Education Clinical Trial
Official title:
Understanding the Immediate and Long-term Effects of Supplemental Nutrition Assistance Program-Education as an Intervention to Improve Food Security Among Households With Children in Indiana
The goal of the study is to determine the immediate and long-term effects of SNAP-Ed on the food insecurity of the entire household, household adults, and household children. The study also aims to determine if there is a dose-response effect on food security after receiving 4 to 10 FNP lessons and if other characteristics influence the change in food security status.
FNP educators, employees of Purdue University Extension, across Indiana will help facilitate
the study. FNP educators have completed CITI training as a requirement for employment through
Purdue University Extension. Before recruiting study participants, participating FNP
educators will attend training sessions facilitated by the co-investigators of the study. The
training sessions will include instructions on how to interact with participants, answer
questions related to the study, and protocol for administering surveys, keeping participant
information private, and the use of identification numbers. The study goals and hypothesis
will not be shared with the FNP educators in order to keep their work with the participants
as unbiased as possible.
After completion of the screening survey and consent process, FNP educators will randomize
participants into one of two groups: control or experimental. The FNP educators will be
assigned a random number using Excel and then listed in order from least to greatest
according to their random number. The first half of the FNP educators will assign their first
recruited participants to the experimental group. After the first assignment, they will
alternate assigning participants to either study group every other appointment. The second
half of the FNP educators will assign first recruited participants to the control group.
After the first assignment, they will also alternate assigning participants to either study
group every other appointment. The control group will wait 1 year before starting FNP
lessons. The experimental group will start FNP lessons immediately. Participants in the
experimental group must take at least the first 4 FNP lessons within a time period of 4 to 10
weeks. The FNP includes 12 lessons and participants may take the additional 6 lessons if
desired.
All participants will complete three 45 minute surveys. The first survey will be administered
upon enrollment in the study. Participants in the experimental group will take the second
survey after they have completed the first 4 lessons between 4 and 10 weeks after enrollment
in the study. Control participants will take the second survey after 4 to 10 weeks with no
lessons. Since participants will be recruited on a rolling basis, they will take surveys at
different times within a designated time period. The third survey will be administered to
both groups after 1 year of participation in the study. The third survey will be offered
online. Surveys are comprised of the US Household Food Security Survey Module from the United
States Department of Agriculture Economic Research Service, questions querying household and
individual level characteristics, and the Indiana Food and Nutrition Program Evaluation Tool.
Two study Facebook pages will be used to keep participants engaged in the study over the
year. One page will be only for the control group and another page will be only for the
experimental group. Both Facebook pages will be identical in content and will prevent the
experimental groups from sharing any nutrition or resource management information with the
control group. The Facebook pages will include a study logo, non-nutrition and non-resource
management related educational material that will cover topics such as parenting, safety,
child development, fun activities to do with children, and relationships The Facebook pages
will serve to keep participants engaged and to help prevent attrition. The Facebook pages
will be updated monthly with new material and postings.
Researchers plan to track which study participants participate in the study Facebook pages
without matching their names to their participant identification numbers. In order to carry
out this procedure, researchers will make a list of all of the names that appear on the study
Facebook pages at the end of recruitment in January 2014. Then researchers will send the
entire list of Facebook study participants to the FNP Educators who are the only study
personnel with information linking participant names to their identification numbers. FNP
Educators will look through the list to see which of their clients are participating in the
study and on a study Facebook page. FNP Educators will then send the researchers only the
participant identification numbers of those study participants using the study Facebook page.
No names matched with identification numbers will be sent to the researchers in order to
preserve the privacy of the study participants through confidentiality. The purpose of
collecting information on which study participants participate on the study Facebook pages
will be useful for controlling for the potential confounding that exposure to the Facebook
page may introduce. The Facebook pages are useful to keep participants engaged, however, they
also introduce a new exposure besides the exposure of interest, the SNAP-Ed lessons. There
may be differential participation in the Facebook page among the intervention and control
groups and adjusting for this exposure in the analysis will allow the researchers a clearer
picture of the relationship between the intervention (SNAP-Ed lessons) and the outcome of
interest (food insecurity).
FNP Educators will collect electronic mailing (e-mail) addresses from all study participants
willing to provide this information. The purpose of collecting e-mail addresses is to provide
researchers with the ability to administer the final survey online. There is the possibility
that FNP Educators will not be able to administer Survey 3 one year from administering the
first survey due to a lapse in appropriations to SNAP-Ed.
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