Dietary, Cooking, and Eating Pattern Outcomes from the Emory Healthy Kitchen Collaborative.

Context: Teaching kitchens are emerging innovative and engaging models for creating lifestyle behavior change. They are increasingly being utilized in workplace settings. Objective: The Emory Healthy Kitchen Collaborative (EHKC) year-long worksite wellness teaching kitchen program sought to improve self-reported health behaviors, including food choices, cooking skills, and mindful eating habits. Study Design and Analysis: This 12-month program included a 10-week didactic and experiential curriculum followed by continued support and access to health coaching. Participant t-tests were used to compare results at different time points. Setting: Emory worksite wellness program Population Studied: Forty benefits-eligible Emory employees aged 18-65, were recruited to participate in the EHKC. Preference was given to employees with elevated body mass index, co-morbid conditions, and high lifestyle change motivation levels. Intervention/Instrument and Outcome Measures: Self-assessment instruments were obtained at baseline, 3-months, 6-months and 12-months. This included the 8-item Starting the Conversation (STC) food frequency instrument, eight questions from a 17-item cooking frequency and confidence questionnaire, and a 28-item mindful eating questionnaire. Results: Between May 30 - June 30, 2019, 40 benefits-eligible Emory employees were enrolled in the EHKC. Dietary eating patterns improved significantly throughout the duration of the program year, as measured by the STC. The largest improvement in STC occurred from baseline to three months (mean: - 2.18, standard deviation: 2.35, p-value: p=0.002). Although cooking frequency and confidence trended towards improvement, there were no significant changes. The mindfulness eating questionnaire improved significantly at 3-months (0.27, 0.32, p<0.001), 6-months (0.23, 0.33, p<0.001), and 12 months (0.33, 0.28, p<0.001), as compared to baseline. Conclusion: The EHKC worksite wellness program provided valuable knowledge and insight into the use of a teaching kitchen as a unique health care delivery model. The program significantly improved participant dietary patterns and mindful eating habits; though did not significantly improve cooking confidence or frequency. Further research is needed to understand long term health consequences and disease risk reduction of the EHKC program.

An Abundance Mindset Approach to Support Nurse Well-Being: The Feasibility of Peer Support.

This article describes the process of building a system-wide, interprofessional peer support program at the onset of the COVID-19 pandemic. With limited resources, but with a dedicated team driven by the desire to provide psychological first aid, nurse leaders from a large academic medical center developed a peer support program, inclusive of 16 hours of peer supporter training and quarterly continuing education. To date, this program has 130 trained peer supporters who offer peer support, active listening, and close partnerships with the health care system and university employee assistance programs. This case study shares lessons learned and considerations on how leaders can initiate their own local peer support programs.

A Teaching Kitchen Program Improves Employee Micronutrient and Healthy Dietary Consumption.

Objective: To measure changes in micronutrient adequacy and diet quality in healthcare and university employees who underwent a 10-week teaching kitchen program. Methods: Thirty-eight healthcare and university employees participated in a 10-week teaching kitchen program. Twenty-seven completed self-administered, 24-hour dietary recalls to measure dietary intake at baseline and 3-months. Micronutrient adequacy and diet quality was assessed using Dietary Reference Intakes (DRIs) and the Healthy Eating Index (HEI). Results: Seventy percent of participants were classified as low or moderate micronutrient adequacy at baseline. The proportion of participants with high micronutrient adequacy increased from 30% to 48% at 3-month follow-up. Total HEI and most HEI components increased at follow-up; with a statistically significant increase in seafood/plant protein score (P = .007). Conclusions and Implications for Practice: Our results suggest an inadequacy in micronutrient intake in university and healthcare employees and that teaching kitchens may help improve micronutrient adequacy and diet quality.

Cost Analysis of Developing, Implementing, and Evaluating a Multi-Disciplinary Teaching Kitchen.

INTRODUCTION: Teaching kitchens have emerged as strategies to deliver lifestyle medicine principles and practices. However, a better understanding of their implementation, delivery cost, and potential benefits are needed. This article provides a comprehensive analysis of the costs associated with the development, deployment, and evaluation of the Emory Healthy Kitchen Collaborative (EHKC) teaching kitchen clinical trial. METHODS: The actual number of hours spent and costs incurred to develop and deploy the EHKC teaching kitchen were recorded and broadly categorized into 1 of 4 areas: program development, course delivery, research, and optional enhancements. Costs of each item were assigned as fixed or variable, enabling calculation of the marginal per participant program cost. RESULTS: Total costs were US$123,898, with 3/4 incurred for program development, research, and optional enhancements. Delivery of the course alone (not including program development costs, research, or any optional enhancements) cost US$30,194. The total cost per participant for the course was US$755, with a marginal participant cost of US$141. CONCLUSION: Teaching kitchens represent viable options to deliver lifestyle medicine interventions. However, more research and cost analyses are needed to better understand the value teaching kitchens provide to determine if they are an effective and economical way to deliver lifestyle medicine.

Development of Culinary and Self-Care Programs in Diverse Settings: Theoretical Considerations and Available Evidence.

Culinary-based self-care programs are innovative and increasingly utilized models for catalyzing behavior change and improving health and well-being. The content, duration, and delivery of existing programs vary considerably. Between January and August 2019, we developed a teaching kitchen and self-care curriculum, which was administered as part of a year-long worksite well-being program to employees at an academic healthcare system. The curriculum domains included culinary skills, nutrition, physical activity, yoga, stress management, mindful eating, and ethnobotany. An informal systematic literature search was performed to assemble and evaluate key principles and practices related to self-care domains, learning methodologies, and programmatic design considerations. Here, we provide a qualitative summary of the evidence-informed development of the curriculum intervention.

Leveraging Lifestyle Medicine Interest Groups Through the COVID-19 Pandemic.

Lifestyle medicine domains, despite accounting for more than 78% of chronic disease risk, are infrequently taught as a part of the medical curriculum. Aspects such as nutrition are taught in less than 25% of medical schools, a statistic that continues to decline, and less than 20% of practicing physicians were required to take even a single course in exercise counseling during their medical school training. To combat this lack of training, the American College of Lifestyle Medicine annually awards the Donald A. Pegg scholarship to fund the development of Lifestyle Medicine Interest Groups (LMIGs) across medical schools worldwide. This scholarship was initiated in 2016 and utilizes private funds to support the development and expansion of LMIGs with the aim of increasing awareness of lifestyle medicine among training practitioners. There are four award winners per year. To date there are sixteen Pegg Award winners. This article will showcase the four 2019-2020 Donald A. Pegg award recipients and their impact on the LMIGs at their institutions. Furthermore, it highlights the ingenuity and adaptation of these LMIGs during the COVID-19 pandemic.