Families Eating Smart and Moving More

FESMM targets low-income parents, pregnant, and breastfeeding women. FESMM incorporates hands-on food preparation using simple recipes that require minimal ingredients, and little equipment. In 2022, 40 county governments partnered with EFNEP (Expanded Food and Nutrition Education Program) in North Carolina to fund peer educators. Program delivery partners included 32 Adult Education & Training sites, 26 faith communities, 32 community centers, two Emergency Food Assistance sites, three farmers markets, one food store, 12 Head Starts, 16 Health Care sites, four libraries, five schools, 15 public housing sites, three shelters, two WIC clinics, two worksites and seven other organizations serving low-income families with children. 1,629 participants enrolled in the program.     Settings:  Farmers markets, Community-wide, Faith-based centers, Food pantries, Healthcare, Retail, Schools, USDA program sites, Worksites  Age/Population Group:  Pregnant/Breastfeeding, Parents/Caregivers, Unhoused Race: All Ethnicity:  All

FESMM's critical components include:   Dialogue around lesson topics that engage and value participant experiences A food activity that includes a tasting, recipe demonstration, or hands-on preparation, modified for budget and facility Participation in a physical activity that is modified for ability or setting A goal setting component for participants  Each lesson of FESMM uses dialogue that helps meet participants where they are in considering behavior change. Through dialogue, food, and physical activities, participants are encouraged to consider a small change they want to make. Strategies to overcome potential barriers to change are also discussed. Educators are provided "media moments" that assist with follow-up between lessons via closed Facebook group, text, or email. Participants are encouraged to share progress on meeting their goals during each session. To support individual behavioral change, educators are provided prompts to engage partners who are positioned to affect PSE changes that support healthy eating and physical activity.   FESMM includes 21 lessons with a minimum of six lessons to achieve impacts. Each lesson includes a recipe that can be implemented through a guided tasting, demonstration, or hands-on preparation. Recipe videos walk participants through the recipe, substitutions, and suggestions to save money. Simple preparation techniques that consider participant time, food costs, preparation skills, and kitchen equipment help participants learn how to prepare and eat more meals at home. Physical activities and curriculum visuals (PowerPoints, participant handouts, videos) are included in each lesson. Included in FESMM is access to nine pre-recorded lessons that are available online. This allows flexibility in lesson delivery as well as enhancing the participant's educational experience. In addition, users of FESMM have access to our comprehensive training website.

Families Eating Smart and Moving More curriculum includes:   A leader guide 21 evidence-based, scripted lessons PowerPoint presentations with embedded recipe, physical activity, and concept videos  Teaching kit with lesson review activities  Four research-developed guides to help facilitators adjust their approach for specific audiences Participant handouts  Recruitment tools  Access to videos for online lesson delivery   Access to the FESMM training website   More information about available materials and a sample lesson can be found at:  https://ncefnep.org/partners/curricula/ You can order materials by completing an order form found online at: https://ncefnep.org/partners/order-forms/  and emailing it to northcarolinaefnep@ncsu.edu .

The program collects success stories annually, and each year these stories include successes individual participants have made in controlling an existing chronic disease, such as high blood pressure or diabetes. Although FESMM is not a weight loss program, several participants report losing weight each year. Success stories are included in our annual reports and can be found at https://ncefnep.org/partners/program-impact-archives/ . This includes the current year's state, district, and county reports, as well as archived reports dating back to 2012. Challenges lie in participant recruitment and partner negotiation for time, food supplies, and space. To address participant recruitment, it is recommended to utilize technology for blended face-to-face and online lessons (6 lessons are currently available) and to have flexible work hours. Negotiations with partners for time, food supplies, and space should be based on common goals and outcomes desired, best practices for achieving goals/outcomes, and partner buy-in equity.   FESMM was piloted 2006-2007 in North Carolina with positive results for targeted behaviors. FESMM has produced consistent positive behavior changes in dietary intake, physical activity, food resource management, and food safety ( https://reeis.usda.gov/reports-and-documents/efnep.html ). Developers and Contributors consist of Extension and Public Health professionals with expertise in adult education, nutrition, physical activity, food safety, and resource management. Revisions (2007, 2011, 2016) of the curriculum go through both an internal and external review. FESMM participated in research projects that helped inform the adoption of new strategies during each revision. Guides for specific settings, media moments, and PSE prompts were informed by research.     Evidence Base:  Practice-Tested

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.   Readiness and Capacity - Short Term (ST) Changes - Medium Term (MT) Effectiveness and Maintenance - Long Term (LT) Population Results (R) Individual   MT1 , MT2 , MT3 , MT4     Environmental Settings       Sectors of Influence       In 2019:   MT1: Healthy Eating   MT1l:  52% of participants completing an entry and exit food recall increased their daily fruit consumption by an average of 0.4 cups MT1d : 70% of participants completing an entry and exit Food and Physical Activity Behavior Questionnaire reported eating red and orange vegetables more often each week and 68% reported eating dark green vegetables more often each week MT1h : 54% of participants completing an entry and exit Food and Physical Activity Behavior Questionnaire reported drinking regular soda less often and 53% reported drinking other sweetened beverages less often MT1j : 44% of participants completing an entry and exit food recall reported an increase in their consumption of whole grains  MT2: Food Resource Management   MT2j : 65% of participants completing an entry and exit Food and Physical Activity Questionnaire reported shopping with a list more often  MT3: Physical Activity and Reduced Sedentary Behavior    MT3a:  67% of participants completing an entry and exit Food and Physical Activity Questionnaire reported exercising for at least 30 minutes, more days a week MT3a : 70% of participants completing an entry and exit Food and Physical Activity Questionnaire reported making small changes to be active more often MT3c : 60% of participants completing an entry and exit Food and Physical Activity Questionnaire reported doing muscle strengthening activities, more days a week  MT4: Food Safety   MT4c : 69% of participants completing an entry and exit Food and Physical Activity Questionnaire reported using a meat thermometer more often

Developed initially for EFNEP, FESMM addresses the four primary goals of the program. Impact data collection tools are the standard tools used for EFNEP. The 24-hour recall and the Food and Physical Activity Behavior Questionnaire are available on the Extension Foundation's Connect Extension website at https://connect.extension.org/g/efnep. Data are collected at entry and exit and analyzed using the Web-Based Nutrition Education Evaluation and Reporting System ( WebNEERS ) https://efneppse.org/reporting , a national web-based reporting system for EFNEP. Data from https://reeis.usda.gov/reports-and-documents/efnep  shows NC's FESMM has produced consistent results since 2007.

Website:  The FESMM website ( www.ncefnep.org)  includes more about the program and living a healthy lifestyle.  Contact Person(s): Lisa Benavente State Coordinator, NC State University Phone:  919-515-3888 Email(s): lisa_benavente@ncsu.edu ;  northcarolinaefnep@ncsu.edu   Megan Halbohm Technology and Training Leader, NC State University Phone: 919-515-4743 Email(s): mcberthi@ncsu.edu ;  northcarolinaefnep@ncsu.edu       *Updated as of August 28, 2023