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Qin, Y.; Rivera, R.L.; Zhang, Y.; Wang, Q.; Tooze, J.A.; Abbott, A.R.; Maulding, M.K.; Craig, B.A.; Bailey, R.L.; Eicher-Miller, H.A.

Background: The goal of US Department of Agriculture Supplemental Nutrition Assistance Program–Education (SNAP-Ed) is to improve the likelihood that those eligible for SNAP will make healthy choices aligned with the Dietary Guidelines for Americans, 2020-2025. Objective: The objective of the study was to evaluate the long-term effects of a direct SNAP-Ed intervention in which participants actively engage in learning with educator instruction about dietary quality and usual intake of key nutrient and food groups among Indiana SNAP-Ed–eligible women participants as an example sample in the context of no similar existing evaluation. Design: The study design was a parallel-arm, randomized controlled, nutrition education intervention, with follow-up at 1 year. Participants/setting: Participants (18 years and older; n = 97 women) eligible for SNAP-Ed and interested in receiving nutrition education lessons were recruited from 31 Indiana counties from August 2015 to May 2016 and randomized to an intervention (n = 53) or control (n = 44) group. Intervention: The intervention comprised core lessons of Indiana SNAP-Ed delivered between 4 and 10 weeks after baseline assessment. Each participant completed a baseline and 1-year follow-up assessment. Dietary intake was assessed using repeated 24-hour dietary recalls (up to 2). Main outcome measures: Mean usual nutrient, food group intake, diet quality (ie, Healthy Eating Index-2010 scores), and proportion of intervention and control groups meeting Dietary Guidelines for Americans, 2020-2025 recommendations and Dietary Reference Intake indicators of requirement or adequacy, were determined using the National Cancer Institute method and the simple Healthy Eating Index-2010 scoring algorithm method. Dietary changes between intervention and control groups were examined over time using mixed linear models. Statistical analyses performed: Bonferroni-corrected significance levels were applied to the results of the mixed linear models for comparisons of usual intake of nutrients and foods. Results: No differences in diet quality, intake of food group components, food group intake, or nutrients were observed at 1-year follow-up, except that vitamin D intake was higher among those who received SNAP-Ed compared with the control group. Conclusions: A direct SNAP-Ed intervention did not improve diet quality, food group intake, or key nutrient intake, except for vitamin D, among Indiana SNAP-Ed–eligible women up to 1 year after the nutrition education. © 2023 Academy of Nutrition and Dietetics