Capturing the whole-school food environment in primary schools.

OBJECTIVE: The school food environment (SFE) is an ideal setting for encouraging healthy dietary behaviour. We aimed to develop an instrument to assess whole-SFE, test the instrument in the school setting and demonstrate its use to make food environment recommendations. DESIGN: SFE literature and UK school food guidance were searched to inform instrument items. The instrument consisted of (i) an observation proforma capturing canteen areas systems, food presentation and monitoring of food intake and (ii) a questionnaire assessing food policies, provision and activities. The instrument was tested in schools and used to develop SFE recommendations. Descriptive analyses enabled narrative discussion. SETTING: Primary schools. PARTICIPANTS: An observation was undertaken at schools in urban and rural geographical regions of Northern Ireland of varying socio-economic status (n 18). School senior management completed the questionnaire with input from school caterers (n 16). RESULTS: The instrument captured desired detail and potential instrument modifications were identified. SFE varied. Differences existed between food policies and how policies were implemented and monitored. At many schools, there was scope to enhance physical eating environments (n 12, 67 %) and food presentation (n 15, 83 %); emphasise healthy eating through food activities (n 7, 78 %) and increase parental engagement in school food (n 9, 56 %). CONCLUSIONS: The developed instrument can measure whole-SFE in primary schools and also enabled identification of recommendations to enhance SFE. Further assessment and adaptation of the instrument are required to enable future use as a research tool or for self-assessment use by schools.

Fun with food - A parent-child community cooking intervention reduces parental fear and increases children's perceived competence.

Cooking is being promoted as a preventative strategy for numerous health outcomes. However, there has been a reported decline in opportunities for children to learn in the home environment due to parental barriers such as time and concerns around children conducting certain skills. Therefore, this study aimed to understand the impact of a parent-child community cooking intervention on children's perceived cooking competence and interest in cooking and parental perceptions around including children in cooking. 'Fun with Food' was a four-week parent-child cooking intervention based on Experiential Learning Theory and designed by Home Economists. A mixed-method approach was undertaken to understand the effectiveness of the community-based intervention. Parents completed pre and post focus group discussions that were analyzed using Thematic Analysis. Pre and post surveys were used to investigate children's perceived cooking competence and analyzed with paired-samples t-tests and Cohen's d. Children's perceived cooking competence significantly increased after the intervention (P < 0.001, effect size -0.92). Parental fears around children performing certain skills, such as chopping and cutting, were reduced. Additionally, both children and parents found it an enjoyable experience, and appreciated the time spent together, which may be an indicator for positive wellbeing. Parents reported that children have been more actively involved in cooking since the intervention. Further, parents felt strongly that children should be cooking from as young as possible and that Home Economics should be introduced in primary school and made compulsory for older students in secondary school. The parent-child format for cooking has shown to be effective for increasing children's perceived cooking competence and reducing parental fears, highlighting it as a promising method for future interventions.

Factors influencing dairy farmers' antibiotic use: An application of the COM-B model.

In dairy farming, mastitis treatment is the most common reason for antimicrobial use. The overuse or misuse of antibiotics in agriculture has been associated with the development and spread of antimicrobial resistance (AMR). Traditionally, blanket dry cow therapy (BDCT), in which all cows receive antibiotic treatment, was used prophylactically to prevent and manage disease spread. In recent years, there has been a move toward selective dry cow therapy (SDCT), in which only clinically infected cows are treated with antibiotics. This study aimed to explore farmer attitudes toward antibiotic use (ABU), using the COM-B (Capability-Opportunity-Motivation-Behavior) model as a framework, to identify predictors of changing behavior toward SDCT and suggest interventions to encourage its uptake. Participant farmers (n = 240) were surveyed online between March and July 2021. Five items were found to be significant predictors of farmers having stopped BDCT: (1) having lower knowledge of AMR, (2) greater awareness of AMR and ABU (Capability), (3) feeling social pressure to reduce ABU (Opportunity), and (4) having greater professional identity, and (5) having positive emotions associated with stopping BDCT (Motivation). Direct logistic regression found that these 5 factors explained between 22 and 34.1% of the variance in making changes to BDCT practices. Additionally, objective knowledge was not correlated with current positive antibiotic practices, and farmers often perceived their antibiotic practices as more responsible than they actually were. A multifaceted approach, encompassing each of the predictors highlighted, should be taken to encourage farmer behavior change in relation to stopping BDCT. Additionally, as farmers' perceptions of their own behaviors may not align with their actual practices, awareness raising of what constitutes "responsible" behavior should be targeted at dairy farmers to motivate them to take action and adopt more responsible antibiotic practices.

From the pandemic to the pan: the impact of COVID-19 on parental inclusion of children in cooking activities: a cross-continental survey.

OBJECTIVE: This study aimed to investigate the impact of COVID-19 on time spent cooking and parental inclusion of children in cooking. The secondary aim was to investigate differences between those who frequently included their children in cooking activities during the COVID-19 pandemic and those who included their children less, on a number of factors such as working from home, parents' diet quality and cooking skills confidence. DESIGN: Cross-continental survey with Wilcoxon-signed ranks, Independent t tests, Mann-Whitney U, χ2 and a binomial logistic regression used for assessment. SETTING: Online. PARTICIPANTS: A convenience sample of parents over 18 years from the island of Ireland (n 180), Great Britain (n 312), the USA (n 120) and New Zealand (n 166). RESULTS: In three regions, parents' time spent cooking and inclusion of children in everyday cooking activities increased (P < 0·001). Country (OR = 3·6, 95 % CI 1·7, 7·6), education (OR = 1·6, 95 % CI 1·1, 2·4), cooking skills confidence (OR = 1·02, 95 % CI 1·009, 1·032) and a parental higher intake of vegetables (OR = 1·3, 95 % CI 1·1, 1·5) were significant predictors of a more frequent inclusion of children in cooking activities. CONCLUSIONS: While there a number of key benefits to including children in cooking for the children such as providing life skills and increases in diet quality, this study highlighted a higher intake of vegetables by parents who included children more frequently in cooking activities. With continued lockdowns due to COVID-19 and perhaps more flexibility in working from home in the future, including children in cooking activities should be a key public health message for both children and parents.

Consumers' perceptions and willingness to purchase pork labelled 'raised without antibiotics'.

As a recent addition to the UK market, it is unknown how 'raised without antibiotics' labelled products are perceived or how they influence consumer food choice. Understanding consumers' perceptions towards the 'raised without antibiotics' label can determine knowledge of the label and what drives them to purchase products raised without antibiotics. Subsequently, using an online questionnaire with 1000 participants aged 18-92 years old, this study explored UK consumers' perceptions and willingness to buy 'raised without antibiotics' labelled pork, and examined their knowledge of antimicrobial use and antimicrobial resistance (AMR1). Cross-sectional data were collected investigating consumer perceptions and willingness to purchase 'raised without antibiotics' labelled pork and hierarchical multiple regression analyses were conducted. Respondents had high levels of knowledge towards EU regulations however, their awareness of AMR was limited. Behavioural beliefs concerning animal welfare and product quality were the main predictors of consumers' willingness to buy 'raised without antibiotics' labelled pork, followed by pork purchasing habits based on animal welfare qualities. Additionally, consumers who were more concerned that AMR would personally affect them, as well as those who favoured antimicrobial use for the preservation of animal welfare were willing to buy this product. Perceptions towards animal antimicrobial use acceptance, beliefs that 'raised without antibiotics' labelled pork is expensive, and a lack of consideration for extrinsic qualities when purchasing pork i.e., appearance, had a negative influence on willingness to buy. Moderate perceptions towards 'raised without antibiotics' labelled pork, lack of knowledge of agricultural antimicrobial use, and the subsequent confusion surrounding this label suggests that it is necessary to explore other labelling options to provide consumers with the information they desire while also safeguarding animal welfare.

The effects of nutrition and health claims on the nutrient composition of single and subsequent meal servings.

Nutrition and health claims (NHCs) can help individuals make better food choices. While NHCs have been found to influence consumer perceptions and consumption, there has been less focus on how claims influence the nutritional composition of servings. There has also been little attention paid to longer term or compensatory effects of claims on subsequent food selection. This manuscript details two studies considering these matters. Study 1 (n = 60) was a within-subjects experiment to measure the impact of NHCs on food selection and nutritional composition at single meal servings. Participants served from three fake food buffet meal stations (breakfast, hot meal, snacks) with NHCs present or absent. Study 2 (n = 55) was a within-subjects experiment to examine the impact of NHCs on food selection and nutritional composition at a subsequent meal. Participants served from a fake food buffet breakfast with or without NHCs followed by a lunch without NHCs. In study 1, while results varied for different meals, the presence of claims was found to significantly reduce the amount of energy, fat, saturated fat, sugar, carbohydrates, and sodium, and increase the amount of protein in meals that were served. Results for fibre were mixed. In addition, NHCs increased the quantity of food served in the snacks condition. There was no evidence of claims at breakfast impacting the nutritional composition of subsequent lunch servings in study 2. Despite claims potentially increasing serving quantities, the nutritional composition of chosen servings was more encouraging and claims may help individuals to meet recommended nutritional daily guidelines. These findings have wider implications in terms of government policy, food reformulation, and the continuing debate around the use of nutrient profiling regulations for products carrying claims.

Cook Like A Boss: An effective co-created multidisciplinary approach to improving children's cooking competence.

Cooking interventions are emphasised as promising methods for changing children's food-related preferences, attitudes and behaviours. However, criticisms remain, including relatively weak intervention designs; lack of validated tools, and limited underpinning theory. Therefore, this research aimed to assess the effectiveness of a theory-driven co-created children's cooking intervention with underpinning rationale for the content, using a validated measure. 'Cook Like A Boss' was a one week, controlled cooking camp style intervention. Thirty two children aged 10-12 years participated. The intervention was developed using the Cook-Ed model for planning, implementing and evaluating cooking programs and was underpinned by Social Learning theory and Experiential Learning theory. The intervention content was developed in a co-creation process with the research team, a chef and the children. The underlying developmental skills required for the recipes were assessed to ensure they were age-appropriate. Children completed pre and post measurements including perceived cooking competence. Process evaluations were also gathered. There was a significant increase in perceived cooking competence after the intervention (P < 0.05) and a significant difference between the intervention and control group (P < 0.001). Additionally, process evaluations found the intervention to have high fidelity and dose received and that it was received extremely positively. The 'Cook Like A Boss' children's cooking camp was an effective multidisciplinary co-created intervention with a vulnerable group, e.g. children, guided by a model and underpinned by theory. The content was developed to ensure it was age-appropriate and achievable for the children. This approach could act as a template for future children's cooking interventions.

The 11 sins of seafood: Assessing a decade of food fraud reports in the global supply chain.

Due to complex, valuable, and often extremely opaque supply chains, seafood is a commodity that has experienced a high prevalence of food fraud throughout the entirety of its logistics network. Fraud detection and prevention require an in-depth understanding of food supply chains and their vulnerabilities and risks so that food business operators, regulators, and other stakeholders can implement practical countermeasures. An analysis of historical criminality within a sector, product, or country is an important component and has not yet been conducted for the seafood sector. This study examines reported seafood fraud incidents from the European Union's Rapid Alert System for Food and Feed, Decernis's Food Fraud Database, HorizonScan, and LexisNexis databases between January 01, 2010 and December 31, 2020. Illegal or unauthorized veterinary residues were found to be the most significant issue of concern, with most reports originating from farmed seafood in Vietnam, China, and India. For internationally traded goods, border inspections revealed a significant frequency of reports with fraudulent or insufficient documentation, indicating that deceptive practices are picked up at import or export but are occurring further down the supply chain. Practices such as species adulteration (excluding veterinary residues), species substitution, fishery substitution, catch method fraud, and illegal, unreported, and unregulated fishing were less prevalent in the databases than evidenced in the scientific literature. The analysis demonstrates significant differences in outcomes depending on source and underlines a requirement for a standardized and rigorous dataset through which food fraud can be scrutinized to ensure enforcement, as well as industry and research resources are directed accurately. Practical Application: Levels of historic food fraud in a product, sector, supply chain node or geographic location provide an indication of historic criminality, the methods used and the location of reported frauds. This study provides an overview of historic levels of seafood fraud that can be used to inform seafood fraud prevention and mitigation activities by the food industry, regulators and other stakeholders.

Effective approaches for early identification and proactive mitigation of aflatoxins in peanuts: An EU-China perspective.

Nearly 700,000 tonnes of peanuts are consumed annually in Europe. In the last 5 years, peanuts imported from China exceeded legal European Union (EU) aflatoxin limits more than 180 times. To prevent and mitigate aflatoxin contamination, the stages of the peanut chain most vulnerable to contamination must be assessed to determine how to interrupt the movement of contaminated produce. This paper discusses effective approaches for early identification and proactive mitigation of aflatoxins in peanuts to reduce a contaminant that is an impediment to trade. We consider (i) the results of the EU Commission's Directorate-General (DG) for Health and Food Safety review, (ii) the Code of Practice for the prevention and reduction of aflatoxins in peanuts issued by Food and Agriculture Organization/World Health Organization, (iii) the results from previous EU-China efforts, and (iv) the latest state-of-the-art technology in pre- and postharvest methods as essential elements of a sustainable program for integrated disease and aflatoxin management. These include preharvest use of biocontrol, biofertilizers, improved tillage, forecasting, and risk monitoring based on analysis of big data obtained by remote sensing. At the postharvest level, we consider rapid testing methods along the supply chain, Decision Support Systems for effective silo management, and effective risk monitoring during drying, storage, and transport. Available guidance and current recommendations are provided for successful practical implementation. Food safety standards also influence stakeholder and consumer trust and confidence, so we also consider the results of multiactor stakeholder group discussions.

CooC11 and CooC7: the development and validation of age appropriate children's perceived cooking competence measures.

BACKGROUND: Learning cooking skills during childhood and adolescence is associated with positive dietary outcomes in adulthood as well as being tracked from adolescence to adulthood. In addition studies have found that perceived competence to be a greater motivator to perform a behaviour than actual competence. However, a lack of validated tools that effectively measure behavioural and dietary changes including cooking confidence in children is a limitation. Therefore, this research aimed to develop and validate age-appropriate perceived cooking competence measures for younger and older primary school aged children. METHODS: Two measures of perceived Cooking Competence (CooC11 and CooC7) for older (8-12 years) and younger (6-7 years) children were developed from a critical evaluation of publically available recommendations and expert consultation. The cooking skills within the measures were illustrated by a graphic designer in consultation with a chef and reviewed in an iterative manner by the research team. The measures were piloted for clarity, ease of use and initial face validity. Multiple studies were used for both CooC11 and CooC7 to establish psychometric properties of the measures, temporal stability, internal consistency reliability, construct validity, as well as responsiveness to change for CooC11. Analysis included Exploratory Factor Analysis, Confirmatory Factor Analysis, Intraclass Correlation Coefficients, Pearson's Correlations, ANOVAs and Cronbach's Alphas. RESULTS: Both measures had high levels of face validity and received positive user feedback. Two factors were shown in both measures with the measures showing excellent temporal stability (ICC > 0.9) and good internal consistency (Cronbach's Alphas > 0.7). Both measures showed initial discriminant validity, with significant differences (P< 0.001) between those who reported assisting their parents with dinner preparation and those who did not. Additionally, CooC11 was significantly correlated with an adult cooking measure and had a significant responsiveness to change (P< 0.01). CONCLUSIONS: The CooC11 and CooC7 are the first validated age-appropriate measures for assessing children's perceived Cooking Competence for ages 8-12 and 6-7 years respectively. They can be used to evaluate the efficacy of children's cooking intervention studies or school nutrition education programmes.

Food environment intervention improves food knowledge, wellbeing and dietary habits in primary school children: Project Daire, a randomised-controlled, factorial design cluster trial.

BACKGROUND: Evidence suggests that dietary intake of UK children is suboptimal. As schools provide an ideal natural environment for public health interventions, effective and sustainable methods of improving food knowledge and dietary habits in this population must be identified. Project Daire aimed to improve children's health-related quality of life, wellbeing, food knowledge and dietary habits via two multi-component interventions. METHODS: Daire was a randomised-controlled, factorial design trial evaluating two interventions across four arms. Primary schools in Northern Ireland were randomised to one of four 6-month intervention arms: i) 'Nourish', ii) 'Engage', iii) 'Nourish' and 'Engage' and iv) Control (Delayed). 'Nourish' was an intervention aiming to alter the whole-school food environment, provide food-related experiences and exposure to locally produced foods. 'Engage' was an age-appropriate, cross-curricular educational intervention on food, agriculture, nutrition science and related careers. Primary outcomes were emotional and behavioural wellbeing and health-related quality of life. A number of secondary outcomes, including dietary intake, cooking competence and food-related knowledge, were also measured. RESULTS: Fifteen schools from areas of varying socio-economic status participated in the randomised trial. A total of 903 (n = 445 aged 6-7 years and n = 458 aged 10-11 years) primary school pupils took part. Total Difficulties Score improved in all pupils (6-7 and 10-11 year old pupils) who received the 'Nourish' intervention compared with those that did not (adjusted difference in mean = - 0.82; 95% CI -1.46, - 0.17; P < 0.02). No statistically significant difference in Health-Related Quality of Life was observed. The 'Nourish' intervention also produced some changes in school-based dietary behaviour, which were most apparent in the 10-11 year old pupils. The 'Nourish' intervention also produced improvements in understanding of food labels (adjusted difference in mean = 0.15; 95% CI 0.05, 0.25; P < 0.01) and knowledge of vegetables in season (adjusted difference in mean = 0.29; 95% CI 0.01,0.56; P = 0.04) whilst an increased willingness to try new foods and improved perceived cooking competence was also observed. CONCLUSIONS: Improvements in childhood emotional and behavioural wellbeing, dietary intake, knowledge about food, cooking skills and willingness to try new foods were associated with the 'Nourish' whole-school food environment intervention. Exploration of the sustainability and long-term effectiveness of such whole-school food interventions should be conducted. TRIAL REGISTRATION: National Institute of Health (NIH) U.S. National Library of Medicine Clinical Trials.gov (ID: NCT04277312 ).

Parental considerations during complementary feeding in higher income countries: a systematic review of qualitative evidence.

OBJECTIVE: Worldwide data suggest a clash between parental complementary feeding practices and recommendations. Understanding the circumstances under which parents form their feeding practices is a crucial step to improve such practices. This paper aimed to systematically review the existing qualitative literature and synthesise the factors that parents take into consideration in relation to complementary feeding. DESIGN: A systematic review was undertaken. Four electronic databases were searched for qualitative studies published after 2001 exploring parental experiences during complementary feeding. A framework that included authors' outcomes of interest was used to extract and synthesise study findings. The Standards for Reporting Qualitative Research were used to critically assess the included studies. SETTING: Upper-middle- and high-income countries. PARTICIPANTS: Parents with a child below the age of 3 years. RESULTS: A total of forty-seven studies met the eligibility criteria and were included in this systematic review. The themes were organised into three main categories: (1) factors related to introduction of complementary foods; (2) factors related to the type of complementary foods and (3) factors related to both timing and type. The selected literature highlights: prevalent baby cues that prompt parents to introduce solid foods; parents' views on the recommended timing of complementary feeding; factors that drive the choice of complementary foods and perceived value in advice received from health professionals and grandmothers. CONCLUSIONS: This systematic review indicates factors that can be barriers to complying with the complementary feeding guidelines, and therefore, its findings are pertinent to improving parental feeding practices through intervention studies and through infant feeding education in a primary care setting.

Guidelines for designing age-appropriate cooking interventions for children: The development of evidence-based cooking skill recommendations for children, using a multidisciplinary approach.

Cooking interventions have been criticised for their weak designs and 'kitchen sink' approach to content development. Currently, there is no scientific guidance for the inclusion of specific skills in children's cooking interventions. Therefore, a four step method was used to develop age-appropriate cooking skill recommendations based on relevant developmental motor skills. The steps include: 1) a critical review of academic and publicly available sources of children's cooking skills recommendations; 2) cooking skill selection, deconstruction and mapping to relevant motor skills; 3) grouping the cooking skills by underlying motor skills for age appropriateness to generate evidence based recommendations; 4) establish face validity using a two-stage expert review, critique and refinement with a multidisciplinary international team. Seventeen available sources of cooking skills recommendations were identified, critiqued and deconstructed and cooking skills mapped to developmental motor skills. These new recommendations consist of 32 skills, across five age categories: 2-3 years, 3-5 years, 5-7 years, 7-9 years, and 9+ years. The proposed recommendations will strengthen programme design by providing guidance for content development targeted at the correct age groups and can act as a guide to parents when including their children in cooking activities at home.

Meal planning by high and low health conscious individuals during a simulated shop in the supermarket: A mixed methods study.

Planning is an essential component of home meal preparation. While level of health consciousness permeates both activities, this relationship is underexplored in the scientific literature. Using a mixed-methods convergent parallel design this study identified the reasoning behind meal planning and compared the characteristics of meals planned by high and low health-conscious adults during a simulated shopping task in a supermarket store. Participants were assigned a task where they were asked to choose ingredients to prepare a hot evening meal for a last-minute guest. High Health Conscious (HHC) participants planned healthier meals with more whole grains/breads/pasta, fruits, and vegetables than Low Health Conscious (LHC) participants. HHC participants mentioned not only health-related motives, but also ingredients' characteristics and cooking habits as influencers of their choices. LHC individuals focused on their own preferences, acknowledged that they struggled with the skills needed to prepare a meal and considered the presence of a guest as the only reason why they would prepare a meal. The mixed methods approach enabled us to link the participants' reasoning with the quantitative differences between meals planned by them - HHC individuals planned healthier meals and manifested closeness to the act of cooking. This suggests that the link between health interest and learning how to cook deserves to be further explored.

Finding my own way in the kitchen from maternal influence and beyond - A grounded theory study based on Brazilian women's life stories.

Mothers are frequently seen as the gatekeepers of the transmission of food-related meanings and practices to their children, but little is known about how they transmit cooking-related aspects. This study aimed to understand the intergenerational transmission of cooking-related meanings and practices using a life course perspective and a constructivist grounded theory approach to present a substantive theory. The study was carried out in southern Brazil with 27 women. The core category Finding my own way in the kitchen from maternal influence and beyond is explained by four other categories. The first three show (1) that daughters implicitly and explicitly learn the idea of cooking responsibility from their mothers; (2) that mothers influence daughters by the way they involve children in the kitchen and by the feelings they express regarding cooking and (3) that daughters learn cooking practices observing their mother's cooking, cooking together, receiving instructions and eating their mother's food. The fourth category shows that daughters recreate what they learned from the mother according to their own life trajectories, social and historical context, and the people they interact with. Some of what they recreate is now part of their mothers' lives, resulting in a bidirectional influence. Strategies designed to encourage cooking need to challenge the view that the activity is solely a woman's responsibility, as well as communicate to the parents that their influence goes beyond transmitting cooking practices, as the attitudes and feelings they express towards cooking are also transferred.

Content of Brazilian supermarket circulars do not reflect national dietary guidelines.

Previous research on foods advertised in supermarket circulars revealed that advertisement for foods at promotional prices influence food choices and shopping behaviour, but no paper reporting the Latin American context was identified. Furthermore, most studies only assessed the products advertised on the front pages and not in the entire circulars. This paper quantifies and categorizes, according to level of processing, the foods advertised in circulars from four Brazilian supermarket chains in order to assess their compatibility with the national dietary guidelines issued by the Ministry of Health. Printed and online circulars were collected between June and July 2016. Foods items advertised were identified and classified into one of four categories using the NOVA classification as unprocessed or minimally processed, processed culinary ingredient, processed or ultra-processed. Sixteen documents were analysed, and 1786 food items identified, where 23% were categorized as unprocessed or minimally processed, and 63% as ultra-processed foods. While the mean proportion of ultra-processed and unprocessed or minimally processed foods advertised on circular covers was similar (p = 0.49), the mean proportion of ultra-processed foods advertised in the entire circular was significantly higher than unprocessed or minimally processed foods (p < 0.001). Brazilian supermarket circulars are stimulating the acquisition of ultra-processed foods, which does not encourage food choices to be in line with what is recommended by the Dietary Guidelines for the Brazilian Population.

Solid advice: Complementary feeding experiences among disadvantaged parents in two countries.

The initiation of complementary feeding (CF; introducing infants to food/drink other than milk) is recommended close to 6 months and not before 4 months of age. Low socio-economic status (SES) is a determinant of nonadherence to CF recommendations, but there is an evidence gap around reasons for nonadherence among these parents. This study investigated knowledge, attitudes, and practices of disadvantaged families (in terms of SES and social support) and use of guidance for CF, in the Republic of Ireland and Northern Ireland. Parents of infants aged 3-14 months were recruited via community groups. Semistructured focus groups aided by vignettes were used. Data were analysed using an inductive thematic approach. Nineteen focus groups took place with parents (n = 83). A range of factors influence parents when introducing solids. Sources of guidance extend to family, friends, the internet, and commercial resources. Parents experience uncertainty and anxiety during this time, driven by lack of knowledge and conflicting advice. Five major themes were identified: (a) more guidance that is accessible, timely, and respectfully needed; (b) the challenge of choosing safe, nutritious food; (c) "everybody has an opinion"; (d) feelings of inadequacy, embarrassment, and guilt; and (e) decisions are ultimately based on individual circumstances. CF advice should be culturally appropriate, practical, and empowering, emphasising the rationale behind updates to recommendations and consequences of nonadherence. Future training of health professionals for delivery of CF advice and guidance should consider these findings. Compliance with CF recommendations is influenced by health professionals, the wider family, and the commercial baby-food sector.

Critical review of behaviour change techniques applied in intervention studies to improve cooking skills and food skills among adults.

BACKGROUND: Cooking and food skills interventions have grown in popularity; however, there is a lack of transparency as to how these interventions were designed, highlighting a need to identify and understand the mechanisms of behavior change so that effective components may be introduced in future work. This study critiques cooking and food skills interventions in relation to their design, behavior change techniques (BCTs), theoretical underpinnings, and outcomes. METHODS: A 40-item CALO-RE taxonomy was used to examine the components of 59 cooking and food skills interventions identified by two systematic reviews. Studies were coded by three independent coders. RESULTS: The three most frequently occurring BCTs identified were #1 Provide information on consequences of behavior in general; #21 Provide instruction on how to perform the behavior; and #26 Prompt Practice. Fifty-six interventions reported positive short-term outcomes. Only 14 interventions reported long-term outcomes containing BCTs relating to information provision. CONCLUSION: This study reviewed cooking and food skills interventions highlighting the most commonly used BCTs, and those associated with long-term positive outcomes for cooking skills and diet. This study indicates the potential for using the BCT CALO-RE taxonomy to inform the design, planning, delivery and evaluation of future interventions.

Domestic cooking and food skills: A review.

Domestic cooking skills (CS) and food skills (FS) encompass multiple components, yet there is a lack of consensus on their constituent parts, inter-relatedness, or measurement, leading to limited empirical support for their role in influencing dietary quality. This review assessed the measurement of CS and FS in adults (>16 years); critically examining study designs, psychometric properties of measures, theoretical basis, and associations of CS/FS with diet. Electronic databases (PsychInfo), published reports, and systematic reviews on cooking and home food preparation interventions provided 834 articles of which 26 met the inclusion criteria. Multiple CS/FS measures were identified across three study designs-qualitative, cross-sectional, and dietary interventions-conducted from 1998 to 2013. Most measures were not theory-based, limited psychometric data were available, with little consistency of items or scales used for CS/FS measurements. Some positive associations between CS/FS and fruit and vegetables intake were reported, though lasting dietary changes were uncommon. The role of psycho-social (e.g., gender, attitudes) and external factors (e.g., food availability) on CS/FS is discussed. A conceptual framework of CS/FS components is presented for future measurement facilitation, which highlights the role for CS/FS on food-related behavior and dietary quality. This will aid future dietary intervention design.

The development and validation of measures to assess cooking skills and food skills.

BACKGROUND: With the increase use of convenience food and eating outside the home environment being linked to the obesity epidemic, the need to assess and monitor individuals cooking and food skills is key to help intervene where necessary to promote the usage of these skills. Therefore, this research aimed to develop and validate a measure for cooking skills and one for food skills, that are clearly described, relatable, user-friendly, suitable for different types of studies, and applicable across all sociodemographic levels. METHODS: Two measures were developed in light of the literature and expert opinion and piloted for clarity and ease of use. Following this, four studies were undertaken across different cohorts (including a sample of students, both 'Food preparation novices' and 'Experienced food preparers', and a nationally representative sample) to assess temporal stability, psychometrics, internal consistency reliability and construct validity of both measures. Analysis included T-tests, Pearson's correlations, factor analysis, and Cronbach's alphas, with a significance level of 0.05. RESULTS: Both measures were found to have a significant level of temporal stability (P < 0.001). Factor analysis revealed three factors with eigenvalues over 1, with two items in a third factor outside the two suggested measures. The internal consistency reliability for the cooking skills confidence measure ranged from 0.78 to 0.93 across all cohorts. The food skills confidence measure's Cronbach's alpha's ranged from 0.85 to 0.94. The two measures also showed a high discriminate validity as there were significant differences (P < 0.05 for cooking skills confidence and P < 0.01 for food skills confidence) between Food preparation novices' and 'Experienced food preparers.' CONCLUSIONS: The cooking skills confidence measure and the food skills confidence measure have been shown to have a very satisfactory reliability, validity and are consistent over time. Their user-friendly applicability make both measures highly suitable for large scale cross-sectional, longitudinal and intervention studies to assess or monitor cooking and food skills levels and confidence.