1. +
Nutrition Education and Low-income families
Rachel Miller
Summer Scholars 2012

2. +
Method:
 Literature review
 Interviews:
 Sue Snider: Expanded Food Nutrition Education Program
(EFNEP), Supplemental Nutrition Assistance Program-
Education (SNAP-Ed), University of Delaware
 Tricia Jefferson: YMCA-Delaware
 Jennifer Barr: Moms Moving Forward- Christiana Care Hospital,
registered Dietician
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3. +
Importance of Research:
 To analyze the effectiveness of nutrition education programs
 Obesity has more than tripled in the last 25 years: 8.7%-
27.4%
 Overweight: 36.9%-62.0%
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4. +
Importance of Research:
 Limited access to healthy resources
 Limited understanding or concern for
mealtime behaviors,
portion sizing, healthy living
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5. +
Importance of Research:
 Economic concerns outweigh health
 Time/ job conflicts
 Stigma & health care professionals
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6. +
Research Goal:
Low income hunger-obesity paradox
How will nutrition education programs
effectively deal with this problem?
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7. +
Research Questions:
 How are low-income neighborhoods affected by poor
nutrition?
 What are nutrition programs aimed at low income families
trying to accomplish?
 What is the relationship between these programs and low-
income individuals in the community?
 Do these programs meet the nutritional needs of low-income
communities?
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8. +
Literature Review:
Reviewed nationally based programs (school-based programs,
early intervention programs)
SNAP-Ed
Federal program implemented in each state
Nutrition education for SNAP members
Goal: healthier food choices on a limited budget
effective to a point
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9. +
Literature Review:
Expanded Food and Nutrition Education Program
(EFNEP)
Help low-income individuals
attain a healthy lifestyle
adult and youth programs
 Paraprofessionals/ peer educators
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10. +
NIFA, Data 2011:
Improvements # improved # responded %
in one or more improvement
practice
Food resource 62,884 75,418 83%
management
practice
Nutrition 62,771 70,670 89%
practice
Food safety 50,256 75,996 66%
practice
Physical 11,389 23,172 49%
activity
practice

11. +
NIFA Data, 2011- EFNEP:
Food Group Entry Exit Change
Grains 5.6 5.5 0.00
Fruit 0.9 1.3 0.5
Vegetables 1.4 1.7 0.3
Milk 1.2 1.5 0.3
Meats 4.9 5.0 0.1
Oils 27.9 25.0 -2.9

12. + Literature Review:
 Nutrition Education Aimed at Toddlers (NEAT). Early
intervention program
 1. expand knowledge of food safety- hand washing, chocking
prevention, etc
 2. increase knowledge of self-regulation for toddler: portion
setting, meal time behavior, hunger/ fullness
 3. increase knowledge of managing family meals with toddlers –
parent/ toddler relations surrounding food
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13. +
Literature Review:
 NEAT:
 Slight improvements (proper food prep, mealtime interaction,
portion sizing, food safety) but no significant long term diet
changes in toddlers or parents
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14. +
Interviews:
 Sue Snider: Expanded Food Nutrition Education Program
(EFNEP), Supplemental Nutrition Assistance Program-
Education (SNAP-Ed), University of Delaware
 Tricia Jefferson: YMCA-Delaware
 Jennifer Barr: Moms Moving Forward- Christiana Care Hospital,
registered Dietician
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15. +
Interviews:
 Goals of nutrition education programs
 Group discussion and experiential learning
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Interviews:
 Barriers to nutrition education programs:
 Trust
 Grants and proper funding
 Limited access to healthy foods
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Conclusions:
 Need proper funding for programs and expert financial
planning
 Attentive staff: experts and paraprofessionals- help gain trust
among community members
 Must be discussion based and include experiential learning/
activities- the more hands-on the better
 Discuss the importance of appropriate meal time behaviors,
portion sizing, children setting their own preferences
 Learning the value of accessing healthy foods
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18. +
Conclusions:
Schoolgardens/ youth market
programs (CAMP FRESH)
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Long term goal:
 long term goal is to design the
ideal or quintessential nutrition
education program for low-income
communities.
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Thank you!
Dr. Bahira Trask
Faculty advisor
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21. + References:
 "About SNAP-Ed." National Institute of Food and Agriculture (NIFA). N.p., n.d. Web. 12 July
 2012. http://www.nifa.usda.gov/nea/food/fsne/about
 Arnold, C. G., & Sobal, J. (2000). Food practices and nutrition knowledge after graduating the expanded food
and nutrition education program. Journal of Nutrition Education, 32(3), 130-138. Retrieved June 30, 2012, from
the Psycinfo database.
 CHANCE. (n.d.). FNEC Home. Retrieved July 22, 2012, from
http://www.fnec.cornell.edu/Our_Initiatives/CHANCE.cfm
 Camp FRESH at Christiana Care Health System. (n.d.). Christiana Care Health System. Retrieved July 23, 2012,
from http://www.christianacare.org/campfresh
 Chaney, M. (1945). Integrating Nutrition Education and Activities in the School Program. Nutrition Education, 35,
728-731. Retrieved July 2, 2012, from the Web of Science database.
 "Child Nutrition and WIC Reauthorization Act of 2004 « Food Research & Action Center." Food Research & Action
Center. N.p., n.d. Web. 12 July 2012. <http://frac.org/leg-act-center/legislative-successes/child-nutrition-and-
wic-reauthorization-act-of-2004/>.
 Dammann, K. W., & Smith, C. (2009). Factors affecting low-income women's food
 choices and the perceived impact of dietary intake and socioeconomic status on their health and weight.
Journal of Nutrition Education and Behavior , 41(4), 242-253. Retrieved June 22, 2012, from the psycinfo database.
 Expanded Food and Nutrition Education Program (EFNEP) . (n.d.). National Institute of Food and Agriculture
(NIFA). Retrieved July 2, 2012, from http://www.csrees.usda.gov/nea/food/efnep/efnep.html
 Gleason, P. (1995). Participation in the national school lunch program and the school breakfast program. The
American Journal of Clinical Nutrition, 61(1), 2135-2205. Retrieved July 1, 2012, from the psycinfo database.
 Gostin, L. (2007). Law as a tool to facilitate healthier lifestyles and prevent obesity. Journal of the American
Medical Association, 297(1), 87-90. Retrieved June 22, 2012, from the Psycinfo database.

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References continued:
 Hammerschmidt, P., Tackett, W., Golzynski, M., & Golzynski, D. (2011). Barriers to and facilitators of healthful eating and
physical activity in low-income schools. Journal of Nutrition Education and Behavior , 43(1), 63-68. Retrieved June 23, 2012,
from the Psycinfo database.
 Lent, M., Hill, T., Dollahite, J., Wolfe, W., & Dickin, K. L. (2012). Healthy children, healthy families: parents making a difference!
a curriculum integrating key nutrition, physical activity, and parenting practices to help prevent childhood obesity . Journal
of Nutrition Education and Behavior , 44(1), 90-92. Retrieved July 2, 2012, from the Web of Science database.
 Nord, M., & Parker, L. (2010). How adequately are food needs of children in low-income households being met?. Children
and Youth Services Review, 32(9), 1175-1185. Retrieved June 22, 2012, from the Psycinfo database.
 Horodynski, M. O., & Hoerr, S. (2004). Nutrition education aimed at toddlers- a pilot program for rural, low-income families.
Family Community Health, 37(2), 103-113.
 Omar, M., Coleman, G., & Hoerr, S. (2001). Healthy eating for rural low-income toddlers: caregivers' perceptions. Journal of
Community Health Nursing, 18(2), 93-106. Retrieved July 2, 2012, from the Psycinfo database.
 Parmer, S., Salisbury-Glennon, J., Shannon, D., & Struempler, B. (2009). School gardens: an experiential learning approach
for a nutrition education program toincrease fruit and vegetable knowledge, preference, and consumption among second-
grade students . Journal of Nutrition Education and Behavior , 41(3), 212-217. Retrieved July 23, 2012, from the Web of Science
database.
 Singh, G. K., Siahpush, M., Hiatt, R. A., & Timsina, L. R. (2011). Dramatic increases in obesity and overweight prevalence and
body mass index among ethnic-immigrant and social class groups in the united states, 1976-2008. Journal of Community
Health, 36(1), 94-110. Retrieved July 2, 2012, from the Web of Science database.
 Vartanian, T., Houser, L., & Harkness, J. (2011). Food stamps and dependency: disentangling the short-term and long-term
economic effects of food stamp receipt and low income for young mothers. Journal of Sociology & Social Welfare, 38(4), 101-
119. Retrieved July 2, 2012, from the Web of Science database.
 Wilfley, Densie E.; Kass, Andrea.; Kolko, Rachel P.; Stein, Richard I.. In Child and adolescent
 therapy: Cognitive-behavioral procedures (4th ed), by Wilfey, Denise E., Kass, Andrea E., Kolko, Rachel P., Stein, Richard I. 283-
323. New York, NY, US: Guilford Press, 2012.