Source: BAYLOR COLLEGE OF MEDICINE submitted to NRP
RE-ESTABLISHING INTER-GENERATIONAL COOKING EDUCATION AND IMPROVING DIET QUALITY THROUGH AN INTEGRATED PARENTING AND HEALTHY COOKING PROGRAM FOR LOW INCOME FAMILIES WITH YOUNG CHILDREN
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
ACTIVE
Funding Source
AFRI COMPETITIVE GRANT
Reporting Frequency
Annual
Accession No.
1031523
Grant No.
2023-68015-40967
Cumulative Award Amt.
$909,615.40
Proposal No.
2022-08673
Multistate No.
(N/A)
Project Start Date
Sep 1, 2023
Project End Date
Aug 31, 2027
Grant Year
2023
Program Code
[A1344]- Diet, Nutrition and the Prevention of Chronic Disease
Recipient Organization
BAYLOR COLLEGE OF MEDICINE
(N/A)
HOUSTON,TX 77030
Performing Department
Health Disparities Research
Non Technical Summary
Low-income children are at high risk of having obesity and poor diet quality, which can impact their long-term health. Eating habits are established in early childhood, and parents, as gatekeepers of the home food environment, are an important target for intervention. Home cooking has been linked to healthier eating, but rates of home cooking have been falling since the 1960s. Cooking education programs may help families comply with the Dietary Guidelines for Americans by encouraging more home cooking and teaching parents strategies to improve the nutritional content of foods they prepare.This project will develop and test a digital intervention focused on healthy cooking, parent feeding practices, and child involvement in home food preparation for families with low income.We will create a series of cooking videos and lessons to teach parents healthy cooking skills, as well as ways to effectively involve their young (age 4-5) children in home cooking. We will then conduct a three-arm randomized trial to test how well the intervention works. To do this, we will recruit three groups of participants from local Head Start programs. Participants will include children (aged 4-5) and caregivers from families that utilizes Head Start. The family participants will either be in a control group (that does not receive any intervention), a group that gets healthy food delivered during the study, or a group that receives both the food delivery and the digital cooking intervention. We will gather information from parents and children before and after participating in the study to examine differences between the groups. We believe that children and parents in the cooking intervention plus food delivery group will have healthier diets than those in the other groups after participating in the intervention. We will take what we learn from this study to implement digital cooking programs through our networks and national extension programs. The goal of the project is to increase healthy cooking behaviors, positive parent feeding practices, and child involvement in home cooking through scalable, digital education tools. These efforts will ultimately improve family diet quality, child cooking skills, and mitigating downstream disease and obesity risk.
Animal Health Component
70%
Research Effort Categories
Basic
0%
Applied
70%
Developmental
30%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
70360201010100%
Knowledge Area
703 - Nutrition Education and Behavior;

Subject Of Investigation
6020 - The family and its members;

Field Of Science
1010 - Nutrition and metabolism;
Goals / Objectives
The objectives of this project are to:Existing cooking education programs are primarily conducted in person and require substantial investment, and many communities lack the resources needed to develop both parent and child in-person cooking programs. We propose to develop a digital intervention focused on healthy cooking, parental feeding practices, and child involvement in home food preparation: CHEF-ED (Cooking HEalthy and Facilitating Early childhood Development). The goal of the CHEF-ED program is to increase home cooking quality, positive parental feeding practices, and child involvement in home cooking through digital education, thus improving family diet quality, child cooking skills, and mitigating downstream disease and obesity risk. The specific objectives are:1. Develop a digitalcooking intervention CHEF-ED), includingvideos and online lessons involving 4-5 year old children in healthy home food preparation and positive parental feeding practices.2: Test the efficacy of the CHEF-ED online program in promoting parent diet quality and positive food parenting practices, as well as child diet quality, and food/cooking skills by conducting a three-arm randomized controlled trial of the completed program in Houston, Texas.and3: Begin dissemination of the CHEF-ED materials through Extension and national organizations.
Project Methods
Efforts: Development of a digital intervention for low income families.In Year 1 of the project, an intervention design team will work to create footage and develop activities for use in the CHEF-ED + Food Delivery group. Investigators on the study design team include two developmental psychologists (Hughes and Power), a trained chef and behavioral scientist (Raber), and an extension faculty member with parent education experience (Kim). We will ensure relevance to the target community by engaging an advisory committee of key stakeholders, including leadership from the local Head Start organization (with whom Dr. Hughes has worked closely on past projects), class facilitators from the University of Nevada, Reno Extension LCLB parenting/cooking program (with whom Dr. Kim has worked closely on ongoing projects), as well as content experts and leadership from organizations that serve low income communities to offer feedback during the development process.Evaluation: Plan/Steps to evaluate the effectiveness of the intervention.In Years 2 and 3 of the project, a 3-arm cluster randomized controlled trial will test the efficacy of the program (Figure 4). We will compare three groups. The CHEF-ED + Food Delivery group will first receive a one-time home food delivery of healthy culinary ingredients shipped to their home from a local grocery distributor. Participants in the CHEF-ED + Food Delivery group will then receive a weekly intervention for 7 weeks including video, infographic, and activity content. The second group is the Food Delivery Only group. This group will receive the one-time home food delivery of healthy culinary ingredients, but no other intervention materials. The final group is a control group, which will receive no intervention or food delivery. The Food Delivery Only and control group will complete all assessments at post-intervention and 6-month follow up. After the 6-month follow up is complete, retained participants in both the Food Delivery Only and Control groups will receive additional materials. Specifically, the control participants will receive the healthy ingredient food delivery and access to the CHEF-ED intervention materials. The Food Delivery Only participants will receive the CHEF-ED intervention materials.Measures: Measures include assessment of parent and child diet, child eating behavior, food parenting practices, parent cooking practices, as well as demographics, acculturation and food insecurity. Follow up interviews will be conducted with intervention participants after completion of the program.Hypotheses, analysis and indicators of success:Hypothesis 1. Parents receiving the 7-week CHEF-ED + Food Delivery intervention will involve their children in planning and preparing foods more often and serve healthier foods at mealtimes compared to mothers in the Control group and Food Delivery Only group. Children of these parents will have higher diet quality. Group differences in each of our primary and secondary outcomes, immediately post intervention (T1), will be examined using separate two-level multi-level Analysis of Covariance (ANCOVA) models. Differences between each outcome of interest will be examined in separate ANCOVA models, with group assignment (Control, Food Delivery Only, and CHEF-ED + Food Delivery) as the statistical predictor, and controlling for baseline values in the outcome measure, child gender, household food security, and parental acculturation as fixed effects. Parameter estimates will be adjusted for the clustering of parents within Head Start Center via the inclusion of Center as a random effect with intercepts and slopes free to vary between centers.Hypothesis 2. Effects of the program will diminish slightly over time for parents receiving the CHEF-ED intervention. Effects, however, will be robust and long lasting, and will still be statistically significant at the 6-month follow-up. The diminishing of effects on the program on outcomes variables between post-intervention (T1) and follow-up (T2) will be examined using similar multi-level ANCOVA models as for hypothesis 1. However, outcomes measures at both the post-intervention (T1) and follow-up (T2) time points will be included, and time point (T1, T2) will be specified as a statistical predictor in addition to group assignment. The clustering of data will be accounted for with a three-level model, whereby the outcome measures (level 1) will be clustered within participant (parent, level 2), and participants will be clustered within Head Start Center (level 3).

Progress 09/01/23 to 08/31/24

Outputs
Target Audience:This first grant year was dedicated to formative work of a healthy eating intervention. This included bringing together community stakeholders in an advisory committee, including leadership from Head Start centers that support low-income families with young children enrolled in Head Start and staff from University of Nevada Extension that run a literacy and cooking program for young children. Other professionals targeted in year 1 to support intervention development include nutrition, child psychology, and behavioral science experts as well as website and video production/graphics professionals. Changes/Problems:The goal of our intervention is to teach low income families with young children healthy cooking skills, involving young children in food preparation, and positive food parenting practices. We orginally aimed to only recruit efficacy study participantsfrom Houston-area Head Start programs. We have decided to open recruitment to Houston families with young children that are eligible for Head Start, whether or not they are enrolled. This will allow us more avenues for recruitment in the region. This decision was made based on other studies happening in the area that are struggling to adequately recruit from Head Start alone and to relieve burden on Head Start administration. What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals?1. Develop a digitalcooking intervention CHEF-ED), includingvideos and online lessons involving 4-5 year old children in healthy home food preparation and positive parental feeding practices. - In the next reporting period, our program audio/video materials will be compeleted and the program uploaded to a digital platform for formal testing. 2: Test the efficacy of the CHEF-ED online program in promoting parent diet quality and positive food parenting practices, as well as child diet quality, and food/cooking skills by conducting a three-arm randomized controlled trial of the completed program in Houston, Texas. and - The efficacy study procedures will be finalized over the summer/ early fall. We aim to begin efficacy study recruitment in December 2024 / January 2025 and rolling recruitment will continue through Year 3 of the grant. 3: Begin dissemination of the CHEF-ED materials through Extension and national organizations. -UNR Extension staff will continue to participate in our advisory committee meetings and give continuous feedback to ensure integration into extension dissemination efforts related to nutrition and parenting for young children at UNR in Year 4.

Impacts
What was accomplished under these goals? 1. Develop a digitalcooking intervention CHEF-ED), includingvideos and online lessons involving 4-5 year old children in healthy home food preparation and positive parental feeding practices. - We completed a draft curricula, had the draft reviewed by the community advisory committee, adjusted the curriculum based on feedback, finalized curriuclum content and developed infographics and scripts for filming video content (to be completed in October 2024), met with several website and app specialists to determine the best method for uploading/storing and distributing content. 2: Test the efficacy of the CHEF-ED online program in promoting parent diet quality and positive food parenting practices, as well as child diet quality, and food/cooking skills by conducting a three-arm randomized controlled trial of the completed program in Houston, Texas. and - Preparations for the efficacy study are underway. An initial IRB application has been approved. We have hired a research coordinator to lead these efforts, created a RedCap database of all study measures, developed study recruitment materials, and set up accounts for proprietary dietary analysis systems (Nutriquest and DHQ3). We aim to begin efficacy study recruitment in December 2024 / January 2025. 3: Begin dissemination of the CHEF-ED materials through Extension and national organizations. -Dissemination has not begun, however UNR Extension staff participate in our advisory committee meetings and give continuous feedback to ensure integration into extension dissemination efforts related to nutrition and parenting for young children at UNR.

Publications