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Dissertation
The Drexel University PA SNAP-Ed DRAGON Project: iterative development and efficacy of a novel nutrition education intervention
Doctor of Philosophy (Ph.D.), Drexel University
Aug 2025
DOI:
https://doi.org/10.17918/00011210
Abstract
Introduction: Child and adult obesity rates in the United States continue to climb, contributing to a growing public health crisis. Overweight and obesity are associated with numerous comorbidities that can significantly diminish quality of life and increase risk of mortality. The Supplemental Nutrition Assistance Program Education (SNAP-Ed) promotes the use of comprehensive, multilevel intervention methods. These evidence-based strategies aim to deliver nutrition education and obesity prevention activities in low-income eligible communities, consistent with the Dietary Guidelines for Americans. Methods: The goal of this research was to conduct an in-depth evaluation of the DRAGON Project, a direct nutrition education and policy, systems, and environmental (PSE) change based intervention developed by Drexel University's Pennsylvania SNAP-Ed Eat Right Philly program (DRX ERP). Using an iterative process, both quantitative and qualitative methods were employed. Baseline and post-test surveys assessed behavior changes during both the DRAGON Project pilot and a three-year intervention. This study also examined how DRX ERP transitioned from in-person to virtual nutrition education during the COVID-19 pandemic. Data collection included student surveys, website analytics, and staff self-assessments. Results: The iterative evaluation process proved effective in assessing and refining the DRAGON Project. Pilot study findings showed medium to high effect sizes, suggesting a positive impact from the program's education delivery. Over the three-year intervention, students demonstrated significant dietary improvements. Protein intake increased (mean change = 0.03, p =.003; group-level p < .001), and fast food consumption decreased (mean change = -0.06, p < .001; group-level p =.046). Significant group-level improvements were also observed in snack (p < .001) and fat consumption (p =.018). Online education assessments revealed increased staff confidence in using Email (p =.033), Integrated Applications (p =.033), and Teaching with Technology (p =.021). Significant improvements were observed in green salad consumption among students who participated in the virtual education pilot (p =.03). Conclusion: Behavior change is complex to both measure and facilitate, particularly in the context of public health interventions. However, rigorous evaluation demonstrates that using multilevel intervention strategies and online education can significantly enhance the reach, accessibility, and effectiveness of nutrition education. These approaches allow facilitators to adapt and improve methods of delivery, ensuring that health education is not only evidence-based but also equitable and responsive to the needs of diverse populations. Lessons from this research serve as a starting point for improving the provision of nutrition education and to guide evidence-based strategies that foster healthier communities.
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Details
- Title
- The Drexel University PA SNAP-Ed DRAGON Project
- Creators
- Kusuma Komala Schofield
- Contributors
- Jennifer J. Quinlan (Advisor)Jennifer Nasser (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University
- Number of pages
- ix, 173 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Nutrition Sciences; College of Nursing and Health Professions; Drexel University
- Other Identifier
- 991022135143804721