P2B276: Cocinando En Familia: A Culturally Informed Cooking Program Aimed at Improving Diet Quality

Background: Family Kitchen (FK) empowers low-income families to make improvements to their diet by promoting culinary skill building using nutrient-dense foods, without BMI referral cutoffs to participate. FK is rooted in principles of nutritional science, behavioral science, and culinary medicine.
Phase one (Sept 2018-Aug 2020) included program design and testing. The structure consisted of a chef and RD leading groups of approximately six families in a 10-week program of five culinary sessions paired with nutrition education. Between sessions, the RD supported families to make incremental diet changes.
Phase two (Dec 2020-Oct 2022) focused heavily on enhancing the cultural relevancy of FK for Spanish-speaking families and on leveraging digital and virtual technologies to enhance the program reach and impact. Figure 1 provides a depiction of the final program design.

Methods: One key enhancement in phase two was the development of a culturally adapted version of the program for Spanish-speaking families ‘Cocinando en Familia,’ (CeF). Recipes were adapted to focus on eating patterns of diverse Hispanic cultures: including Central American gallo pinto, and tacos al pastor from Mexico. CeF classes were co-taught by a Spanish-speaking chef and pediatrician, in-person in our Lifestyle Medicine (LM) teaching kitchen.
Phase two digital enhancements included the deployment of a validated digital diet quality assessment, Diet ID. Diet ID’s web-based assessment allowed for an engaging method of evaluating pre and post participation diet quality. Participants incrementally selected from composite images to determine their unique diet pattern.

Results: The relevance of this program was demonstrated by filled cohorts with a waiting list. FK reached 124 children and adolescents. Most families completed the program: 91.2% of English-speaking families, 76.4% of Spanish-speaking families. On a 5-point Likert scale, nearly 100% of participants reported being likely (4) or very likely (5) to recommend the program.
One adult per family completed the Diet ID digital assessment of the household diet quality at baseline and upon program completion. Diet ID quantifies dietary risk on a score of 1-10. Table 1 depicts the diet quality and nutrient improvements noted.

Conclusion: Diet quality is a leading metric for health, predicts intermediate biomarker change, long term health care costs, and is a powerful driver of health disparities. Tracking changes in diet quality requires clinicians assess this metric during clinical encounters in a rapid and scalable method, so that effectiveness of nutritional interventions can be trended longitudinally.
We developed a program well-liked by participants that demonstrated improvement to diet quality. Dietary patterns have cultural significance within communities, and our CeF program incorporated these insights. The LM team has developed partnerships with local food pantries, mobile produce vans, and grocery stores in underserved areas. Partnerships were key to FK program reach and continue to be instrumental in growing and sustaining this program.