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Subjects
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Subjects were low-income
females, 18 years of age or older, living in 16 Tennessee counties served by EFNEP.
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Design
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This study used a quasi-experimental
Nonequivalent Control Group Design with three groups: 1) experimental group A (group
receiving nutrition education from EFNEP that collected cash register receipts for
food), 2) experimental group B (group receiving nutrition education from EFNEP that
estimated food expenditures from recall), and 3) group C (group that qualified for
EFNEP, but delayed participation until subjects in groups A and B completed their
EFNEP education).
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Measuring Costs
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Direct costs.
Most direct costs were obtained
from a Grant and Contract Budget and Expenditure Report from the University Office
of the Treasurer. All costs were collected over a 6-month time horizon and multiplied
by 2 to determine yearly expenditures.
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Indirect costs.
Indirect costs were estimated
using the rate of 21.79% of directs costs for expenses on campus and a rate of 10.79%
for expenses off campus.
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Measuring Benefits
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Food expenditure data.
Food expenditures were obtained
from the item, "money spent on food last month," on the 24-hour food recall. Changes
in food expenditures were determined by subtracting the amount of money spent on
food at program entry from the amount at program exit.
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Food and nutrient data.
Food and nutrient intakes and practices related to food resource management, and
food selection and preparation, were obtained from pre and post 24-hour recalls
and the EFNEP Survey.
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Comparing costs to program benefits. The Net Present Value (NPV) of EFNEP was calculated using the difference
in monthly food expenditures at program entry and exit over 5 years at a discount
rate of 7%. A benefit-cost ratio was calculated by taking the present value (PV)
of future net benefits (using the 7% discount rate) over the one-time investment
cost.
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RESULTS
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Sample
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Three hundred seventy-one
subjects completed the study: 121 in group A, 129 in group B, and 121 in group C.
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Cost Per Participant
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Total program cost was $388.26
per family (total cost divided by the number of graduates).
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Food Expenditures
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Subjects in group A saved
an average of $10.36 per month.
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Subjects in group B saved
an average of $19.53 per month.
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Subjects in the control
group C spent $5.52 more per month.
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Net Present Value and Benefit-Cost Ratio
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The NPV of EFNEP related
to food expenditures was $600.52 over a 5-year time frame at a discount rate of
7%. Sensitivity analysis showed that NPV varied from -$36.60 to $699.10 and depended
on how long benefits were maintained (three or five years), whether food expenditures
were estimated or collected from records, and the discount rate (3%, 5%, or 7%).
The benefit-cost ratio was 2.48/1 (i.e., $2.48 saved for every $1 spent).
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Food and Nutrient Intakes and Behaviors
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At the same time participants
saved money of food expenditures, they consumed more iron, vitamin A, vitamin C,
and fiber. They also improved resource management and food selection and preparation
practices.
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CONCLUSIONS
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EFNEP families realized
a savings of $600.52 in food expenditures. For every dollar spent to implement EFNEP,
$2.48 was saved in food expenditures. Society benefits from EFNEP because money
saved can be used to purchase other goods and services and may reduce the need for
emergency food resources.
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At the same time families
saved on food expenditures, they improved nutrient intakes and behaviors related
to food selection, preparation, and resource management.
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The longer benefits are
retained, the greater the NPV and benefit-cost ratio. Therefore, longevity studies
are needed to document how long changed behaviors are sustained.
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The single measure of effectiveness
reported in this study could be combined with other benefits to further document
the cost-benefit of EFNEP.
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