Super Chef - an Online Program Promoting the Mediterranean Dietary Pattern to Lower Income Families

N/AActive Not RecruitingNCT05863559

Baylor College of Medicine88 enrolled

Overview

Given the limited effectiveness of single food group-targeted interventions to enhance child nutrition, a key component of current and future health, innovative approaches are needed. Healthy dietary patterns are emerging as an important intervention target, and the Mediterranean Dietary pattern has been particularly effective at reducing cardiovascular disease risk factors, a leading cause of death in the US. Since parents are the gatekeepers of the home food environment and influence child intake through food-related parenting practices, children enjoy cooking with parents, and home food preparation is associated with more healthful dietary intake. Therefore, the investigators propose to develop and assess the feasibility, acceptability, and preliminary efficacy of an online cooking intervention for parent-child dyads living in low-income households that promotes the Mediterranean dietary pattern and healthful food-related parenting practices.

Few interventions targeting single food groups have demonstrated long-term health success. The Mediterranean Diet dietary pattern has been associated with reduced risk of cardiovascular disease (CVD), a leading cause of death in the US. Dietary behaviors established in childhood track into adulthood, suggesting that healthful dietary behaviors should be established during childhood. Children living in low-income households are at greater risk of CVD and generally have less healthful diets, indicating a need for interventions promoting more healthful dietary practices. Parents are the gatekeepers of the home food environment and influence children's dietary behaviors through parenting practices around food (i.e., modeling of eating behaviors, home availability). Foods prepared and eaten at home have been associated with better diet quality. Cooking skills have been associated with home meal preparation, and children enjoy cooking with parents. Encouraging parents to involve children in home food preparation and using healthful food parenting practices may be an effective way to help children adopt a healthful dietary pattern. However, to promote behavior change, interventions should be convenient, enjoyable, and personally relevant. Since Internet use and access are prevalent, including among families with lower incomes, the proposed research will build on previous research with parent-child dyads from low-income households to develop an online cooking education intervention that promotes the Mediterranean dietary pattern and healthful food parenting practices. Once developed, the investigators will assess its feasibility, acceptability, and preliminary efficacy with 44 parent-child dyads. The results of this study have the potential to enhance child cardiovascular health and inform the design of digital interventions promoting sustainable dietary behaviors in at-risk children.

Interventions

Super Chef: Family Fun in the Kitchen!BEHAVIORAL

Two-phase intervention: in the online phase, a professional chef will demonstrate cooking strategies to help families modify existing recipes to be consistent with the Mediterranean Dietary pattern. Effective food parenting practices will also be integrated into the intervention. The intervention is guided by theory - Family Systems, Social Cognitive, and Self Determination - and gamification techniques. At the end of the online phase, dyads will set a goal to use the cooking strategy and make a plan to facilitate goal attainment. In the home phase, the dyad will work together to use the plan to meet the goal. Dyads can also participate in bonus activities. Prior to viewing the next session, dyads will report whether the goal was attained and any bonus activities completed. Collectively, this will determine level of Super Chef status the family achieves at the end of the program (Session 4).

Eligibility

Sex: ALLMin age: 10 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * a 10-12 years old child and a parent/caregiver * family qualifies for free or reduced price meals at school * reliable internet access * resident of Texas * fluent in English Exclusion Criteria: * major auditory or vision impairment * lack of binocular vision * history of seizure disorder * claustrophobia * vertigo * psychiatric conditions (e.g., paranoia, manic depressive psychosis) * prior dizziness or motion sickness when using virtual reality * currently being treated with medications or medical condition that impacts dietary intake (e.g., cancer, attention deficit hyperactivity disorder) or ability to participate in data collection (e.g., intellectual impairments) * physician advice to modify diet for a current or ongoing health or medical condition * eligible but child birth sex stratum (male, female) filled * another parent or sibling participated in program development

Outcomes

Primary Outcomes

Recruitment goal attainment as assessed by staff logs

Staff will maintain logs of the number of families who express interest in the study and of those, the number who qualify and enroll in the study

Time frame: pre-intervention

Number of families who complete all phases of the study as assessed by staff logs

Staff will maintain logs of when a family completes each phase of the study, including pre-intervention data collection, the online program sessions, and data collection immediately after completing the intervention. Family completion is defined as both parent and child completion of a phase.

Time frame: through study completion, an average of 10 weeks

Parent satisfaction with the Intervention as assessed by a 10 item survey

The 10-item measure has been used by Dr. Thompson in previous studies with children and adults. Items will be rated using a 2-point Likert scale (no=1, yes=2). Scores can range from 10-20, with higher scores representing higher satisfaction

Time frame: immediately after the intervention

Child satisfaction with the Intervention as assessed by a 10 item survey

Time frame: immediately after the intervention

Acceptability of wearing recording device at pre-intervention as assessed by agreement to wear a recording device

Staff will maintain logs of parents who agree to wear the recording device as part of pre-intervention data collection (yes=1, no=0).

Time frame: pre-intervention

Acceptability of recording device immediately after the intervention as assessed by agreement to wear the device

Staff will maintain logs of parents who agree to wear a recording device as part of data collection immediately after the intervention (yes=1, no=0).

Time frame: immediately after the intervention

Usability of recordings from device collected during pre-intervention data collection as assessed by staff logs

Staff will maintain logs of number of recordings generated and the number of recordings that could be analyzed

Time frame: pre-intervention

Usability of recordings from device collected during data collection immediately after the intervention as assessed by staff logs

Staff will maintain logs of number of recordings generated and the number of recordings that could be analyzed

Time frame: immediately after the intervention

Secondary Outcomes

Change in autonomous motivation to help child learn to cook as assessed by the adapted Treatment Self-Regulation Motivation Questionnaire

The survey will be adapted from the Treatment Self-Regulation Motivation Questionnaire-diet which has demonstrated strong construct validity. This is a 15-item questionnaire that uses a 7 point Likert scale, ranging from 1, not at all true, to 7, very true. The scale was designed to be adapted for different behaviors and situations. The scale measures regulatory style and has three subscales, ranging from amotivation, controlled motivation, autonomous motivation.

Time frame: immediately after the intervention

Change in parent self efficacy to involve child in home food preparation as assessed by the adapted self-efficacy scale of the Cooking and Food Provisioning Action Scale

The 13-item self-efficacy scale of the Cooking and Food Provisioning Action Scale will be adapted to assess parent self-efficacy for involving their child in home food preparation. The scale uses a 7-point Likert response scale ranging from strongly disagree to strongly agree.