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A Cost-Benefit Analysis of the Tennessee Expanded Food and Nutrition Education Program  

For every dollar spent to implement the Expanded Food and Nutrition Education Program (EFNEP), $2.48 is saved on food expenditures.  This can reduce the need for emergency food assistance and save money for other necessities.

This study applied cost-benefit analysis to determine:
1) if participation in EFNEP helps households use their food resources wisely,
2) if participation in EFNEP helps households improve their nutrient intake, and
3) what it costs to improve these behaviors.


METHODS

Subjects
Subjects were low-income females, 18 years of age or older, living in 16 Tennessee counties served by EFNEP.
Design
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).
Measuring Costs
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.
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.
Measuring Benefits
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.
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.
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.
RESULTS
Sample
Three hundred seventy-one subjects completed the study: 121 in group A, 129 in group B, and 121 in group C.
Cost Per Participant
Total program cost was $388.26 per family (total cost divided by the number of graduates).
Food Expenditures
Subjects in group A saved an average of $10.36 per month.
Subjects in group B saved an average of $19.53 per month.
Subjects in the control group C spent $5.52 more per month.
Net Present Value and Benefit-Cost Ratio
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).
Food and Nutrient Intakes and Behaviors
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.
CONCLUSIONS
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.
At the same time families saved on food expenditures, they improved nutrient intakes and behaviors related to food selection, preparation, and resource management.
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.
The single measure of effectiveness reported in this study could be combined with other benefits to further document the cost-benefit of EFNEP.

Prepared by: Janie Burney, PhD, RD, The University of Tennessee Agricultural Extension Service. This study was conducted in partial fulfillment of a doctoral degree from The University of Tennessee in 1998.