What is the evidence of the effectiveness of skill and participation focused cooking programs for community-dwelling older adults?

Andrea Cherny, Belinda Fragale & Kathryn VisserMaster of occupational therapy students, Swinburne University of Technology

Overview• Introduction and relevance

• Occupational therapy, cooking programs & reablement

• Method

• Results

Psychosocial

Cooking skills

Food skills

Facilitator input

• Implications

Strengths, limitations & future research

• Recommendations

In 2017, over 1 in 7 Australians were aged 65 years and over (Australian institute of health and welfare (AIHW), 2018).

95% of those over 65 are living in their own households

(Australian institute of health and welfare (AIHW), 2017).

28% of population are 55 years and over

23,900 residents are at post-retirement age (65+)(Knox Community Demographics, 2017)

Aim

To review the evidence surrounding cooking skills

interventions, to inform the development of a

community-based cooking program for older adults

(65+), ‘Meals for Me’, at Knox City Council.

Occupational therapy, cooking programs & reablement

● Evidence-based cooking

interventions with a range of

populations, and disciplines,

including within occupational

therapy settings

● Occupational therapy uses

cooking activities to assess

physical motor skills, cooking

skills and executive functioning

within different populations and

settings

Occupational therapy &

reablement

reablement

● Promoting independence

● Regaining and building

capacity and skills

● Encouraging social and

community participation

● Active and meaningful

engagement

● Building confidence

Evidence-based cooking

Methodology

PRISMA

Flow Diagram

From: Moher D, Liberati A, Tetzlaff J, Altman DG,

The PRISMA Group (2009). Preferred Reporting

Items for Systematic Reviews and Meta-Analyses:

The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097

Charting results

Table 1.

Descriptive table of our 10 studies, showing methodology, results, strengths and limitations, and outcomes

Table 2.

Analytical table that highlights features of program designs that were outlined across the 10 articles. 8 programs were included.

Exploring

outcomes

Themes

1. Psychosocial; Confidence, socialisation, enjoyment in cooking

2. Cooking skills; Quality of cooking, instrumental cooking skills, strategies

3. Food skills; Purchasing behaviours, food safety knowledge and food waste, and

improving health and nutrition knowledge

These themes all demonstrated areas of improvement for participants, and no

negative implications or outcomes were reported across all studies

Results

Psychosocial

Confidence, socialisation and enjoyment in cooking

Participants of the ‘Frankston Community Kitchen Program’ reported a 69% (n=28/42) increase in self-confidence in completing tasks following the program, which extended beyond culinary endeavours, and influenced their desire to participate more in community-based activities and

organisations. (Gunnion, 2008)

Cooking skills

Quality of cooking, instrumental cooking skills and strategies

In the ‘Men Can Cook’ program 84.2% (n=16/19) of participants developed skills in recipe reading, and 73.7% (n=14/19) in cooking food according to recipes (Keller et al., 2004).

Results

Food skills

Purchasing behaviours, food safety knowledge and food waste, and improving health and nutrition knowledge

“Participants in the ‘Eat Better, Feel Better’ program reported, post-intervention, that they understood why a balanced diet and health eating was important. This influenced 50% (n=21/42) of participants reporting an overall increase in accurately reading food labels”

(Garcia et al., 2017)

Facilitator input

Type of facilitator; trained community-worker or volunteer, dietician or nutritionist

Participant involvement in program design

Strengths, limitations & future research

Strengths

o Inclusion of 10 studies and multiple

programs

o The inclusion of systematic, and critical

reviews

o Quantitative and qualitative studies

included - appraised by CASP tools

o Use of grey literature

Limitations

o Rapid review time constraints

o Prioritising relevance of studies over evidence

quality

o Some selection methodologies of lower quality

o Majority of data was qualitative, reducing

objectivity of findings

o Broadened scope of population to all adults

o Due to general diversity of programs, systematic

reviews were unable to provide conclusive data

o Exclusion of programs in which outcomes were

all nutrition/dietetics assessment evaluated

Future research

o Development of higher quality evidence in evaluating these

programs

o Jamie’s program highlighted, that these programs can be

studied with a control group

1) Programs have a three pronged focus;

participatory cooking, nutritional education,

and social opportunities

2) Cooking interventions should incorporate a

practical skills component and provide

nutritional information.

3) Input from a trained facilitator that is most

appropriate to the group needs.

4)Allow participants to be active in program

design

Recommendations

for practice

Recommendations for

practice

5) Providing take home materials can assist in transfer of skills

6) Evidence supports meeting weekly

7) Sharing the meal at the end of the session provides additional chances to socialise

Evaluation tools

8) Need for development of validated assessment tools to better evaluate cooking program outcomes

ReferencesAustralian institute of health and welfare. (2018). Older Australia at a glance. Canberra: Australian Government.

Australian Institute of Health and Welfare (2017). Australia’s welfare 2017. Australia’s welfare series no. 13. AUS 214. Canberra: AIHW.

Farmer, N., Touchton-Leonard, K., & Ross, A. (2018). Psychosocial Benefits of Cooking Interventions: A Systematic Review.Health Education & Behavior,

45(2), 167–180. Doi:http://doi-org.ezproxy.lib.swin.edu.au/10.1177/109019811773635

Foley, W., Spurr, S., Lenoy, L., De Jong, M., & Fichera, R. (2011). Cooking skills are important competencies for promoting healthy eating in an urban

Indigenous health service. Nutrition & Dietetics, 68(4), 291-296.

Garcia, A., Hammond, E., Parrett, A., & Gebbie-Diben, A. (2017). Evaluation of the “Eat Better Feel Better” Cooking Programme to tackle barriers to

healthy eating. International Journal of Environmental Research and Public Health, 14(4), 1-18. Doi:https://doi.org/10.3390/ijerph1404038

Gunnion, T. (2008). Frankston Community Kitchen Pilot Report. Frankston: Peninsula Health. Retrieved from

http://communitykitchens.org.au/wp-content/uploads/2015/06/Frankston-pilot-project-report-2008.pdf

Hardin-Fanning, F., & Ricks, J. (2017). Attitudes, social norms and perceived behavioral control factors influencing participation in a cooking skills

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Herbert, J., Flego, A., Gibbs, L., Waters, E., Swinburn, B., Reynolds, J., & Moodie, M. (2014). Wider impacts of a 10-week community cooking skills

program - Jamie’s Ministry of Food, Australia. BMC Public Health, 14(1). doi: 10.1186/1471-2458-14-1161

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http://www.utas.edu.au/__data/assets/pdf_file/0018/204219/Review-of-Models-for-Social-Eating.pd

ReferencesHollywood, L., Surgenor, D., Reicks, M., McGowan, L., Lavelle, F., Spence, M., Raats, M., McCloat, A., Mooney, E., Caraher, M., &, Dean, M. (2017). Critical

review of behaviour change techniques applied in intervention studies to improve cooking skills and food skills among adults. Critical Reviews in Food Science and

Nutrition, 1(7), 1-14. DOI:10.1080/10408398.2017.1344613.

Keller, H., Gibbs, A., Wong, S., Vanderkooy, P., & Hedley, M. (2004). Men Can Cook!. Journal Of Nutrition For The Elderly, 24(1), 71-87. doi: 10.1300/j052v24n01_06

Knox Community Demographics. (2017). Knox City Council. Retrieved from http://www.knox.vic.gov.au/demographics

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