Food Stamp Nutrition
Education Report
SUMMARY
Background
The purpose of this study is to provide FNS with descriptive
information about how States have elected to provide nutrition education
and information to food stamp recipients and eligibles. The specific
objectives of the study are to:
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Describe the organizational structure and administrative components
of the agencies implementing food stamp nutrition education;
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Describe the key design features of food stamp nutrition education
activities, including setting goals and objectives, identifying the
target audience and developing nutrition education messages;
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Describe approaches being used by States to implement their
nutrition education activities, including developing nutrition
education materials and designing methods by which nutrition education
can be delivered; and
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Describe efforts to assess the effectiveness of the nutrition
education programs, including examining barriers identified by the
States that have affected their ability to implement their program,
identifying some of the lessons learned by the implementing agencies,
and discussing efforts made by agencies to conduct evaluations of
their programs.
Data were collected through an abstraction of information contained in
State nutrition education plans, a mail-out survey to implementing
agencies, and follow-up telephone interviews. Data are presented in
summary form, with detailed agency responses to key survey questions
contained in the appendix.
Organizational Structure and Administration
of Food Stamp Nutrition Education
Unlike some programs where a single type of State agency is required to
administer the program, food stamp nutrition education provides the
opportunity for different types of State governmental agencies to
negotiate agreements with the State Food Stamp Agency to become
implementing agencies for the program. If they wish, State Food Stamp
Agencies can even select more than one implementing agency to administer
nutrition education in their State. Key components of the implementing
agencies' organizational structure and administration follow.
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Of the 38 States with approved food stamp nutrition education plans,
29 States had only one implementing agency, seven States had two
implementing agencies, and two States had three or more implementing
agencies.
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Fifty implementing agencies were identified for this study. When
examined, six different categories of implementing agencies were
identified, including programs operating under 34 Cooperative
Extension Services, five State public health agencies, four nutrition
education networks, two State welfare agencies, four other
university-affiliated programs not attached to Cooperative Extension,
and one State Department of Aging. Seven States report having two
implementing agencies in their State, while two States report having
three or more.
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Twenty-two agencies (44%) use one Statewide approach to nutrition
education with activities generally targeting the same audiences,
using the same materials, and following similar delivery protocols.
Nineteen agencies (38%) use State- level administration, but develop
customized plans for different target audiences and geographic areas.
Nine agencies (18%) elect to use a system that allows for local
administration and implementation of nutrition education activities.
Key Design Features of the Food Stamp
Nutrition Education
While agencies take a variety of approaches in designing food stamp
nutrition education, they all follow three important steps in preparing
their plans. These steps involve setting goals and objectives, selecting
the target audience, and selecting specific nutrition education messages
to be delivered. Agencies reported the following key design features in
these three areas:
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Agencies focus on setting both broad program goals and specific
behavioral objectives. Most of the behavioral objectives are designed
to help clients select healthful foods on a limited budget and improve
on their food preparation skills.
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The target audience selected by the most agencies are families, such
as families with young children, single parents, pregnant women or
parents of school-aged children. However, some agencies also target
special populations, including persons with disabilities, the
homeless, unemployed persons, and persons with chronic diseases. In
addition, 57 percent of the agencies reported targeting individuals
whose primary language is one other than English.
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Nutrition messages are designed to meet the behavioral objectives,
so it is no surprise that 80 percent of the agencies report focusing
their nutrition messages on purchasing healthy foods and eating a
healthful diet. It is interesting to note that 61 percent of the
agencies have developed formal data collection methods to help them
develop nutrition messages to meet the needs of specific target
populations. The most common methods for collecting these data are
focus groups, client interviews, and reviewing existing literature.
Materials and Methods Used by Implementing
Agencies to Deliver their Nutrition Education Messages
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The study examined the nutrition education materials used by the
agencies and the modes of delivery used to present their nutrition
education messages. The development of materials and modes of
delivering nutrition that are acceptable to the target audience is key
to the success of the program. Some of the key materials and methods
identified by the agencies are presented below.
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Agencies obtained nutrition education materials through a number of
methods, including developing their own nutrition education materials,
modifying materials developed by other agencies, or simply using
materials from other agencies without any modifications. Sixty-six
percent of agencies who reported developing their own material used
one or more formal data collection methods to test their materials
with their target audiences.
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The methods used by agencies for delivering nutrition education
include in- person delivery of nutrition education and mass media.
Forty-five (96%) of the agencies reported using in-person delivery of
nutrition education, 22 (47%) agencies reported using both in-person
and mass media.
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When providing in-person nutrition education, agencies used a
combination of three different approaches: structured groups,
structured one-on-one delivery of nutrition education; and
unstructured individual or group nutrition sessions.
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Agencies tended to select sites for the delivery of in-person
nutrition education that were located in the target population's
community, rather than in government or university facilities. The
most popular site was community- based centers or buildings, which 36
agencies reported using.
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Twenty-two implementing agencies (47%) reported using mass media as
a mode of delivering nutrition education. The most common mass media
method used was radio. Fifteen of these 22 agencies reported using
radio advertisements, radio talk shows, or radio public service
announcements as their mass media delivery method.
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The majority of staff providing nutrition education work at the
local level. Twenty-eight out of 36 agencies reporting educational
level of staff delivering nutrition used peer educators who had a high
school diploma/GED or never achieved a high school diploma/GED. A peer
educator is a lay individual who has been trained to teach basic
nutrition and the educator is a member of the community where he/she
works. Agencies using peer educators felt that peer educators would be
better accepted in the community and clients would be more accepting
of the nutrition information provided.
Barriers and Lessons Learned by
Implementing Agencies Conducting Food Stamp Nutrition Education Activities
Some agencies were able to identify the barriers they have faced in
developing their activities and reported on the lessons learned from
implementing their nutrition education. Some of the important findings
include:
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Agencies have faced difficulties with both hiring and retaining
staff to provide nutrition education. Finding bi-lingual staff and the
low pay scales for nutrition educators were both cited as problems.
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Agencies reported facing challenges trying to reach their target
audiences, as many low-income clients are skeptical about the value of
nutrition education. This skepticism results in difficulties with both
recruiting new clients and with attendance at nutrition education
sessions.
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Several agencies reported problems working with collaborative
agencies. Because low-income clients are likely to have contact with a
number of agencies, both public and private, that provide some form of
nutrition education, it is very important for agencies to coordinate
their efforts so as to not appear contradictory or repetitive.
Agencies reported that time and scheduling constraints most often
played a role in their inability to work with collaborators.
Agencies also reported on their own efforts to evaluate their
activities. Seventy-eight percent of the implementing agencies reported
conducting both process and outcome evaluations. Implementing agencies
primarily used the process evaluations to determine the number of clients
served and to identify improvements that could be made to their methods of
delivering nutrition education and developing their messages.
With regard to outcome evaluations, agencies reported using evaluation
information to measure the effect of nutrition education on audience
behavior, assess the audience knowledge of nutrition education, measure
audience skills, and determine if they had changed audience attitudes. The
outcome evaluation methods and units of measure differed so much across
States that meaningful comparisons could not be made.
Conclusion
The phenomenal growth of food stamp nutrition education over the last
several years is a testament to both its importance and popularity.
However, with continued growth, FNS will likely face a number of
challenges over the next few years. Some of these potential challenges
include:
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The need to ensure better service delivery coordination between the
various nutrition education activities sponsored by FNS and other
Federal agencies;
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The need to facilitate coordination between agencies delivering
in-person nutrition education with agencies delivering nutrition
education through social marketing and mass media; and
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The need to develop reporting systems to report both the number of
clients being served by agencies and agency progress in meeting goals
and objectives.
April 2000
Last modified: 12/04/2008
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