Research Article| Volume 53, ISSUE 5, P401-409, May 2021

Download started.


Food Resource Management Mediates the Relationship Between Participation in a SNAP-Ed Nutrition Education Program and Diet Quality

Published:October 28, 2020DOI:



      To examine the mediating effects of food resource management skills (FRM) on the relationship between participation in a Supplemental Nutrition Assistance Program Education (SNAP-Ed) nutrition education program and diet quality.


      Secondary analysis of data from a propensity score-matched sample of participants (n = 396) and nonparticipants (n = 111) in a SNAP-Ed nutrition education program.


      Independent-samples t tests were used to compare entry, exit, and gain scores in FRM and diet quality between participants and nonparticipants. Structural equation modeling was used to examine direct and mediated relationships among participation, FRM, and diet quality.

      Main Outcome Measures

      Food resource management was measured as a summated rating scale, and diet quality measured as Healthy Eating Index and program participation.


      Mediated effect of FRM on the relationship between participation in a SNAP-Ed program and diet quality was statistically significant (P < 0.01). The effect size for the mediation effect indicated that about 70% of program participation on diet quality was transferred by FRM skills. The hypothesized model had acceptable fit indices as model χ2 was nonsignificant (P = 0.31), all fit indices were above 0.9, and the root mean square of error approximation was low at 0.02.

      Conclusions and Implications

      Participation in a SNAP-Ed program enhanced participants’ FRM, which in turn enhanced their diet quality.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access

      SNEB Member Login

      SNEB Members, full access to the journal is a member benefit. Login via the SNEB Website to access all journal content and features.


      Subscribe to Journal of Nutrition Education and Behavior
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. US Department of Agriculture, Food and Nutrition Service. Supplemental Nutrition Assistance Program Education (SNAP-Ed) Factsheet. Washington, DC: US Department of Agriculture; 2016. Accessed May 7, 2020.

      2. Chang Y, Kim J, Chatterjee S. The effect of food price on food insecurity and diet quality: exploring potential moderating roles of SNAP and consumer competency. University of Kentucky Center for Poverty Research Discussion Paper Series, DP2016-06. Accessed May 7, 2020.

        • Wardlaw M
        • Baker S.
        Long-term evaluation of EFNEP and SNAP-Ed.
        Forum Fam Consum Issues. 2012; 17: 1-14
        • Dollahite J
        • Olson C
        • Scott‐Pierce M
        The impact of nutrition education on food insecurity among low‐income participants in EFNEP.
        Fam Consum Sci Res J. 2003; 32: 127-139
        • Koszewski W
        • Sehi N
        • Behrends D
        • Tuttle E
        The impact of SNAP-Ed and EFNEP on program graduates 6 months after graduation.
        J Extension. 2011; 49: 1-8
        • Lohse B
        • Belue R
        • Smith S
        • Wamboldt P
        • Cunningham-Sabo L
        About Eating: an online program with evidence of increased food resource management skills for low-income women.
        J Nutr Educ Behav. 2015; 47: 256-272
        • Pooler JA
        • Morgan RE
        • Wong K
        • Wilkin MK
        • Blitstein JL
        Cooking Matters for Adults improves food resource management skills and self-confidence among low-income participants.
        J Nutr Educ Behav. 2017; 49: 545-553.e1
        • Kaiser L
        • Chaidez V
        • Algert S
        • et al.
        Food resource management education with SNAP participation improves food security.
        J Nutr Educ Behav. 2015; 47: 374-378.e1
        • Farrell JA.
        The Impact of Nutrition Education on Food Security Status and Food-Related Behaviors. Master's thesis.
        University of Massachusetts, 2014
        • Pomerleau J
        • Lock K
        • Knai C
        • McKee M
        Interventions designed to increase adult fruit and vegetable intake can be effective: a systematic review of the literature.
        J Nutr. 2005; 135: 2486-2495
        • Manios Y
        • Moschonis G
        • Katsaroll I
        • Grammatikaki E
        • Tanagra S
        Changes in diet quality score, macro- and micronutrients intake following a nutrition education intervention in postmenopausal women.
        J Hum Nutr Diet. 2007; 20: 126-131
        • Guenther PM
        • Luick BR.
        Improved overall quality of diets reported by Expanded Food and Nutrition Education Program participants in the mountain region.
        J Nutr Educ Behav. 2015; 47: 421-426.e1
        • Memon MA
        • Cheah J
        • Ramayah T
        • Ting H
        • Chuah F
        Mediation analysis issues and recommendations.
        J Appl Struct Equ Model. 2018; 2: 1-9
        • Donaldson SI.
        Mediator and moderator analysis in program development. In: Sussman S, ed.
        Handbook of Program Development for Health Behavior Research and Practice. SAGE Publications, Thousand Oaks, CA2001: 470-496
        • Institute of Medicine, National Research Council
        Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy.
        National Academies Press, Washington, DC2013
        • Rivera RL
        • Maulding MK
        • Abbott AR
        • Craig BA
        • Eicher-Miller HA
        SNAP-Ed (Supplemental Nutrition Assistance Program-Education) increases long-term food security among Indiana households with children in a randomized controlled study.
        J Nutr. 2016; 146: 2375-2382
        • Hersey J
        • Anliker J
        • Miller C
        • et al.
        Food shopping practices are associated with dietary quality in low-income households.
        J Nutr Educ. 2001; 33: S16-S26
        • Dill NK.
        Oklahoma Community Nutrition Education Program Participant's Diet Quality Does Not Differ by Food Security Status. Master's thesis.
        Oklahoma State University, 2004
        • Adedokun OA
        • Plonski P
        • Jenkins-Howard B
        • Cotterill D
        • Vail A
        Healthy Choices for Every Body adult curriculum improves participants’ food resource management skills and food safety practices.
        J Nutr Educ Behav. 2018; 50: 638-644
        • Chung SJ
        • Hoerr SL.
        Evaluation of a theory-based community intervention to increase fruit and vegetable intakes of women with limited incomes.
        Nutr Res Pract. 2007; 1: 46-51
        • Perkins S
        • Daley A
        • Yerxa K
        • Therrien M
        The effectiveness of the Expanded Food and Nutrition Education Program (EFNEP) on diet quality as measured by the healthy eating index.
        Am J Lifestyle Med. 2019; 14: 316-325
        • Rivera RL.
        Evaluating the Effect of SNAP-Ed on Household Food Security Status and Dietary Intake of SNAP-Ed-Eligible Participants in Indiana. Dissertation.
        Purdue University, 2018
        • Wirt A
        • Collins C.
        Diet quality–what is it and does it matter?.
        Public Health Nutr. 2009; 12: 2473-2492
        • Spronk I
        • Kullen C
        • Burdon C
        • O'Connor H
        Relationship between nutrition knowledge and dietary intake.
        Br J Nutr. 2014; 111: 1713-1726
        • Stables GJ
        • Subar AF
        • Patterson BH
        • et al.
        Changes in vegetable and fruit consumption and awareness among US adults: results of the 1991 and 1997 5 A Day for Better Health Program surveys.
        J Am Diet Assoc. 2002; 102: 809-817
        • Wiig K
        • Smith C.
        The art of grocery shopping on a food stamp budget: factors influencing the food choices of low-income women as they try to make ends meet.
        Public Health Nutr. 2009; 12: 1726-1734
        • Dubowitz T
        • Cohen DA
        • Huang CY
        • Beckman RA
        • Collins RL
        Using a grocery list is associated with a healthier diet and lower BMI among very high-risk adults.
        J Nutr Educ Behav. 2015; 47: 259-264
        • Kim SY
        • Nayga Jr RM
        • Capps Jr O
        The effect of food label use on nutrient intakes: an endogenous switching regression analysis.
        J Agric Resour Econ. 2000; 25: 215-231
        • Crawford D
        • Ball K
        • Mishra G
        • Salmon J
        • Timperio A
        Which food-related behaviours are associated with healthier intakes of fruits and vegetables among women?.
        Public Health Nutr. 2007; 10: 256-265
        • Fairchild AJ
        • McDaniel HL.
        Best (but oft-forgotten) practices: mediation analysis.
        Am J Clin Nutr. 2017; 105: 1259-1271
        • Austin PC.
        An introduction to propensity score methods for reducing the effects of confounding in observational studies.
        Multivariate Behav Res. 2011; 46: 399-424
        • Rosenbaum PR
        • Rubin DB.
        The central role of the propensity score in observational studies for causal effects.
        Biometrika. 1983; 70: 41-55
        • Hansen BB
        • Bowers J.
        Covariate balance in simple, stratified and clustered comparative studies.
        Stat Sci. 2008; 23: 219-236
        • Iacus SM
        • King G
        • Porro G
        CEM: software for coarsened exact matching.
        J Stat Softw. 2009; 30: 1-27
      3. US Department of Agriculture. EFNEP checklist. Accessed May 8, 2020.

      4. US Department of Agriculture. National Institute of Food and Agriculture. WebNEERS: planning, evaluation, and reporting. Accessed December 9, 2019.

        • Raper N
        • Perloff B
        • Ingwersen L
        • Steinfeldt L
        • Anand J
        An overview of USDA's dietary intake data system.
        J Food Compos Anal. 2004; 17: 545-555
        • Conway JM
        • Ingwersen LA
        • Vinyard BT
        • Moshfegh AJ
        Effectiveness of the US Department of Agriculture 5-step multiple-pass method in assessing food intake in obese and nonobese women.
        Am J Clin Nutr. 2003; 77: 1171-1178
        • Moore CJ
        • Williams TN
        • Berg AC
        • Durward CM
        An evaluation of inter-coder and intra-coder reliability for 24-hour dietary recall data entered in WebNEERS.
        J Nutr Educ Behav. 2019; 51: 432-439
        • Costello AB
        • Osborne J.
        Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis.
        Pract Assess Res Eval. 2005; 10: 1-9
        • Guenther PM
        • Casavale KO
        • Reedy J
        • et al.
        Update of the healthy eating index: HEI-2010.
        J Acad Nutr Diet. 2013; 113: 569-580
        • Guenther PM
        • Kirkpatrick SI
        • Reedy J
        • et al.
        The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans.
        J Nutr. 2014; 144: 399-407
        • Cohen J.
        Statistical Power Analysis for the Behavioral Sciences.
        2nd ed. Lawrence Erlbaum Associates, Hillsdale, NJ1988
        • Kline RB.
        Principles and Practice of Structural Equation Modeling.
        Guilford Press, New York, NY2005
        • Arbuckle JL.
        Amos 6.0 User's Guide.
        Amos Development Corporation, Chicago, IL2005
        • Adedokun OA
        • Childress AL
        • Burgess WD
        Testing conceptual frameworks of nonexperimental program evaluation designs using structural equation modeling.
        Am J Eval. 2011; 32: 480-493
        • Cohen J
        A power primer.
        Psychol Bull. 1992; 112: 155-159
        • Fairchild AJ
        • McQuillin SD.
        Evaluating mediation and moderation effects in school psychology: a presentation of methods and review of current practice.
        J Sch Psychol. 2010; 48: 53-84
        • Wilson MD
        • Ramírez AS
        • Arsenault JE
        • Miller LMS
        Nutrition label use and its association with dietary quality among latinos: the roles of poverty and acculturation.
        J Nutr Educ Behav. 2018; 50: 876-887
        • Gibson RS
        • Charrondiere UR
        • Bell W
        Measurement errors in dietary assessment using self-reported 24-hour recalls in low-income countries and strategies for their prevention.
        Adv Nutr. 2017; 8: 980-991
        • Gopalan M
        • Rosinger K
        • Ahn JB
        Use of quasi-experimental research designs in education research: growth, promise, and challenges.
        Rev Res Educ. 2020; 44: 218-243