by Jennifer McCaffrey, PhD, MPH, RD
This year marks the 50th anniversary of the Expanded Food and Nutrition Education Program (EFNEP), the first national nutrition education program. The EFNEP exemplifies nutrition education that has evolved to meet the changes in society and the challenges and needs of the intended target audience of low-income families. A unique aspect of EFNEP that makes it a good case study for nutrition education is the way the program has blended theory and practice. This intersection is at the heart of what makes nutrition education effective.
From its inception, EFNEP has been built on theory. In early references, Spindler1 describes how “Diffusion of Innovations”2 was applied to the program, and over the years, EFNEP has provided a platform for researchers and practitioners to ascertain the use of theory in nutrition education interventions. Through a search of the published literature, you will quickly see the influence EFNEP has had in the field.
In studying the application of theory in health interventions, Glanz3 categorizes the use theory in4 ways: interventions informed by theory, interventions that apply theory, interventions developed that test theory, and interventions researching the creation of theory. While the research associated with EFNEP is vast, EFNEP has been an avenue for researchers and practitioners to build interventions using theory across all of those categories. However, the use of theory remains limited, and many health interventions are still challenged to fully apply or test theoretical components and fall into the “informed by theory” category.3, 4 Furthermore, we know that behavior change is complex and may require the blend of theories and more in-depth testing of multi-level interventions. As the trends in implementation science5 move forward, EFNEP, and programs that have grown from its roots, still remain an avenue to test the application of theories and more rigorous methodologies. Community-based nutrition education programs, such as EFNEP, epitomize how effective nutrition education relies on a blend of multiple theoretical aspects and is embedded in communities with different cultural, social, and environmental systems. Just as EFNEP has evolved, I encourage researchers and practitioners to continue building the science at the deeper and more complex level of theory application through these community-based programs.
As my year as SNEB President comes to a close, I have had the opportunity to witness the passion and dedication our members. The collaborative nature of the members in the Society is unique and provides the right environment to continue to advance the science of theoretical applications in nutrition education. With the launch of the SNEB's research division this past year, I am excited to see leaders in our field continuing to create avenues for new research opportunities and implement nutrition education interventions. We look forward to seeing your work published here and presented at future annual meetings.
- Spindler, E. “Program aides” for work with low income families. J Am Dietetic Assoc. 1967; 50: 478–479
- Rogers, EM. Diffusion of Innovations. The Free Press, Glencoe, NY; 1962
- Glanz K.Social and Behavioral Theories. E- Source Behavioral Science Research. Washington, DC: Office of Behavioral Science and Research, National Institutes of Health. https://obssr.od.nih.gov/training/online-training-resources/esource/. Accessed May 15, 2019.
- Glanz, K and Bishop, DB. The role of behavioralscience theory in development and implementation of public health interventions. Annu Rev Public Health. 2010; 31: 399–418
- Swindle, T, Curran, GM, and Johnson, SL. Implementation science and nutrition education and behavior: opportunities for integration. J Nutr Educ Behav. 2019; 51: 763–774