A randomized controlled trial of a community-based nutrition education program for low-income parents

Abstract

Objective: Assess effectiveness of the Expanded Food and Nutrition Education Program on nutrition behaviors post-education and longitudinally.

Design: Switching replications randomized experimental design. Participants randomly assigned to immediate education (IE) or delayed education (DE). Participants in IE received intervention the first 8 weeks, and those in DE the second 8 weeks, with no intervention during alternate periods. Data were collected in 3 repeated measures.

Participants: Parents (n = 168 randomized; n = 134 completed) of children in 2 Head Start and 6 low-income schools.

Intervention: Eight weekly workshops, based on Eating Right is Basic-Enhanced adapted to incorporate dialogue approach with experiential learning.

Main outcome measures: Ten-item self-reported behavior checklist on nutrition, food resource management, food safety, and food security; responses on a 5-point scale reporting frequency of behavior.

Analysis: Chi-square, analysis of variance, and multiple regression.

Results: Groups were demographically similar. Both groups reported improved behaviors pre- to post-education (P < .05). There was no significant difference between groups at Time 1 (T1) or DE control period (T1 vs T2). Changed IE behavior was retained T2 to T3. A multiple regression model of overall change, controlling for T1 score and educator, showed significant improvement (n = 134, β = 5.72, P < .001).

Conclusions and implications: Positive outcomes were supported by this experimental study in a usual program context, with reported behavior changes retained at least 2 months.

Keywords: EFNEP; Head Start; longitudinal behavior change; low income; parents; randomized controlled trial.