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MT1: Healthy Eating*

Framework Component

Changes - Nutrition-Related Behavioral Changes

Indicator 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 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 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:

Throughout the day or week:



*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.


Older adults, adults, adolescents, children, preschoolers, and toddlers (via parents, teachers, or child care providers)

Surveys and Data Collection Tools



Additional Resources or Supporting Citations

English and Spanish Food Behavior Checklists citations for formative research and validation studies:

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.