Evaluation of CalFresh Healthy Living Adult Education 2023

Statewide Evaluation of CalFresh Healthy Living Adult Education Prepared by the Nutrition Policy Institute October 2023 1

Background In FFY 2023, several local health departments (LHD) in California evaluated series-based CalFresh Healthy Living (CFHL) nutrition education delivered to adults. Eating, drinking, and food resource management behaviors were measured before and after direct education through a self-reported survey. Among 1575 direct education participants, 591 completed the survey at pre and post. 586 completed pre-test only and 398 completed post-test only 60 records were excluded during data cleaning, for a final sample of n=531a Funded by USDA SNAP, an equal opportunity provider and employer. Visit www.CalFreshHealthyLiving.org for healthy tips. a sample sizes may vary slightly due to nonresponse

Demographic Characteristicsa (n=531) Age (in years) Race 100% 100% 80% 80% % of participants % of participants 60% 60% 48% 38% 40% 29% 40% 23% 17% 16% 20% 20% 9% 7% 6% 3% 1% 0% 0% 18-35 36-50 51-64 65 and older *AIAN Asian Black *NHPI White Other Prefer not to answer Sex Ethnicity 100% 100% 77% 80% % of participants % of participants 70% 80% 60% 60% 40% 22% 40% 25% 20% 1% 20% 5% 0% 0% Male Female Prefer not to answer Hispanic Non-Hispanic Prefer not to answer a reported at pre-test *AIAN: American Indian or Alaska Native NHPI: Native Hawaiian or Pacific Islander

Fruit Consumption Behaviors Average Fruit Consumption (n=513) 2 Mean change from pre to post: 0.4 p-valuea: < 0.0001 There was a statistically significant increase in fruit consumption from pre to post 1.5 Quantity (in cups) 1.5 1.1 1 0.5 Average daily fruit consumption increased by .4 cups. 0 Before After Consume More Than 1 Kind of Fruit (n=517) The proportion of participants who reported often or always consuming more than one type of fruit each day increased from 39% to 56%. Before p-valueb: < 0.0001 After 54% 60% % of participants 38% 35% 40% 26% 21% 20% 13% 8% 5% 0% No Yes, sometimes Yes, often Yes, always a Paired T Test adjusting for clustering was conducted. Statistical significance set at p-value < 0.05 b Wilcoxon Signed Rank test adjusting for clustering was conducted. Statistical significance set at p-value < 0.05

Vegetable Consumption Behaviors Average Vegetable Consumption (n=511) Mean change from pre to post: 0.3 p-valuea: 0.0003 2 There was a statistically significant increase in vegetable consumption from pre to post 1.6 Quantity (in cups) 1.3 1.5 1 0.5 Average daily vegetable consumption increased by approximately 1/3 cup. 0 Before After Consume More Than 1 Kind of Vegetable (n=517) The proportion of participants who reported often or always consuming more than one type of vegetable each day increased from 46% to 62%. Before p-valueb: < 0.0001 60% After 48% % of participants 38% 40% 33% 28% 24% 18% 20% 6% 5% 0% No Yes, sometimes Yes, often Yes, always a Paired T Test adjusting for clustering was conducted. Statistical significance set at p-value < 0.05 b Wilcoxon Signed Rank test adjusting for clustering was conducted. Statistical significance set at p-value < 0.05

Beverage Consumption Behaviors Consume Fruit Drinks, Sports Drinks, & Punch (n=528) 70% Before p-valuea: < 0.0001 There was a statistically significant decrease in sugary drink consumption from pre to post 60% 53% After % of participants 47% 50% 40% 40% 28% 30% 15% The proportion of participants who reported not consuming fruit drinks, sports drinks, and punch increased from 28% to 40%. 20% 10% 5% 10% 2% 0% No Yes, sometimes Yes, often Yes, everyday Consume Regular Soda (n=526) The proportion of participants who reported not consuming soda increased from 34% to 49%. 70% p-valuea: < 0.0001 Before 60% 49% 49% % of participants After 50% 43% 34% 40% 30% 20% 12% 6% 5% 10% 3% 0% No Yes, sometimes Yes, often Yes, everyday a Wilcoxon Signed Rank test adjusting for clustering was conducted. Statistical significance set at p-value < 0.05

Food Shopping & Resource Management Behaviors Reads Nutrition Facts Label When Food Shopping (n=514) There was a statistically significant increase in the use of the nutrition facts label. Before p-valuea: < 0.0001 60% After 50% % of participants 37% The proportion of participants who reported often or always using the nutrition facts label when shopping increased from 37% to 57%. 40% 30% 29% 27% 26% 30% 19% 18% 20% 14% 10% 0% No Yes, sometimes Yes, often Yes, always Runs Out of Food Before the End of the Month (n=520) Before p-valuea: 0.2572 60% There was no significant change in the proportion of participants who reported running out of food by the end of the month. After 47% 50% % of participants 44% 40% 33% 32% 30% 20% 13% 11% 10% 10% 10% 0% No Yes, sometimes Yes, often Yes, always a Wilcoxon Signed Rank test adjusting for clustering was conducted. Statistical significance set at p-value < 0.05

Potential Focus Areas for CFHL Programming The survey asks questions to help identify opportunities to reach participants and their families in other settings with CFHL programming. Places Where the Household Shopped for Food Last Month (n=521) Have a Child Who Attends K-12 School (n=501) 75% Large Grocery 64% % of participants 50% 50% 50% Warehouse 35% 25% Half of the participants have a child who attends a K-12 school Discount Grocery 34% Small Grocery 26% 0% Yes No Food Bank 22% Have a Child Who Regularly Attends Before or After School Program (n=246) Out of those, 41% of the participants have a child who attends before or after school program Produce store 13% Online Grocery 11% 75% 59% % of participants Convenience store 11% 50% 41% Farmer's Market 10% The majority of participants shopped at a large grocery store in the past month 25% 0% 25% % of participants 50% 75% 0% Yes No