# Estimating the value of an early childhood education nutrition program

**Authors:** Ruchira Mahashabde, Allen Smith, Taren Massey-Swindle, Julie M. Rutledge, Zhang Dong, Jacob T. Painter

PMC · DOI: 10.3389/fnut.2025.1613236 · Frontiers in Nutrition · 2025-11-04

## TL;DR

The WISE nutrition program for young children in Arkansas Head Start improved diet quality at a lower cost than usual education.

## Contribution

The study provides a cost-effectiveness analysis of a nutrition intervention in early childhood education settings.

## Key findings

- Children in WISE sites had a greater increase in fruit and vegetable intake compared to those in UNE sites.
- The WISE program cost less per child per month than the usual nutrition education.
- WISE remained cost-effective even when implementation costs were considered.

## Abstract

The objective of the study was to estimate the cost, effectiveness, and value of the Together, We Inspire Smart Eating (WISE) intervention compared to usual nutrition education (UNE) in Arkansas Head Start programs that are part of the Child and Adult Care Food Program (CACFP).

A pre-post study design with non-randomized group assignment was employed to compare cost, body mass index (BMI), and fruit and vegetable intake (measured using the Food Frequency Questionnaire, FFQ) among children aged 3–5 years between September 2015 and April 2018.

Children at WISE sites showed a greater increase in FFQ scores (0.29 units, p < 0.01) compared to those at UNE sites (0.05 units, p = 0.15), with no significant BMI differences between the groups. The WISE intervention costs $2.16 per child per month, whereas the UNE allocates $3.52 per child per month. Overall, WISE was both more effective and less expensive 25% of the time, costing $0.26 per 1-unit increase in FFQ scores. The WISE intervention remained favorable even when sites were unwilling to pay for its implementation.

WISE promoted healthier diets at a lower cost than UNE, as evidenced by improved FFQ scores. These findings provide insights for decision makers regarding the intervention’s cost, potential savings, and overall value.

## Full-text entities

- **Diseases:** cancer (MESH:D009369), Head Start (MESH:D006258), obese (MESH:D009765), Overweight (MESH:D050177), BMI (MESH:C536030), micronutrient deficiencies (MESH:D007153), malnutrition (MESH:D044342), WISE (MESH:D001068)
- **Chemicals:** sugars (MESH:D000073893), carotenoid (MESH:D002338), UNE (-)
- **Species:** Daucus carota (carrot, species) [taxon 4039]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12623320/full.md

## References

30 references — full list in the complete paper: https://tomesphere.com/paper/PMC12623320/full.md

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Source: https://tomesphere.com/paper/PMC12623320