Framework Component
Changes - Nutrition-Related Behavioral ChangesIndicator Description
Changes in individual and family healthy eating behaviors on the pathway to achieving the current Dietary Guidelines for Americans recommendations.
*SNAP-Ed Priority Outcome The desired benefit, improvement, or achievement of a specific program or goal. Indicator
Background and Context
Indicator MT1 measures healthy eating behavioral changes reported by SNAP-Ed participants before and after participation in a series of direct nutrition education classes offered face-to-face or over the Internet. Agencies measure the extent to which participants are improving their dietary patterns across food groups on the pathway toward achieving current Dietary Guidelines for Americans recommendations.
MT1 builds upon ST1 by assessing whether participants are making the behavioral changes they intended. LT1 then builds upon MT1 and should use the same survey or data collection tool to assess behavior change long-term (6 months or longer).
The number of SNAP-Ed classes and contacts vary by program model, underlying behavioral theory, or curriculum, ranging from four to eight sessions and sometimes longer. Differences in reportable outcomes may be explained by the intensity of nutrition education programming received by participants.
Outcome The desired benefit, improvement, or achievement of a specific program or goal. Measures
The number or percentage of participants reporting a healthy eating behavior during the period assessed, the frequency, type of behavior(s), or cups of fruits and vegetables consumed:
During main meals:
| MT1a. | Protein foods prepared without solid fats (e.g., saturated and/or trans fats) or fresh poultry, seafood, pork, and lean meat, rather than processed meat and poultry |
| MT1b. | Ate a serving size of protein less than the palm of a hand or a deck of cards |
Throughout the day or week:
| MT1c. | Ate more than one kind of fruit |
| MT1d. | Ate more than one kind of vegetable |
| MT1e. | Ate nuts or nut butters |
| MT1f. | Used MyPlate to make food choices |
Frequency How often a person does an activity (e.g. days/week). :
| MT1g. | Drinking water |
| MT1h. | Drinking fewer sugar-sweetened beverages (e.g., regular soda or sports drinks)* |
| MT1i. | Consuming low-fat or fat-free milk (including with cereal), milk products (e.g., yogurt or cheese), or fortified soy beverages |
| MT1j. | Eating fewer refined grains (e.g., spaghetti, white rice, white tortilla)* |
| MT1k. | Eating fewer sweets (e.g., cookies or cake)* |
Servings:
| MT1l. | Cups of fruit consumed per day |
| MT1m. | Cups of vegetables consumed per day |
*Note: For certain outcome measures, a reduction in the behavior is desired. An example is drinking sugary beverages, such as regular soda or sports drinks, or consuming refined grains or grain-based desserts.
What to Measure
At present, there is no standardized survey instrument or composite score used in SNAP-Ed programming due to the variety of curricula and population subgroups served. Evaluators are encouraged to select one or more measures to determine if participants changed their targeted dietary outcome behaviors during the period assessed. Choose at least one outcome measure from the list provided, and select a measurement approach based upon the type of survey question and responses. For a description on ordinal and nominal outcomes, please see Appendix D. Given the variety of measures that make up healthy eating behaviors, it will be useful to measure the degree of correlation among the survey responses listed in this indicator.
Evaluators should prioritize survey questions that provide a range of options, such as frequency measures using a Likert scale (e.g., never, seldom, sometimes, etc.) or times per day or week or behavior that occurs. These response options are more sensitive to detecting change during the period assessed than questions with "yes" or "no" answers. Where possible, FNS strongly encourages SNAP-Ed providers to also measure cups of fruit and cups of vegetables consumed. Pictures or visual cues of per-cup equivalents of fruits and vegetables aid survey respondents.
Typically, a pre-test is administered at program entry and a post-test is administered at program exit. In some instances, a post-only test is administered in which respondents are asked to look back on their behaviors before the series compared to their current behaviors.
Population
Older adults, adults, adolescents, children, preschoolers, and toddlers (via parents, teachers, or child care providers)Surveys and Data Collection Tools
ADULTS
CHILDREN & YOUTH
Key Glossary Terms
Refined grains Grains that have been milled to give them a finer texture and improve their shelf life. This process removes dietary fiber, iron, and many B vitamins. , Solid fats Fats that are solid at room temperature, like beef fat, butter, and shortening. Solid fats mainly come from animal foods and can also be made from vegetable oils through a process called hydrogenation. , Sugar-sweetened beverages Liquids that are sweetened with various forms of added sugars.
Additional Resources or Supporting Citations
English and Spanish Food Behavior Checklists citations for formative research and validation studies: https://townsendlab.ucdavis.edu/publications/.
BSQ - Neuhouser ML, Lilley S, Lund A, Johnson DB. Development and validation of a beverage and snack questionnaire for use in evaluation of school nutrition policies. J Am Diet Assoc. 2009; 109(9): 1587-1592.SPAN - Thiagarajah K, Fly AD, Hoelscher DM, et al. Validating the food behavior questions from the elementary school SPAN questionnaire. J Nutr Educ Behav. Sep-Oct 2008;40(National Cancer Institute & 5 a Day Program Evaluation Group):305-310.