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

Am J Lifestyle Med. 2015 Oct 7;11(4):344-353. doi: 10.1177/1559827615607194. eCollection 2017 Jul-Aug.

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.

Keywords: EFNEP; Healthy Eating Index; SNAP-Ed; low-income adults; nutrition education.