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Updated: Jul 5, 2026
'Boden Food Plate': Novel Interactive Web-based Method for the Assessment of Dietary Intake
Published on: September 18, 2018
An economic evaluation of the expanded food and nutrition education program
Jamie Dollahite1, Donald Kenkel, C Scott Thompson
1Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853, USA. jsd13@cornell.edu
Objective:
To evaluate the New York State Expanded Food and Nutrition Education Program using economic methodology.
Design:
Data were collected by nutrition educators in a pretest, posttest design with an epidemiological modeling approach to assess costs and estimate potential health benefits of the state program.
Setting:
Cooperative Extension, 35 counties.
Participants:
5730 low-income participants.
Intervention:
Series of 6 or more food and nutrition lessons.
Main Outcome Measures:
Cost (program and participant); health benefits in quality adjusted life years (QALYs); and monetized benefits: society's willingness to pay for QALYs, and benefits of avoiding or delaying health care costs and loss of productivity.
Analysis:
Cost-effectiveness estimated from behavior change and QALY weights. Cost-benefit ratios estimated from costs and monetized benefits. Sensitivity analyses provided ranges where lack of agreement exists around parameters' values.
Results:
Cost was $892/graduate. Cost-effectiveness was 245 QALYs saved, at $20863/QALY (sensitivity 42-935 QALYs, $5467-$130311 per QALY). Societal willingness to pay benefit-to-cost ratio was $9.58:$1.00 (sensitivity $1.44-$41.92:$1:00); narrow governmental benefit-to-cost ratio was $0.82:$1.00 (sensitivity $0.08-$4.33:$1:00).
Conclusions And Implications:
Outcome data indicate that food and nutrition behavior changes resulting from the Program are likely to improve future health and reduce health care costs. Cost-effectiveness is estimated to be as great as for many current health interventions.
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