Nutrition Education: USDA Actions Needed to Assess Effectiveness, Coordinate Programs, and Leverage Expertise
Fast Facts
Poor nutrition contributes to costly chronic diseases that are among the leading causes of death for Americans. USDA's nutrition education efforts aim to educate Americans on nutrition and improve their dietary choices.
However, USDA lacks information on whether one of its largest nutrition education programs is meeting its goals. Further, USDA officials who work on nutrition education programs aren't always coordinating with one another or consulting other USDA nutrition experts, including those who develop dietary guidance—which reduces the effectiveness of these efforts.
We recommended actions USDA could take to address these issues.
A pile of different types of fruits and vegetables, including grapes, strawberries, and broccoli, among others.
Highlights
What GAO Found
The U.S. Department of Agriculture (USDA) administers five key programs that provide nutrition education and has information on participation, expenditures, and effectiveness for most of these programs. USDA tracks the number of participants in direct education, such as classes and counseling, as well as other measures of program reach. For example, Supplemental Nutrition Assistance Program Education (SNAP-Ed), one of USDA's largest nutrition education programs, served 3.8 million participants through direct education in fiscal year 2018. USDA also collects nationwide expenditure data for all of its nutrition education programs, which totaled nearly $907 million in fiscal year 2017—the most recent year with complete data available. In addition, USDA collects some information on the effectiveness of most of its nutrition education programs; yet information USDA collects from states on SNAP-Ed effectiveness cannot be easily aggregated or reviewed. States provide this information in narrative reports, which hinders USDA's ability to assess the effectiveness of interventions used across the country and determine whether SNAP-Ed is achieving its goals.
U.S. Department of Agriculture Nutrition Education Program Expenditures, Fiscal Year 2017
USDA does not have a formal coordination mechanism for its nutrition education efforts and does not fully leverage the department's nutrition expertise. According to USDA officials, coordinating nutrition education efforts has not been a priority in recent years, and the department does not have a dedicated individual or entity with leadership responsibility for nutrition education. This has resulted in limited coordination across USDA's nutrition education programs, including programs with similar target populations. GAO previously reported that effective coordination can help reduce overlap and duplication. In its absence, USDA's nutrition education programs are missing opportunities to share information and avoid duplicating efforts. Further, some USDA nutrition experts are not located in agencies or offices overseeing the nutrition education programs, and possibly because of this, program staff consult these experts on a limited basis, if at all. Failing to leverage its internal expertise hinders USDA's development of nutrition education materials that are informed by the latest nutrition guidance and research and may reduce the effectiveness of these efforts.
Why GAO Did This Study
The Centers for Disease Control and Prevention reports that many Americans' diets lack adequate sources of good nutrition and that this contributes to costly chronic health conditions. USDA funds and administers a variety of nutrition education efforts, which aim to help educate Americans on nutrition and improve their dietary choices. GAO was asked to review these efforts.
This report examines the extent to which USDA (1) has information on participation, expenditures, and effectiveness for its nutrition education programs; and (2) coordinates its nutrition education efforts and leverages internal nutrition expertise for these efforts. GAO reviewed relevant federal laws, regulations, guidance, and GAO's prior work on nutrition education and leading practices for collaboration; analyzed USDA data on nutrition education participation in fiscal year 2018 and expenditures in fiscal year 2017, the most recent year with complete data available; and reviewed program evaluations and available outcome data for fiscal year 2018. GAO also interviewed USDA officials and representatives of relevant organizations.
Recommendations
GAO is making three recommendations to USDA, including that USDA improve how it gathers information on SNAP-Ed effectiveness, develop a formal mechanism for coordinating nutrition education across the department, and take steps to fully leverage the department's nutrition expertise for its nutrition education efforts. USDA generally agreed with GAO's recommendations.
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Agriculture | The Administrator of the Food and Nutrition Service (FNS) should improve how FNS gathers information on the effectiveness of SNAP-Ed interventions, in order to ensure that these interventions are meeting program goals. (Recommendation 1) |
Closed – Implemented
FNS has taken several steps to improve how it gathers information on the effectiveness of SNAP-Ed interventions. FNS purchased a national license in June 2021 to implement the SNAP-Ed National Program Evaluation and Reporting System, which is intended to improve data aggregation and visualization, according to FNS officials. In September 2021, FNS completed the development of new SNAP-Ed State plan and annual report forms to improve data reporting, including aligning annual reporting with the SNAP-Ed Evaluation Framework priority indicators. In addition, FNS developed the Needs Assessment and Behavior Outcome Measurement Toolkits in fiscal year 2022 to assist State SNAP-Ed providers with using the new plan and annual report forms. To facilitate consistent and streamlined reporting, FNS' Fiscal Year 2023 SNAP-Ed Plan Guidance provides expanded information on the reporting of SNAP-Ed Evaluation Framework indicators.
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| Department of Agriculture | The Secretary of Agriculture should direct the Under Secretaries for Food, Nutrition, and Consumer Services and for Research, Education, and Economics to develop a formal mechanism, such as a designated individual or group of individuals, for providing cross-department leadership for USDA's nutrition education efforts and facilitating cross-program information sharing. (Recommendation 2) |
Closed – Implemented
As of May 2021, USDA has taken steps necessary to address this recommendation. In July 2020, USDA established a nutrition promotion working group coordinated by USDA's Office of the Chief Scientist and comprised of representatives from each USDA mission area conducting nutrition promotion or related research and evaluation. According to its charter, the working group will support coordination among USDA agencies charged with ensuring that federal investments in nutrition promotion are judicious and designed to produce the maximum possible impact for USDA and its stakeholders. The working group held its first quarterly meeting in February 2021, according to USDA officials. Additionally, in November 2020, USDA held an interdepartmental nutrition and food safety workshop to facilitate cross-program information sharing. These efforts to better coordinate nutrition education efforts across the department will help USDA to maximize program reach and impact and avoid potentially wasteful duplication of effort.
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| Department of Agriculture | The Secretary of Agriculture should direct the Under Secretaries for Food, Nutrition, and Consumer Services and for Research, Education, and Economics to identify and implement mechanisms to fully leverage the department's nutrition expertise for its nutrition education efforts. (Recommendation 3) |
Closed – Implemented
USDA has deployed various mechanisms to more fully leverage nutrition expertise for its nutrition education efforts. In February 2020, the Office of the Chief Scientist released the USDA Science Blueprint: A Roadmap for USDA Science from 2020 to 2025, which is intended to guide USDA's science priorities for the next 5 years. The Blueprint outlines five overarching themes for USDA's science initiatives, including Food and Nutrition Translation. The report highlights Research, Education, and Economics (REE) research expertise and recognizes the research authorities in Food, Nutrition, and Consumer Services (FNCS), as well as other mission areas. In December 2020, USDA released the Dietary Guidelines for Americans, 2020-2025. The Dietary Guidelines for Americans serve as the basis for nutrition education among federal programs. According to officials, USDA nutritionists from FNCS, REE, and other mission areas within USDA supported the development, review, and release of the latest dietary guidelines. As of May 2021, FNCS also initiated the Nutrition Enterprise Initiative to coordinate nutrition education and information across FNCS, leveraging the skills and expertise of FNCS nutritionists. Through this initiative, officials said FNCS is making a concerted effort to speak with one voice across its food and nutrition programs to ensure consistent messaging based on the Dietary Guidelines for Americans.
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