The Healthy Cooking Index: Nutrition optimizing home food preparation practices across multiple data collection methods

Authors: RABER, MARGARET - Md Anderson Cancer Center; BARANOWSKI, TOM - Children'S Nutrition Research Center (CNRC); CRAWFORD, KARLA - Md Anderson Cancer Center; SHARMA, SHREELA - University Of Texas Health Science Center; SCHICK, VANESSA - University Of Texas Health Science Center; MARKHAM, CHRISTINE - University Of Texas Health Science Center; JIA, WENYAN - University Of Pittsburgh; SUN, MINGUI - University Of Pittsburgh; STEINMAN, EMILY - Md Anderson Cancer Center; CHANDRA, JOYA - Md Anderson Cancer Center

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/14/2020
Publication Date: 4/9/2020
Citation: Raber, M., Baranowski, T., Crawford, K., Sharma, S.V., Schick, V., Markham, C., Jia, W., Sun, M., Steinman, E., Chandra, J. 2020. The Healthy Cooking Index: Nutrition optimizing home food preparation practices across multiple data collection methods. Journal of the Academy of Nutrition and Dietetics. https://doi.org/10.1016/j.jand.2020.01.008.
DOI: https://doi.org/10.1016/j.jand.2020.01.008

Interpretive Summary: Cooking education has become both an important single activity and a component of nutrition education programs. A problem in the evaluation of cooking alone or cooking as part of nutrition education is that no measure exists to assess the impact of the education program on healthy home cooking practices. This study assessed the accuracy of a measure of home cooking practices called the Healthy Cooking Index, as assessed by self report of parents, in home observation combined with video recording of meal preparation, and a wearable camera, called the eButton. Data were collected among a sample of parent-child dyads wherein the child was a pediatric cancer survivor. The eButton and in home observations had highly comparable outcomes, while the self report measure correlated at a lower level with both video procedures. An analysis of the observed recordings to identify how these healthy cooking practices might group together revealed two groups: 1) meat products and 2) health and taste enhancing practices. This indicates that people who attend to meat in the diet tend to adhere to multiple mean practices, while those who do health and taste enhancing practices, are likely to do other practices within this group. This information should help design and evaluate cooking skills education programs.

Technical Abstract: Food preparation interventions are an increasingly popular target for hands-on nutrition education for adults, children, and families, but assessment tools are lacking. Objective data on home cooking practices, and how they are interpreted through different data collection methods, are needed. The goal of this study was to explore the utility of the Healthy Cooking Index in coding multiple types of home food preparation data and elucidating healthy cooking behavior patterns. Parent-child dyads were recruited between October 2017 and June 2018 in Houston and Austin, Texas for this observational study. Food preparation events were observed and video recorded. Participants also wore a body camera (eButton) and completed a questionnaire during the same event. Parents with a school-aged child were recruited as dyads (n=40). Data collection procedures took place in participant homes during evening meal preparation events. Food preparation data were collected from parents through direct observation during preparation as well as eButton and paper questionnaires completed immediately after the event. All data sets were analyzed using the Healthy Cooking Index coding system and compared for concordance. A paired sample t test was used to examine significant differences between the scores. Cronbach's alpha and principal components analysis were conducted on the observed Healthy Cooking Index items to examine patterns of cooking practices. Two main components of cooking practices emerged from the principal components analysis: one focused on meat products and another on health and taste enhancing practices. The eButton was more accurate in collecting Healthy Cooking Index practices than the self-report questionnaire. Significant differences were found between participant reported and observed summative Healthy Cooking Index scores (P<0.001), with no significant differences between scores computed from eButton images and observations (P=0.187). This is the first study to examine nutrition optimizing home cooking practices by observational, wearable camera and self-report data collection methods. By strengthening cooking behavior assessment tools, future research will be able to elucidate the transmission of cooking education through interventions and the relationships between cooking practices, disease prevention, and health.