An Economic Evaluation of the Expanded Food and Nutrition Education Program
Abstract
Objective
To evaluate the New York State Expanded Food and Nutrition Education Program using economic methodology.
Design
Data were collected by nutrition educators in a pretest, posttest design with an epidemiological modeling approach to assess costs and estimate potential health benefits of the state program.
Setting
Cooperative Extension, 35 counties.
Participants
5730 low-income participants.
Intervention
Series of 6 or more food and nutrition lessons.
Main outcome measures
Cost (program and participant); health benefits in quality adjusted life years (QALYs); and monetized benefits: society's willingness to pay for QALYs, and benefits of avoiding or delaying health care costs and loss of productivity.
Analysis
Cost-effectiveness estimated from behavior change and QALY weights. Cost–benefit ratios estimated from costs and monetized benefits. Sensitivity analyses provided ranges where lack of agreement exists around parameters' values.
Results
Cost was $892/graduate. Cost-effectiveness was 245 QALYs saved, at $20863/QALY (sensitivity 42-935 QALYs, $5467-$130311 per QALY). Societal willingness to pay benefit-to-cost ratio was $9.58:$1.00 (sensitivity $1.44-$41.92:$1:00); narrow governmental benefit-to-cost ratio was $0.82:$1.00 (sensitivity $0.08-$4.33:$1:00).
Conclusions and implications
Outcome data indicate that food and nutrition behavior changes resulting from the Program are likely to improve future health and reduce health care costs. Cost-effectiveness is estimated to be as great as for many current health interventions.
1Division of Nutritional Sciences, Cornell University, Ithaca, New York
2Department of Policy, Analysis, and Management, Cornell University, Ithaca, New York
Address for correspondence: Jamie Dollahite, PhD, RD, Division of Nutritional Sciences, 3M14 MVR, Cornell University, Ithaca, NY 14853; Phone: (607) 255-7715; Fax: (607) 255-0027
This research was supported by a USDA Research Development Grant from the Joint Center for Poverty Research (2000), the College of Human Ecology at Cornell University, and Cornell Cooperative Extension.
Continuing Education Questionnaire available at www.sne.org/ Meets Learning Need Codes for RDs and DTRs 4010, 4070, and 4080.
ABSTRACT
An Economic Evaluation of the Expanded Food and Nutrition Education Program