Designing the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild-to-moderate intellectual disability.

BACKGROUND: People with intellectual disability have diverse needs and experience higher rates of diet-related chronic disease such as type 2 diabetes compared to people without disability. However, they are infrequently included in development and implementation of interventions to address diet-related chronic disease. The present study describes the process to plan, develop and refine the Food and Lifestyle Information Program (FLIP) culinary nutrition intervention for adults with mild-to-moderate intellectual disability. METHODS: The project was initiated by a disability service provider and was guided by the Cook-Ed™ model and inclusive research principles. Initially the disability service provider and academic research team members co-designed pre-program consultation and pilot studies, and draft program resources. Pre-program consultation explored paid disability support worker (n = 10) perceptions of cooking and food skills, nutrition priorities and optimal program format, which guided further program drafting. Program resources and pilot study design were further developed and refined with co-researchers with lived experience of intellectual disability who attended a pre-pilot and then pilot study sessions as remunerated co-facilitators. RESULTS: Key characteristics of the FLIP intervention arising from pre-program consultation included providing cooking task instruction in small steps, enabling participant choice in program activities, promoting an inclusive and social atmosphere, and providing paper-based resources. CONCLUSIONS: FLIP intervention co-design was enabled through ongoing input from the disability service provider and people with lived experience of intellectual disability. Evaluation of FLIP feasibility, acceptability and preliminary effectiveness to improve diet-related health is underway.

Facilitators and barriers to providing culinary nutrition, culinary medicine and behaviour change support: An online cross-sectional survey of Australian health and education professionals.

BACKGROUND: An Australia wide cross-sectional online survey examined facilitators and barriers of health and education professionals to providing culinary nutrition (CN) and culinary medicine (CM) education and behaviour change support in usual practice, in addition to identifying continuing professional development (CPD) needs in this domain. METHODS: Survey items included socio-demographic characteristics, cooking and food skills confidence, nutrition knowledge (PKB-7), fruit and vegetable intake (FAVVA) and CPD needs. Data were summarised descriptively. RESULTS: Of 277 participants, 65% were likely/somewhat likely to participate in CN CPD. Mean (SD) cooking and food skill confidence scores were 73 (17.5) and 107.2 (24), out of 98 and 147, respectively. Mean PKB-7 score was 3.7 (1.4), out of 7. Mean FAVVA score was 98 (29), out of 190. CONCLUSIONS: Gaps in knowledge and limited time were the greatest modifiable barriers to providing CM/CN education and behaviour change support in practice. Health and education professionals are interested in CPD conducted by dietitians and culinary professionals to enhance their knowledge of CM/CN and behaviour change support.

Impact and evaluation of an online culinary nutrition course for health, education and industry professionals to promote vegetable knowledge and consumption.

BACKGROUND: Poor diet, including inadequate vegetable intake, is a leading risk factor for noncommunicable disease. Culinary and nutrition education provided to trainee and practising health and education professionals is an emerging strategy to promote improved dietary intake, including vegetable consumption. We evaluated the impact and feasibility of an online culinary medicine and nutrition (CM/CN) short course for health, education and vegetable industry professionals. The course aimed to improve participants' skills and confidence to prepare vegetables, knowledge of evidence-based nutrition information and recommendations for improving vegetable consumption and diet quality. METHODS: A pre-post study consisting of two separate groups participating in two course rounds recruited practising professionals (n = 30) working in health; community, adult and/or culinary education; and the vegetable industry. Evaluation assessed diet quality, vegetable consumption barriers, cooking and food skill confidence, nutrition knowledge and process measures. RESULTS: Seventeen participants (68%) completed the programme. Pre- to postintervention statistically significant increases in vegetables (M 1.3, SD 2.2), fruit (M 1.6, SD 3.1), and breads and cereal (M 1.1, SD 1.7) intakes were observed. Statistically significant increases and large effect sizes for mean food skill confidence scores (M 8.9, SD 15.4, Cohen's d 0.56) and nutrition knowledge scores (M 6.2, SD 15.4, Cohen's d 0.83) were also observed pre- to postintervention. CONCLUSIONS: The short online course was feasible and improved diet quality, food skill confidence and nutrition knowledge. Online CM/CN education for practising professionals represents a promising area of research. Future research involving a larger study sample and a more rigorous study design such as a randomised control trial is warranted.

Development of the Cook-EdTM Matrix to Guide Food and Cooking Skill Selection in Culinary Education Programs That Target Diet Quality and Health.

Culinary education programs are generally designed to improve participants' food and cooking skills, with or without consideration to influencing diet quality or health. No published methods exist to guide food and cooking skills' content priorities within culinary education programs that target improved diet quality and health. To address this gap, an international team of cooking and nutrition education experts developed the Cooking Education (Cook-EdTM) matrix. International food-based dietary guidelines were reviewed to determine common food groups. A six-section matrix was drafted including skill focus points for: (1) Kitchen safety, (2) Food safety, (3) General food skills, (4) Food group specific food skills, (5) General cooking skills, (6) Food group specific cooking skills. A modified e-Delphi method with three consultation rounds was used to reach consensus on the Cook-EdTM matrix structure, skill focus points included, and their order. The final Cook-EdTM matrix includes 117 skill focus points. The matrix guides program providers in selecting the most suitable skills to consider for their programs to improve dietary and health outcomes, while considering available resources, participant needs, and sustainable nutrition principles. Users can adapt the Cook-EdTM matrix to regional food-based dietary guidelines and food cultures.

Culinary medicine and culinary nutrition education for individuals with the capacity to influence health related behaviour change: A scoping review.

BACKGROUND: Culinary medicine (CM) or culinary nutrition (CN) education provided to professionals with the capacity to influence behaviour change is an emerging strategy to promote diet quality and reduce the burden of diet related chronic disease in adults. The purpose of this scoping review was to synthesise current research describing CM/CN education provided to or by health, education and culinary professionals, or students of these disciplines. METHODS: Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was used. Eleven electronic databases were searched in March 2019. Included studies were: (i) nutrition, health or lifestyle programs with a CM/CN component; (ii) study participants or programs facilitated by people working or training in health, community and/or adult education, or culinary roles where facilitator training was described; (iii) reported in the English language; and (iv) published from 2003. RESULTS: In total, 33 studies were included. Nineteen studies delivered programs to general population groups and were facilitated by health professionals and/or health university students. Fourteen studies delivered CM/CN training to health professionals or students. Studies reported changes in participants' culinary skill and nutrition knowledge (n = 18), changes in dietary intake (n = 13), attitudes and behaviour change in healthy eating and cooking (n = 4), and competency in nutrition counselling and knowledge (n = 7). CONCLUSIONS: Further research examining the effectiveness of CM/CN programs, and that describes optimal content, format and timing of the programs, is needed. Research evaluating the impact of training in CM/CN to education and culinary professionals on healthy cooking behaviours of their patients/clients is warranted.

Cook-EdTM: A Model for Planning, Implementing and Evaluating Cooking Programs to Improve Diet and Health.

Domestic cooking education programs are typically designed to improve an individual's food and cooking skills, although not necessarily diet quality. Currently, there are no comprehensive models to guide the planning, implementation and evaluation of domestic cooking education programs that focus on improving diet and health. Our aim was to address this through development of the Cooking Education ("Cook-EdTM") model, using the PRECEDE-PROCEED model as the underlying Cook-EdTM framework. A review of the food and cooking skills education literature informed the content of the Cook-EdTM model. Cook-EdTM was critiqued by experts in consumer behaviour, cooking and nutrition education research and education until consensus on model content and format was reached. Cook-EdTM leads cooking program developers through eight distinct stages, engaging key stakeholders in a co-design process from the outset to tailor programs to address the need of individuals and inform the development of program content, program delivery, and evaluation. A Cook-EdTM scenario applied in practice is described. The proposed Cook-EdTM model has potential to be adapted for use in domestic cooking education programs delivered in clinical, community, school or research settings. Further research will establish Cook-EdTM's utility in enhancing program development and in improving food and cooking skills, dietary patterns and health outcomes.