A framework for estimating cost effectiveness of the youth Expanded Food and Nutrition Education Program (EFNEP), one of the largest nutrition education programs in the US, is developed. Using costs and effects data from 15 program counties in Virginia for the school year 2011/2012, the cost effectiveness ratio (CER) of the Healthy Weights for Healthy Kids (HWHK) program was estimated. Improvements in nutrition related behavior, and improvements in nutrition related self-efficacy, from pretest to posttest, were considered as two indicators of program effects. Direct costs associated with the provision of the HWHK program were considered program costs. The total cost of the program was estimated to be $134,333 for one year. Among 1,864 participants, 1,786 improved in behavior indicators and 1,782 improved in self-efficacy indicators. The estimated CER is about $75 per improvement for each outcome indicator. Cross county comparisons reveal a wide variation in CER estimates across counties. The results from this study provide the first piece of information on the CER for youth EFNEP which quantify the effects of investment on youth EFNEP program in Virginia in achieving the stated program objectives.


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