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1 Ranju Baral, PhD student 1,2 Dr . George C. Davis, Professor

Utilizing National Data to Estimate Average Cost Effectiveness of the EFNEP Outcomes by State/Territory . 1 Department of Agricultural and Applied Economics 1,2 Department of Human Nutrition, Foods and Exercise Virginia Tech. 1 Ranju Baral, PhD student 1,2 Dr . George C. Davis, Professor.

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1 Ranju Baral, PhD student 1,2 Dr . George C. Davis, Professor

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  1. Utilizing National Data to Estimate Average Cost Effectiveness of the EFNEP Outcomes by State/Territory 1 Department of Agricultural and Applied Economics 1,2 Department of Human Nutrition, Foods and Exercise Virginia Tech 1Ranju Baral, PhD student 1,2Dr. George C. Davis, Professor

  2. Objectives • Objective 1: Use national level data to calculate upper limits on the average cost per participant and per outcomes per state/territory • Objective 2: Utilize these upper limits on the average cost to obtain more precise estimates for states based on the state specific knowledge

  3. Data • Costs: USDA’s annual budget allocation for the EFNEP • Outcomes: USDA’s Nutrition Education Evaluation and Reporting System (NEERS) database Ten behavioral checklists questions used by USDA to develop 3 indices • Food Resource Management Practices (FRMP) • Nutritional Practices (NP) • Food Safety Practices (FSP) • 50 states and 6 US territories for the fiscal years 2000 to 2006

  4. Methods Average cost analysis where, • ACij = is the average cost for the ith state/territory on the jth outcome • TCi = the total cost of EFNEP for the ithstate/territory • yij = the “j”outcome of interest in state “i” Outcomes (yij) 1. Total number of EFNEP participants 2. Expected number of EFNEP participants who improved in outcome (a) FRMP (b) NP (c) FSP

  5. Results: Summary Statistics of Costs and Outcomes Data Aggregated Across the Years and States/Territories

  6. Fig 1: Average Cost per Participant

  7. Fig 2: Average Cost of Improving NP

  8. Fig 3: Average Cost of Improving FRMP

  9. Fig 4: Average Cost of Improving FSP

  10. Extension 1 : Adjusted Average Cost Analysis For example: Texas The upper limit average cost (see figure 2, 3, and 4) • FRMP = $162; NP = $156; FSP = $198 Suppose, 70% of the budget is spent on the adult program and of this 70% budget devoted to • FRMP = 30%; NP =50%; FSP = 20% The adjusted average cost estimates then become • FRMP = .70 × .30 × $162 = $34 • NP = .70 × .50 × $156 = $55 • FSP = .70 × .20 × $198 = $28

  11. Extension 2: Calculation of Cost Effectiveness Ratio Using Information from Dollahite et al. (2008) Paper QALYk= [A] × [Bk] × [Ck] × [Dk] × [Ek] Where, • QALY = Quality Adjusted Life Years • [A] = Number of graduates • [Bk] = Incidence rate of condition k • [Ck] = Diet attributable risk for condition k • [Dk] = Percentage of graduates practicing optimal nutrition behaviors related to condition k • [Ek] = Present value of QALYs saved for condition k

  12. Extension 2: Calculation of Cost Effectiveness Ratio Using Information from Dollahite et al. (2008) Paper

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