Project:
Lessons Learned From the Spend Less, Eat Well, Feel Better Program Efficacy Trial

Year: 2001

Research Center: Department of Nutrition at the University of California, Davis

Investigator: Derrickson, Joda P., G. Kaui Asing, Annette Okuma, and Chad Buchanan

Institution: Full Plate, Inc.

Project Contact:
Joda P. Derrickson, Nutrition Consultant
Full Plate, Inc.
44-155-4 Laha Street
Kaneohe, HI 96744
Phone: 808-247-0324
laniwai4@pixi.com

This study evaluated the effect of the Spend Less, Eat Well, Feel Better (SLEWFB) educational intervention on (1) household food security status, (2) ability to pay rent, (3) average daily fruit and vegetable intake, and (4) success in accomplishing self-set financial and food goals. SLEWFB is an educational program initiated and delivered by the Family Service Office (FSO) of the Salvation Army in Honolulu, HI. FSO is the primary distributor of emergency housing and utility assistance in Honolulu. SLEWFB is a 3-hour session on financial resource management and food, diet, and health. It is intended to provide resources, skills, and motivation that will “teach participants how to fish, rather than just giving them fish.”

Participants eligible for the evaluation included 438 FSO clients who entered FSO offices between January and August 2001. Upon their initial entry to the FSO office, participants were randomly placed in the intervention group, which received the SLEWFB session, or in the control group, which received a 1-hour course in food safety.

Members of both groups were surveyed both before and after the intervention. The pre-intervention survey was completed in person, and a followup survey was administered 4-6 weeks after the intervention through the mail, by phone, or in person. A third interview, scheduled for 6 months after the intervention, was canceled due to poor response rates to the followup survey. Both surveys included seven questions used to measure household food security, a question about ability to pay rent on time, and two questions pertaining to the frequency of fruit and vegetable consumption. Pearson’s chi-square analysis and repeated measures of application of analysis of variance (ANOVA) were used to assess statistical significance of variables over time and by intervention. The researchers also conducted two focus groups to clarify the perceived value of the SLEWFB.

Two hundred participants, or 46 percent of those eligible, completed the SLEWFB session or the food safety course. Of the 200 participants, 115 completed the SLEWFB session and 85 completed the food safety course. About half (47 percent) of all participants completed the followup survey, 48 percent of the SLEWFB group, and 47 percent of the food safety course group. The authors found that food security status improved in both the control and intervention groups. SLEWFB participants were 26 percent more likely than the control group to report that they could pay rent on time before and after the intervention. Members of the intervention group were also significantly more likely than those in the control group to report that they no longer had to choose between food and rent in the followup survey. Small but statistically significant improvements in fruit and vegetable intake were demonstrated only by the SLEWFB participants. Goal progress did not vary by intervention type; 88 percent of the subjects reported at least some progress toward their financial goal. Focus group participants confirmed that the SLEWFB intervention improved their ability to manage their resources and their selfperception. Participants confirmed the value of dialogue with their peers in similar circumstances, although most felt a financial incentive was required to entice their participation in either educational class. In addition, four of six focus group participants reported that they had decreased the number of packages of cigarettes smoked a day because of the SLEWFB intervention, although this was not a specific objective of the program.

The authors conclude that even a short, 3-hour contact can improve desired outcomes if delivered in a manner that encourages self-assessment, motivates clients, and provides adequate monitoring of project variables for every client. However, the authors note that participants reported a need for a financial incentive to participate in the SLEWFB and that the low survey response rates made it impossible to assess the longterm effects of the educational program.