Bringing nutrition home: An exploration of home-based cooking kit interventions for children and families

Abstract

Adequate fruit and vegetable (FV) consumption is essential for chronic disease prevention, yet many U.S. children, particularly those residing in low-income and food-insecure households, fall short of recommended levels. This research explored the use of home-based cooking kits as an innovative strategy for improving FV intake. The dissertation comprises 3 manuscripts. Manuscript 1 is a scoping review of home-based cooking kit interventions for households with children. Of the 24 publications included, there was a wide range of study characteristics, participant characteristics, and outcomes. The review identified a need for more research on intervention development details, stakeholder perspectives, and long-term sustainability. A systematic review of the literature with broadened inclusion criteria is warranted. Manuscript 2 quantitatively evaluated the Food Activity Bag (FAB) intervention, a novel home-based cooking kit, integrated within a Produce Prescription program for pediatric patients (2 – 17 years old) at a Federally Qualified Health Center in Hawai’i. Pre- and post-intervention surveys with children showed no statistically significant changes between intervention and comparison groups. However, the intervention group exhibited near-significant improvements in food and nutrition knowledge (p=0.08), willingness to try vegetables (p=0.07), WTT FV targeted in the intervention (p=0.07), and WTT some of the targeted FV. The small sample size may have limited statistical power, necessitating larger-scale studies. Manuscript 3 qualitatively explored the FAB intervention through semi-structured interviews with intervention participants (parents and children), revealing 5 key themes on feasibility, acceptability, and preliminary impact of the FAB intervention. Overall, the FAB was well-accepted and demonstrates potential as an appropriate intervention for the predominantly Native Hawaiian and Pacific Islander population. The Coronavirus 2019 pandemic introduced considerable challenges throughout the research process. Future research conducted under more stable conditions may be able to obtain a larger sample size and more effectively evaluate the intervention’s impact. Collectively, this dissertation suggests home-based cooking interventions, such as the FAB, hold promise for improving FV intake, among other health outcomes. Future studies on cooking kits should report detailed development processes, explore broader stakeholder perspectives, and identify ways to support long-term sustainability.