Karasz, HilaryCasey, Melissa2021-07-072021-07-072021-07-072021Casey_washington_0250O_22619.pdfhttp://hdl.handle.net/1773/47080Thesis (Master's)--University of Washington, 2021The objective of the study was to assess the long-term effect of the Expanded Food and Nutrition Education Program (EFNEP) on participants' diet quality using 24-hr dietary recall (24HDR) data collected from a sample of English and Spanish speaking EFNEP participants from January 2018 through October 2019. Healthy Eating Index (HEI) scores collected at 4 time points – pre-EFNEP (Week 1 of a 9-week nutrition education class series), post-EFNEP (Week 9), 6-months post-EFNEP, and 12-months post-EFNEP – were analyzed using Generalized Estimating Equations (GEE) linear regression and paired t-tests. This study was limited due to its small sample size, little variation in participant demographics, and missing data. Total HEI – estimated due to the missing data – improved substantially by 4.8 points from pre-EFNEP to the 12-month follow-up. HEI subcomponent scores improved in total fruit, whole fruit, and fatty acids whereas scores decreased in total vegetables, green beans, and sodium. Further research is essential to demonstrate the long-term impacts of EFNEP on participants’ dietary behaviors and thus, the efficacy and value of evidence-based nutrition education programs targeting low-income families.application/pdfen-USnonePublic healthHealth servicesThesis