MedPath

Biomarker Cost-Benefit Analysis of EFNEP

Not Applicable
Recruiting
Conditions
Chronic Disease
Interventions
Behavioral: Expanded Food and Nutrition Education Program (EFNEP)
Registration Number
NCT05558085
Lead Sponsor
South Dakota State University
Brief Summary

The goal of this integrated project is to assess whether EFNEP is a cost-effective nutrition education intervention that generates sustained improvement in chronic disease biomarkers. This project will be unique in its use of objective biomarkers, instead of self-reported behaviors, to quantify the economic benefits generated by EFNEP through chronic disease prevention. A paired location untreated control group quasi-experimental design will be employed, with biomarkers (BMI, blood pressure, HbA1c) measured for 500 adults across four representative state EFNEP programs (CO, FL, MD, WA). Biomarkers will be measured pre-EFNEP, 6-months-post-EFNEP and 1-year-post-EFNEP. Analytical techniques will include cost-benefit, bivariate, and multivariate analyses.

Detailed Description

According to the CDC, 60% of US adults have a diagnosed chronic disease. This indicates the need for focused efforts to change modifiable risk factors including diet and exercise. The Expanded Food and Nutrition Education Program (EFNEP) aims to prevent chronic diseases by educating and encouraging vulnerable populations to adopt a healthy diet and physical activity. Addressing the program priority area Diet, Nutrition and the Prevention of Chronic Diseases, the long-term goal of this integrated project is to assess whether EFNEP is a cost-effective nutrition education intervention that generates sustained improvement in chronic disease biomarkers. This project will be unique in its use of objective biomarkers, instead of self-reported behaviors, to quantify the economic benefits generated by EFNEP through chronic disease prevention.

Project research objectives include analyzing EFNEP's sustained impact on chronic disease biomarkers and developing and applying a biomarker-based cost-benefit analysis methodology. Extension objectives are to develop an online cost-benefit analysis tool and webinar for nutrition education program evaluation. Education objectives are to provide graduate students with experiential learning opportunities in data collection and analysis.

A paired location untreated control group quasi-experimental design will be employed, with biomarkers (BMI, blood pressure, HbA1c) measured for 500 adults across four representative state EFNEP programs (CO, FL, MD, WA). Biomarkers will be measured pre-EFNEP, 6-months-post-EFNEP and 1-year-post-EFNEP. Analytical techniques will include cost-benefit, bivariate, and multivariate analyses. Project results will expand the EFNEP knowledge-base, allowing for program content and delivery modifications that maximize the impact of taxpayer dollars allocated to chronic disease prevention.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
500
Inclusion Criteria
  • Free-Living
  • Speaks and understands English and/or Spanish
  • Income at or below 185% of the Federal Poverty Line
Exclusion Criteria
  • Being pregnant, nursing, and/or less than 9-months postpartum

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
EFNEP GroupExpanded Food and Nutrition Education Program (EFNEP)Subjects will receive the EFNEP Eat Smart Being Active class series.
Primary Outcome Measures
NameTimeMethod
Change in Height from Baseline to 6 Months Post InterventionChange in height measurement from baseline to 6 months post intervention

Height (m) is measured using a portable stadiometer.

Change in Height from Baseline to 12 Months Post InterventionChange in height measurement from baseline to 12 months post intervention

Height (m) is measured using a portable stadiometer.

Change in Systolic and Diastolic Blood Pressure from Baseline to 12 Months Post InterventionChange in Systolic and Diastolic blood pressure measurements from baseline to 12 months post intervention

Systolic and Diastolic blood pressure are measured using an OMRON Silver blood pressure monitor

Change in Weight from Baseline to 12 Months Post InterventionChange in weight measurement from baseline to 12 months post intervention

Weight (kg) is measured using a portable scale.

Change in Weight from Baseline to 6 Months Post InterventionChange in weight measurement from baseline to 6 months post intervention

Weight (kg) is measured using a portable scale.

Change in Systolic and Diastolic Blood Pressure from Baseline to 6 Months Post InterventionChange in Systolic and Diastolic blood pressure measurements from baseline to 6 months post intervention

Systolic and Diastolic blood pressure are measured using an OMRON Silver blood pressure monitor

Change in HbA1c from Baseline to 6 Months Post InterventionChange in HbA1c measurement from baseline to 6 months post intervention

HbA1c is measured using A1CNow monitor.

Change in HbA1c from Baseline to 12 Months Post InterventionChange in HbA1c measurement from baseline to 12 months post intervention

HbA1c is measured using A1CNow monitor.

Secondary Outcome Measures
NameTimeMethod
Participant Demographics BaselineBaseline.

A range of participant demographics will be collected including sex, age, race/ethnicity, public assistance receipt, pregnancy status, and breastfeeding status.

Participant Demographics 12 Months Post Intervention12 Months Post Intervention

A range of participant demographics will be collected including public assistance receipt, pregnancy status, and breastfeeding status.

Participant Health Status BaselineBaseline

A Health Questionnaire will be used to identify whether participants have a health condition, take medication(s) for a health condition, and smoke.

Participant Health Status 12 Months Post Intervention12 Months Post Intervention

A Health Questionnaire will be used to identify whether participants have a health condition, take medication(s) for a health condition, and smoke.

Participant Demographics 6 Months Post Intervention6 Months Post Intervention

A range of participant demographics will be collected including public assistance receipt, pregnancy status, and breastfeeding status.

Change in EFNEP Adult Questionnaire Responses Baseline to 6 Months Post InterventionChange in EFNEP Adult Questionnaire Responses Baseline to 6 Months Post Intervention

The EFNEP Adult Questionnaire includes questions regarding food and physical activity behaviors.

Change in EFNEP Adult Questionnaire Responses Baseline to 12 Months Post InterventionChange in EFNEP Adult Questionnaire Responses Baseline to 12 Months Post Intervention

The EFNEP Adult Questionnaire includes questions regarding food and physical activity behaviors.

Change in 24-Hour Dietary Recalls Baseline to 6 Months Post InterventionChange in 24-Hour Dietary Recalls Baseline to 6 Months Post Intervention

24-hour dietary recalls will be administered to capture change in food and beverage intake.

Participant Demographics Post InterventionImmediately Post Intervention.

A range of participant demographics will be collected including public assistance receipt, pregnancy status, and breastfeeding status.

Change in 24-Hour Dietary Recalls Baseline to 12 Months Post InterventionChange in 24-Hour Dietary Recalls Baseline to 12 Months Post Intervention

24-hour dietary recalls will be administered to capture change in food and beverage intake.

Participant Health Status 6 Months Post Intervention6 Months Post Intervention

A Health Questionnaire will be used to identify whether participants have a health condition, take medication(s) for a health condition, and smoke.

Trial Locations

Locations (4)

Colorado State University

🇺🇸

Fort Collins, Colorado, United States

University of Maryland

🇺🇸

College Park, Maryland, United States

Washington State University

🇺🇸

Pullman, Washington, United States

University of Florida

🇺🇸

Gainesville, Florida, United States

© Copyright 2025. All Rights Reserved by MedPath