The point of diminishing returns in nutrition education through home visits by aides: an evaluation of EFNEP.

This three-year evaluation of field work with poor, rural homemakers by nutrition aides employed by the Expanded Food and Nutrition Education Program (EFNEP) of the Maryland Cooperative Extension Service is based on successive annual interviews with 93 homemakers and a control group of 58 designated friends. The results suggest various points of diminishing returns beyond which behavioral and attitudinal changes brought about by the specific educational strategies are too small to justify continued visits to a homemaker. To sustain cost-effective home visits after the first year, more emphasis must be placed on reinforcement of first-year gains, and on expanding the scope of nutrition education to include more health education of other kinds.