A one-year NIFA no-cost extension was secured.

Quality of Life: E-QoL psychometric testing delayed by funding; a grant application is under review and smaller funding is being sought to begin testing.

Youth Evaluation: Data collection delayed by student-recruitment challenges; rescheduled collection at one middle school and identifying additional sites.

Spanish FPAQ: Psychometric testing underway; delayed by incentive funding, now being secured through partnerships to collect part of the target sample.

Physical Activity Education Barriers: On schedule; data collection complete, analysis underway.

Curricula Content Analysis: Content analyses complete; implementation-survey instruments in development and on timeline.

Short-term and Medium-term Outcomes:

Behavioral CBA: Increased awareness through joint presentation with Biomarker CBA project at Western Region EFNEP meeting.

Biomarker CBA: Increased network awareness of objective biomarker collection for economic modeling; graduate students gained proficiency in econometric modeling, data cleaning, and longitudinal database synchronization.

Spanish FPAQ: Increased awareness of Spanish-translated EFNEP evaluation tools and translation methods among researchers.

Curricula Content Analysis: The evaluation instrument was used to review the most common EFNEP adult lessons and can be adopted by other stakeholders; the AI-based analysis provided professional skill development for members.

• Leschewski A, Pierce SJ, Aragon MC, Baker SS, Udahogora M, Pybus K, Duffy NO, Roe AJ, Sankavaram K. A Proposed Cost-Benefit Analysis of Adult EFNEP Utilizing Biomarkers of Chronic Disease Risk. J Nutr Educ Behav. 2024. 56(12):904-17. DOI: 10.1016/j.jneb.2024.07.008
• Leschewski A, Baker S, Pierce S, Peitzmeier S, Udahogora M, Shelnutt K, Roe A. A Cost-Benefit Analysis of EFNEP Utilizing Biomarkers of Chronic Disease Risk: Year Three. J Nutr Educ Behav. 2025. 57(8):S81. DOI: 10.1016/j.jneb.2025.05.171
• Leschewski A, Pierce S, Baker S, Pybus K, Udahogora M, Shelnutt K, Roe A, Owens Duffy N, McDermott C, Peitzmeier S, McDonnell B. A Longitudinal Evaluation of EFNEP’s Impact on Biomarkers of Chronic Disease Risk. J Nutr Educ Behav. 2025. 57(8):S42-S43. DOI: 10.1016/j.jneb.2024.07.008
• Bastian GE, Desai-Shah H, Fitzgerald N, Baker SS, D’Alonzo K, Liang LE, Mayaki TB, Palmer-Keenan DM. (2026) Impacts of a Gamified Nutrition and Physical Activity Curriculum for High Schoolers from Communities with Low Income: Rev It Up! J Nutr Educ Behav. In Press. DOI: 10.1016/j.jneb.2026.04.009
• Daraboina R, Leschewski A, Simpson A, Bastian G, Michael S, Langelett G, Finkelstein S. (2026) Predicting Attrition in a Public Nutrition Education Program: A Machine Learning Approach. J Nutr Educ Behav. 58(5):438-446. DOI: 10.1016/j.jneb.2026.01.010
• Roe AJ, Bastian GE, Russell JK, Rani R. (2026) Frozen Fruit and Vegetable Perceptions and Usage among a Multistate Sample of SNAP-Ed and EFNEP Participants. Curr Dev Nutr. 10(2):107640. DOI: 10.1016/j.cdnut.2026.107640
• Austin Cantu S, Necessary K. Beyond Nutrition: Building Health Access Through EFNEP EXCITE Immunization Integration and Geographic Expansion Across Arizona. Final Pilot Report to the Extension Foundation EXCITE Program, May 12, 2026. (Curricula Content Analysis)
• Austin Cantu S. Reimagining Extension at the Intersection of Policy, Workforce, and Community Health: Arizona’s Transition to a Health Extension Model. J Human Sciences and Extension (special issue), forthcoming 2027; manuscript due for peer review October 5, 2026.
• Instruments developed: a 68-question curriculum content-coverage instrument (teaching methods and EFNEP core domains: diet quality, physical activity, food resource management, food safety) plus AI-based variations (Curricula Content Analysis); optimal nutrition behavior criteria / disease matrix for chronic-disease risk assessment (Behavioral CBA); draft E-QoL questionnaire ready for further validation (Quality of Life).