Creating Healthful Home Food Environments: Results of a Study with Participants in the Expanded Food and Nutrition Education Program

ObjectiveTo evaluate a modified curriculum for the 6-session Texas Expanded Food and Nutrition Education Program (EFNEP) promoting healthful home food environments and parenting skills related to obesity prevention.DesignTwo-group randomized control trial; intervention versus usual EFNEP curriculum.SettingTexas EFNEP classes.Participants1,104 EFNEP clients in 100 classes.InterventionSix short videos, with goal setting, problem solving, guided discussion, and handouts, incorporated into existing EFNEP classes.Main Outcome MeasuresBody mass index (BMI), diet, psychosocial variables with baseline measurements, immediately post, and 4 months later.AnalysisMixed-model repeated measures analysis of variance.Results100 classes were randomized (54 intervention/46 comparison), with 1,006 participants at baseline (582 intervention, 424 comparison, 97% women, 89% Hispanic). Significant improvements over time were found for both groups' consumption of most food items and nutrients, and nearly all psychosocial variables, regardless of study group. Only the intervention group had a significant BMI decrease at post. Fidelity to the intervention class session structure was high, and comments from intervention staff and clients were positive.Conclusion and ImplicationsExisting EFNEP programs in local communities could have a significant impact on family dietary behaviors for populations at risk of obesity. Replication with similar populations is warranted.