Objective: To assess the impact of the Eat Smart, Live Strong (ESLS) intervention on low-income older adults' fruit and vegetable consumption through two independent evaluations.
Study Design, Setting, Participants, and Intervention: The ESLS intervention developed by USDA includes four lessons (45-minutes of nutrition education and 20 minutes of physical activity) that were delivered at senior centers and supplemented with take-home materials between March and July 2012. Both evaluations used a quasi-experimental research design to assess program impacts among Supplemental Nutrition Assistance Program (SNAP)-eligible older adults living in Michigan. A total of 34 senior centers and 614 adults aged 60 and older participated in the evaluations.
Outcome, Measures and Analysis: The primary impact measure was increase in participants' average daily intake of fruit and vegetables measured using food frequencies (Evaluation 1) and 24-hour dietary recalls (Evaluation 2). Difference-in-difference models were used to estimate program impact, comparing change across time (baseline and follow-up) in the intervention group with change across time in the comparison group.
Results: Evaluation 1: Increased participants' average daily consumption of fruit by 0.2 cups (p < 0.05) and vegetables by 0.31 cups (p < 0.01). Evaluation 2: Increased participants' average daily consumption of fruit by 0.35 cups (p < 0.05) and vegetables by 0.37 cups (p < 0.05). Results from participant surveys and instructor interviews suggest that participants were highly satisfied with the program.
Conclusions and Implications: ESLS is an effective curriculum for helping SNAP-eligible older adults eat healthier and should be broadly implemented.