Report| Volume 45, ISSUE 2, P183-187, March 2013

Using National Data to Estimate Average Cost Effectiveness of EFNEP Outcomes by State/Territory

Published:December 03, 2012DOI:


      This report demonstrates how existing national data can be used to first calculate upper limits on the average cost per participant and per outcome per state/territory for the Expanded Food and Nutrition Education Program (EFNEP). These upper limits can then be used by state EFNEP administrators to obtain more precise estimates for their states, based on their state-specific knowledge. Across all states, EFNEP appears most cost effective in nutrition practices, followed by food resource management practices, and then food safety practices. All but 3 states have cost per quality adjusted life years that are considered cost effective.

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        • United States General Accounting Office
        Nutrition Education: USDA Provides Services through Multiple Programs, but Stronger Linkages among Efforts are Needed.
        United States General Accounting Office, Washington, DC2004 (GAO-04-528)
      1. United States Department of Agriculture. Expanded Food and Nutrition Education Program Impacts. National Institute of Food and Agriculture Web site. Updated February 2, 2012. Accessed June 21, 2012.

      2. United States Department of Agriculture. National Institute of Food and Agriculture Extension Activities: Appropriation History, Fiscal Years 2000 - 2010. Accessed June 21, 2012.

      3. Anliker J, Willis W, Montgomery S. The Development and Testing of the Behavior Checklist Questions for the EFNEP Evaluation/Reporting System. National Institute of Food and Agriculture Web site. Published 1998. Accessed June 21, 2012.

      4. Anliker J. Development and Testing of the Original ERS Behavior Checklist: An Historical Perspective. National Institute of Food and Agriculture Web site. Accessed June 21, 2012.

        • Varian H.
        Intermediate Microeconomics: A Modern Approach.
        7th ed. WW Norton & Co., New York, NY2006
        • Serrano E.
        • McFerren M.
        • Lambur M.
        • et al.
        Cost-effectiveness model for youth EFNEP programs: what do we measure and how do we do it?.
        J Nutr Educ Behav. 2011; 43: 295-302
        • Dollahite J.
        • Kenkel D.
        • Thompson C.S.
        An economic evaluation of the Expanded Food and Nutrition Education Program.
        J Nutr Educ Behav. 2008; 40: 134-143
      5. Gold M.R. Siegel J.E. Russell L.B. Weinstein M.C. Cost-Effectiveness in Health and Medicine. Oxford University Press, New York, NY1996
        • Garber A.M.
        • Phelps C.E.
        Economic foundations of cost-effectiveness analysis.
        Journal of Health Economics. 1997; 16: 1-31
        • van Gils P.F.
        • Tariq L.
        • Verschuuren M.
        • van den Berg M.
        Cost-effectiveness research on preventive interventions: a survey of the publications.
        Eur J Public Health. 2010; 21: 260-264