Evidence-base

Evaluations of Eating Smart • Being Active (research-based)

Before the original version of Eating  Smart ● Being Active was developed, a needs assessment was conducted to identify which state EFNEP programs were either editing current curricula or writing new curricula as a result of the major changes in the 2005 Dietary Guidelines for Americans as compared to the previous version AND the release of MyPyramid to replace the Food Guide Pyramid.  From this evaluation, researchers discovered that most states didn’t know what they were going to do AND that the curricula most commonly used around the country were not going to be updated (1).  This led researchers to choose to develop a new curriculum – Eating Smart ● Being Active.

Several evaluation studies have been conducted to assess the effectiveness of Eating Smart ● Being Active.   Specifically, curriculum developers utilized experts in adult education, nutrition and the Expanded Food and Nutrition Education Program (EFNEP) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) from multiple states to review the curriculum during its development.  Reviewers assessed the curriculum and confirmed it adhered to and effectively applied the tenets and principles of Social Cognitive Theory and Adult Learning and the content was based on the 2005 Dietary Guidelines (2) (Eating Smart • Being Active has since been updated to reflect the 2015-2020 Dietary Guidelines for Americans).

In a separate research project, researchers compared behavior change outcomes from Eating Smart • Being Active with behavior change outcomes of prior EFNEP curricula in five states (3).   Eating Smart • Being Active generally produced better outcomes than curricula used previously.  In addition, when comparing pre- and post-test scores from participants taught Eating Smart • Being Active, participants reported significant, positive behavior change in food resource management, nutrition, food safety, and physical activity.  Researchers also found that participants who received Eating Smart • Being Active increased their fruit and vegetable intakes (3). Similar results were seen in an Iowa study of a draft version of Eating Smart • Being Active (4).

Case studies, pilot studies, and evidence from the field (practice-based)

Eating Smart • Being Active was originally piloted by four states (California, Colorado, Iowa, and South Carolina) for six months.  Results from the pilot and formative evaluation (described above) drove the editing process leading to the 2007 version of Eating Smart • Being Active.  The curriculum was released in 2008, revised in 2010 and 2015 (to comply with the Dietary Guidelines) and is now being used by EFNEP and/or SNAP-Ed programs in over 40 states and US territories.

Evaluation of the revised curriculum 

To maintain the evidence-base of the curriculum as it has been extensively revised for the 2015-2020 Dietary Guidelines for Americans, curriculum authors have taken several systematic steps including a needs assessment whereby field feedback was gathered from six states using the curriculum.  Front line educators were asking to provide feedback on all lesson activities, content, recipes, and related materials.  Curriculum authors along with a revision committee made edits based on this feedback in addition to updating the content for the latest version of the Dietary Guidelines.

The physical activity segments of the curriculum changed drastically as compared to previous versions; therefore, in-depth evaluations of these segments was necessary.  Two physical activity specialists led the development of the physical activity segments.  The new segments were piloted by front line educators in two states.  These educators participated in focus groups to gather thoughts and feedback about the physical activity segments.  Focus group feedback contributed to edits that strengthened these lesson components.

Lastly, curriculum authors identified an expert panel of 10 members with varying expertise related to the curriculum including: nutrition, food safety, food resource management, and physical activity content; nutrition education program leaders; and adult learning experts.  The expert panel thoroughly reviewed each lesson based on their identified expertise area.  Curriculum authors incorporated much of the expert panel’s suggested edits.

Curriculum authors plan to publish manuscripts related to the revision and evaluation of Eating Smart • Being Active.  Future quantitative and qualitative evaluations of the revised curriculum are planned to strengthen the curriculum’s evidence-base.

 

Multi-level theoretical framework

  • Individual level
    • Educators using Eating Smart • Being Active give low-income adults the knowledge and skills needed to choose healthy foods, cook healthy foods for themselves and their families, keep food safe to eat, increase their level of physical activity, and stretch their food resources further increasing their food security.
  • Environmental level
    • Eating Smart • Being Active is designed to be used with low-income adults.  The goal is that by educating the parents not only on how to feed their children healthy foods but also teaching the parents how they can choose to live a healthy lifestyle, that the home environment for the child will be affected positively.  This will set the child up to choose healthy behaviors throughout their life
    • Through the use of Eating Smart ● Being Active in our Colorado State University Extension EFNEP program, we have found that some organizations we work with have been willing to change their policies to incorporate the classes into their client services. As a result of these changes in policy, the organizational environments have been changed.   Examples of some of these policy changes include:
      • Temporary Assistance for Needy Families (TANF) case workers requiring recipients to attend the series of classes to receive benefits.
      • Rehabilitation centers including the series of classes as part of a treatment plan.
      • Halfway houses incorporating the class series into treatment plans for inmates that are soon to be released.
      • Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Supplemental Nutrition Assistance Program (SNAP) offices offering the lessons to their front line staff who not only often qualify for the programs but also help to promote the programs and refer clients to the classes.
      • Employers including a wellness program for employees after receiving the lessons as a result of increased value on nutrition and health.

Resources

  1. Rogers, K., Diker, A., Kendall, P., & Baker, S. (2006). In-depth Review of Selected EFNEP Curricula Revised for the 2005 Dietary Guidelines and MyPyramid. The Forum for Family and Consumer Issues, 11(2). Available at: http://ncsu.edu/ffci/publications/2006/v11-n2-2006-december/ar-1-in-depth.php.
  2. Natker, E. Baker, S., Auld, G., McGirr, K., Sutherland, B., Cason, K. Formative Evaluation of EFNEP Curriculum: Ensuring the Eating Smart • Being Active Curriculum Is Theory-based. Journal of Extension. 2015; 53(1). http://www.joe.org/joe/2015february/rb1.php.  Accessed March 4th, 2015.
  3. Auld, G., Baker, S., Conway, L., Dollahite, J., Lambia, M. C., McGirr, K. (2015). Outcome Effectiveness of a Widely Adopted EFNEP Curriculum. Journal of Nutrition Education and Behavior, 47:19-27.
  4. Hoover JR, Martin PA, Litchfield RE. Evaluation of a new nutrition education curriculum and factors influencing its implementation. Journal of Extension. 2009; 47(1). http://www.joe.org/joe/2009february/a4.php. Accessed August 16th, 2013.