Nutrition Education for Healthy Eating and Food Security

Recruiting at 1 trial location

Overseen By Heather Eicher-Miller

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Purdue University

Disqualifiers: Pregnancy, Lactation, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

300 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Supplemental Nutrition Assistance Program-Education (SNAP-Ed) for healthy eating and food security?

Research shows that SNAP-Ed helps improve food security, meaning it helps people have reliable access to enough food, especially among low-income families. However, its impact on improving overall nutrition or dietary habits is less clear, with mixed results in studies. ^{1 2 3 4 5}

Is SNAP-Ed safe for humans?

SNAP-Ed, which provides nutrition education to help people make healthier food choices, is generally considered safe for humans as it focuses on education and support rather than medical treatment. ^{1 2 4 5 6}

How is the treatment SNAP-Ed unique for improving healthy eating and food security?

SNAP-Ed is unique because it focuses on providing nutrition education specifically to low-income individuals and families, aiming to improve their dietary habits and food security. Unlike other treatments, it combines education on nutrition, budgeting, and healthy lifestyle choices to address food insecurity and promote long-term healthy eating behaviors. ^{1 2 4 5 6}

What is the purpose of this trial?

Food insecurity and low diet quality are persistent problems linked with chronic disease and poor health among limited-resource children and adults using Supplemental Nutrition Assistance Program (SNAP). We have shown nutrition education via adult-focused, direct SNAP-Education (SNAP-Ed) improved household food security by 25% but not adult dietary quality among SNAP-eligible households using a randomized, controlled, longitudinal SNAP-Ed intervention in Indiana. Households experiencing food insecurity often reserve food considered "healthful" for children, so child dietary quality improvement may precede that observed among adults when household food security improves. This study will determine the effect of adult-focused direct SNAP-Ed on child dietary quality and household food security using a longitudinal randomized, controlled SNAP-Ed intervention. Assessment will include repeated 24-hour dietary recalls to determine usual intake, the U.S. Household Food Security Survey Module, and behavior data from before and after the 10-week "intervention period," and 1 year later, after which the control group will receive the intervention. Low-income participants (n=275) from Indiana will be recruited following SNAP-Ed protocol. Results of the study will inform the creation of supplementary on-demand SNAP-Ed educational material focused on improving healthful dietary intake for children and adults in situations of food insecurity in households with children. Education on modeling healthy attitudes and behaviors, planning and preparing family meals, and dietary shortfalls as informed by the results and previous evidence will be included and evaluated. The study aligns with the goals of USDA to increase food security and this RFP to improve healthful behaviors, food quality and nutrition.

Research Team

Heather Eicher-Miller, PhD

Principal Investigator

Purdue University

Eligibility Criteria

This trial is for low-income households in Indiana with children, where adults are willing to participate and wait a year for SNAP-Ed. Participants must speak English, be eligible for SNAP benefits, and allow a child aged 5-18 years to join the study. Pregnant or lactating individuals or those who've had SNAP-Ed lessons in the past year cannot participate.

Inclusion Criteria

Households with children

English speaking

I am willing to let my child, who is between 5-18 years old, participate.

Exclusion Criteria

I have not participated in SNAP-Ed lessons in the last year.

Not pregnant or lactating (due to inherent dietary changes)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Recruitment

Recruitment of participants at a rate of 10 per week for 9 months across 4 regions

9 months

Monthly visits to each region

Intervention

Participants receive SNAP-Ed lessons over a 10-week period

10 weeks

4 lessons (in-person or group setting)

Follow-up

Participants are monitored for changes in dietary quality and food security

12 months

Monthly contact to update information

Delayed Intervention for Control Group

Control group receives SNAP-Ed lessons after the 1-year follow-up

10 weeks

Treatment Details

Interventions

• Supplemental Nutrition Assistance Program-Education

Trial Overview The study tests if adult-focused nutrition education (SNAP-Education) can improve dietary quality in children and increase household food security. It involves tracking diet through surveys before, after a 10-week course, and one year later. The control group will receive the intervention after this period.

Participant Groups

Group I: Supplemental Nutrition Assistance Program-Education Experimental Treatment 1 Intervention

This group will receive the core content of the Supplemental Nutrition Assistance Program-Education over the 10-week "intervention period".

Group II: Control Active Control 1 Intervention

This group will not receive the Supplemental Nutrition Assistance Program-Education during the "intervention period" nor throughout the study (1 year).

Supplemental Nutrition Assistance Program-Education is already approved in United States for the following indications:

Approved in United States as SNAP-Ed for:

• Improving household food security
• Enhancing dietary quality among SNAP-eligible households

Who Is Running the Clinical Trial?

Purdue University

Lead Sponsor

Trials

239

Recruited

72,200+

Wake Forest University Health Sciences

Collaborator

Trials

1,432

Recruited

2,506,000+

Findings from Research

SNAP-Ed has been shown to be effective in improving food security among low-income populations, with evidence from four reports supporting its impact.

However, the evidence for SNAP-Ed's effectiveness in improving nutrition and dietary outcomes is less consistent, highlighting the need for more rigorous studies to better evaluate its impact in these areas.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) on food security and dietary outcomes. Rivera, RL., Maulding, MK., Eicher-Miller, HA.[2020]

Out of six SNAP-Ed interventions aimed at promoting healthy eating in low-income children, only one successfully increased fruit and vegetable consumption by the targeted 0.3 cups per day, indicating that some interventions can be effective.

Three of the interventions showed a small but statistically significant increase in either fruit and vegetable consumption or the use of low-fat or fat-free milk, suggesting that with proper implementation and refinement, dietary habits can improve among low-income families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children's At-Home Diets. Williams, PA., Cates, SC., Blitstein, JL., et al.[2015]

A systematic review of 10 studies on food provision programs for patients with type 2 diabetes or prediabetes showed that those including nutrition education consistently reduced HbA1c levels, indicating improved diabetes management.

Programs varied widely in their design and implementation, but those that incorporated nutrition education—covering topics like general nutrition and fruit/vegetable consumption—tended to yield better dietary quality and health outcomes compared to those without such education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A narrative review of clinic-community food provision interventions aimed at improving diabetes outcomes among food-insecure adults: examining the role of nutrition education. Schier, HE., Chetty, KS., Garrity, K., et al.[2023]

A SNAP-Ed nutrition education intervention for 97 eligible women in Indiana showed no significant improvements in overall diet quality or nutrient intake after one year, except for an increase in vitamin D intake among participants.

The study highlights that while the intervention aimed to promote healthier eating aligned with dietary guidelines, it did not lead to substantial changes in dietary habits for most nutrients and food groups over the follow-up period.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Randomized Intervention of Supplemental Nutrition Assistance Program-Education Did Not Improve Dietary Outcomes Except for Vitamin D Among Lower-Income Women in Indiana. Qin, Y., Rivera, RL., Zhang, Y., et al.[2023]

The Indiana SNAP-Ed program significantly improved food security scores among low-income households with children, with notable reductions in food insecurity observed one year after the intervention.

While adults in the intervention group showed improved food security, the program did not result in a significant change in food security scores for children compared to the control group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SNAP-Ed (Supplemental Nutrition Assistance Program-Education) Increases Long-Term Food Security among Indiana Households with Children in a Randomized Controlled Study. Rivera, RL., Maulding, MK., Abbott, AR., et al.[2023]

A qualitative study involving 26 participants across eight California State University campuses highlighted the need for SNAP-Ed programs to be tailored specifically to address the unique food insecurity challenges faced by college students.

Key themes identified included the importance of aligning program content with students' needs, such as incorporating relevant cooking skills and recipes, which could enhance engagement and effectiveness of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SNAP-Ed Programming for College Students Experiencing Food Insecurity: A Qualitative Process-Focused Evaluation. Gray, VB., Grijalva-Martinez, E., Zuniga, C., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Effect of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) on food security and dietary outcomes. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Evaluating the Impact of Six Supplemental Nutrition Assistance Program Education Interventions on Children's At-Home Diets. [2015]

3. United States pubmed.ncbi.nlm.nih.gov

A narrative review of clinic-community food provision interventions aimed at improving diabetes outcomes among food-insecure adults: examining the role of nutrition education. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

A Randomized Intervention of Supplemental Nutrition Assistance Program-Education Did Not Improve Dietary Outcomes Except for Vitamin D Among Lower-Income Women in Indiana. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

SNAP-Ed (Supplemental Nutrition Assistance Program-Education) Increases Long-Term Food Security among Indiana Households with Children in a Randomized Controlled Study. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

SNAP-Ed Programming for College Students Experiencing Food Insecurity: A Qualitative Process-Focused Evaluation. [2023]