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Create Better Health Online Course

| Utah

May 15, 2023

The Utah State University Extension Create Better Health (SNAP-Ed) Online Course is a thorough, cost-saving, and effective on-demand educational delivery option, shown to positively impact families’ eating and physical activity behaviors.

Purpose:        

Utah State University Extension Create Better Health (Utah SNAP-Ed) online course was developed to teach SNAP-Ed participants how to eat well and be active on a budget. The intended audience is limited-income, SNAP-Ed qualifying adults who access information online. This audience may not be able to attend in-person SNAP-Ed instruction or they may live in areas without a SNAP-Ed program. The online course opened in February 2021 for a pilot study and then launched to the general SNAP-Ed audience in July 2021.

As SNAP-Ed programs evolve and strive to meet their audience where they work, learn, and play, virtual education and online learning is becoming more and more relevant.

Description:

The online course was developed in the Canvas learning management system and is video-guided and self-paced. Canvas provides tracking management to certify participants after they complete an entire series. The course is an adaptation of the evidence-based Create Better Health SNAP-Ed curriculum. It includes eight different in-depth modules with video lesson presentations and video recipe demos, including easy tips for individuals and families. It is based on the USDA Dietary Guidelines and MyPlate for developing healthy eating patterns, and includes information from the 2018 Department of Health and Human Services Physical Activity Guidelines for Americans to help create an active lifestyle. In addition to in-depth lesson modules on MyPlate and critical components of USDA Dietary Guidelines, it also includes simple tips, including quick and easy recipes, menu planning ideas, budget-friendly ways to shop for healthy foods, and advice for active living and creating an overall healthy lifestyle.

According to virtual learning best practices, the online course includes interactive questions to mimic the interaction of in-person classes, where responses from other class participants can be seen anonymously. The development team created professional videos along with presentations to visually show details of the topics. They also created animated videos on the importance of physical activity and tips on creating exercise routines. The team worked closely with nutrition educators to choose healthy, delicious, family-friendly, inexpensive, and easy-to-make recipes then scripted and filmed videos for each recipe. 

Results:

February through April 2021, a small group (N=117) participated in a pilot of the online course, and 73 participants completed course evaluations. Pre- and post-surveys were administered in addition to surveys after each online course module. Surveys were based on the Create Better Health curriculum evaluations. Mid-course lessons included additional questions measuring the participants’ intent to change to account for potential attrition in an online setting. Data was analyzed to determine if the online course improved dietary behaviors as effectively as in-person classes. 

Create Better Health Intent to Change Survey bar graph. Figure 1. Intent to Change Behavior Face-to-Face Participants Compared to Online Participants pre/post. Group Mean n scores are 1 =never, 2=seldom- 3=sometimes 4= usually and 5= always. For the behavior “Chose a variety of food based on MyPlate recommendations, the pretests for both face-to-face and online participants are similar at about 3.2.  The post test for both groups are also similar at about 4.1.  For the statement “I am physically active for
see long description below

Figure 1 below shows participants’ intent to change behaviors based on each lesson module. Each behavior has at least 50% of participants reporting an increase in frequency in these key behaviors that help create healthy patterns that reduce the risk of chronic disease. Figure 1 also shows intent to change behaviors of past face-to-face Create Better Health class participants compared to the Create Better Health online course participants, showing the online course is at least as effective as in-person classes.

In addition to intent to change behaviors, the pilot study gathered data on participant increases in select behaviors after participating in a series of Create Better Health classes. Figure 2 shows the program impact of the Create Better Health online course where at least 50% or more of participants are making changes in select behaviors that decrease the risk of chronic diseases as a direct result of taking the online course. 

Furthermore, 75% of participants downloaded handouts and recipes. Of those, 84% used the handouts at home, and 74% used the recipes at home. The course also collected qualitative data from participants.

Figure 2 bar graph showing differences in pre and post series surveys. Long description below.
see long description below

Participant Responses:

“The recipes and real-life applicable ideas. I also LOVED that there was no shaming, and it was encouraging. Loved the comment about every little change helping. Felt less overwhelming.”

“I loved the recipes and the tips for making meals more economical.”

“I liked the information about exercising and the recommended amount for adults each week. I liked how the course described different exercises such as weight training should be incorporated at least two times a week. The information was presented very well and easy to understand through quizzes and video instruction. “

Course Layout:

Online course is based on the Create Better Health (SNAP-Ed) curriculum. Below are links to some of the videos and lessons within the course.

Screenshot of an online nutrition course- educators talking about MyPlate
Lesson 4: Fruit and Veggies
https://youtu.be/konfi3F65sw
Screen capture of recipe video showing ingredients for black beans and roasted sweet potato salad
Recipe: Black Bean and Roasted Sweet Potato Salad https://youtu.be/PnkejwjiN88
screenshot of online lesson title page "Physical Activity, Overcoming barriers to exercise"
Lesson 3: Physical Activity Barriers
https://youtu.be/1jMFbC5qKHA

Another feature of the online course is the ‘Beet’ The Odds section in each lesson with a click-through slideshow of tips to implement ways to beat the odds of chronic disease.

2 slides showing 'Beet Tips": first has a beet character and text "A well-stocked Pantry" Next slide has image of pantry goods and text "Stock up on canned or frozen items like beans or vegetables when they go on sale: choose low-sodium options if available."

As SNAP-Ed programs evolve and strive to meet their audience where they work, learn, and play, virtual education and online learning is becoming more and more relevant. Low or no cost online courses are an efficient and effective way to provide education. This medium is one of the ways Create Better Health is addressing barriers to participants who cannot attend in-person classes.  Utah’s participant impact data collection is growing, but already it reveals online learning to be an effective medium for nutrition messaging and public education. We look forward to expanding and improving our online education opportunities for SNAP-Education in Utah.


This article was written and submitted Utah State University Extension Create Better Health (Utah SNAP-Ed). For further information please contact Heidi Leblanc and Lea Palmer.


Long Descriptions:

Figure 1: Create Better Health Intent to Change Survey bar graph. Figure 1. Intent to Change Behavior Face-to-Face Participants Compared to Online Participants pre/post. Group Mean n scores are 1 =never, 2=seldom- 3=sometimes 4= usually and 5= always. For the behavior “Chose a variety of food based on MyPlate recommendations, the pretests for both face-to-face and online participants are similar at about 3.2.  The post test for both groups are also similar at about 4.1.  For the statement “I am physically active for at least 30 minutes, at least 5 days per week” the face-to-face group’s pretest value was about 3.2 and the post test for this group was just under 4.  For the online group, the pretest started lower at about 2.7 and the post test was at 4, indicating a slightly higher rate of increase for the online group.  For the statement
“I adjust meals to use foods I have on hand,” the pretest for the face-to-face group was about 3.7 and the post test was about 4.3.  For the online group, the pretest was about 3.2 and the post test was 4, indicating a slightly higher rate of change for the online group
.

Figure 2: Create Better Health Pre-post series survey. Figure 2: Comparison of Face-to-Face (n=84) and online (n=48) Participant Reported Increases in Select Behaviors After Participating in a Create Better Health Serie. bar graph shows comparison for the following behaviors: “Be physically active at least 30 minutes, 5 days a week,” “Adjust meals to use foods on hand,” “Increase vegetable intake,” “Increase Fruit intake,” “Use nutrition facts labels,” and “Use MyPlate to make food choices.” “Be physically active at least 30 minutes, 5 days a week” shows a slight decrease for online series participants.  All other behaviors show increases for Online Series participants compared to face-to-face series participants.

 

SNAP-Ed Strategies