title: An economic evaluation of the expanded food and nutrition education program.
abstract: OBJECTIVE
  To evaluate the New York State Expanded Food and Nutrition Education Program using economic methodology.
  
  
  METHODS
  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.
  
  
  METHODS
  Cooperative Extension, 35 counties.
  
  
  METHODS
  5730 low-income participants.
  
  
  METHODS
  Series of 6 or more food and nutrition lessons.
  
  
  METHODS
  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.
  
  
  METHODS
  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
  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.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853, USA. jsd13@cornell.edu
authors.forename: Jamie
authors.initials: J
authors.lastname: Dollahite
authors.forename: Donald
authors.initials: D
authors.lastname: Kenkel
authors.forename: C Scott
authors.initials: CS
authors.lastname: Thompson
mesh_terms: D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006266:Health Education / Q000191:economics*; D009518:New York; D052756:Nutritional Sciences / Q000191:economics* / Q000193:education*; D011203:Poverty; D015397:Program Evaluation; D011788:Quality of Life