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 $20 863/QALY (sensitivity 42-935 QALYs, $5467-$130 311 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.
Key Words
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Article info
Footnotes
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.
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Copyright
© 2008 SOCIETY FOR NUTRITION EDUCATION. Published by Elsevier Inc. All rights reserved.
