We know that lower levels of education, alongside low income and socioeconomic deprivation, are associated with poor diet1 but additional factors, such as a lack of practical cooking skills, are also important barriers to healthy eating.2 our guest blogger, Hazel Long, has helped set up an educational programme within NHS Grampian to tackle this very issue...

Many of the messages we deliver in public health nutrition involve an element of food skills, whether that be knowing what to do with a vegetable, following a recipe, or reading a food label. We often take for granted that not everyone has the same knowledge and skills. Research has shown that cooking programmes can have a positive immediate impact on children and family food choices, as well as increasing awareness of food labelling.3

'CONFIDENCE TO COOK' PROGRAMME

One aspect of my role within NHS Grampian is to lead on the development and expansion of food skills work in our most deprived areas. We run a programme called 'Confidence to Cook', which aims to increase participants' knowledge regarding food and health, whilst developing their cooking skills. The course is typically delivered as a six-week block, but can also be adapted for individual workshops, such as a ‘cost of living cooking session’.

THE BIG CHALLENGE

One of the most notorious challenges we face, as seen in all areas of public health, is reaching the people who find it difficult to take advantage of the opportunities that are available to them. Building trust and relationships is a key aspect of engaging hard to reach groups.4 However this can be challenging when public services are in a fragile position with reduced provision for supporting healthier lives.

PARTNERSHIP WORKING

Our Confidence to Cook programme offers training to partners to enable them to deliver classes to the vulnerable groups they work with, allowing us to reach far more people than if we were to do this alone.

Since 2022, we have trained 23 partners in our areas of highest deprivation. Consequently, we have seen classes delivered to a wide range of people, including young people, parents of young children, nursey children, those who struggle with alcohol and drugs misuse, and older adults.

We have been able to work with partners to undertake community consultation, which is an important aspect of community-led health and allows us to understand the needs of the target audience. Community-led health is a way of improving health by starting with what people say is important to them.5

An additional benefit of this approach is that partners can tailor the programme to the needs of the target audience. For example, Health Visitors use the programme to deliver one-to-one sessions in the comfort of parents’ own homes. This overcomes the barrier of childcare and allows for a real-life scenario using their own equipment. On the other hand partners who are working with those with mental health problems encourage cooking in a group setting, as they feel the social aspect of the class helps their clients.

BUILDING A SUPPORT NETWORK

In addition to developing partnerships for the delivery of classes, we have also worked hard to build a network of support. This includes partners who support our work in other ways, such as food donations from supermarkets, the provision of kitchen spaces, third sector organisations providing equipment and the use of local transport assets. This allows us to overcome additional barriers to participation, such as transport and lack of equipment.

NEXT STEPS

We are currently working with the University of Aberdeen to develop some online, quick and accessible recipe videos. This is based on the feedback from our communities, and may help people access food-skills education if they cannot attend a class in person.

We need to develop a better evaluation process to allow us to understand the long-term impact of delivering these classes. Although we do a pre- and post-course evaluation, we do not do a follow-up with participants, so it is difficult to capture whether this work elicits any long-term behaviour change.

We have recently trained school and college staff, and will be in a good position to deliver training to young people in the new academic year. Based on the consultation work we have done, there is an urgent need to upskill young people to be able to prepare healthier meals during the current cost of living crisis.

Hazel Long, RNutr

Hazel Long is a registered nutritionist working part time in the NHS and
as a freelancer in her private practice HCL Nutrition. She is passionate about
evidence-based nutrition and supporting individuals to have a
positive relationship with food.

Instagram: hcl_nutrition

References:

1. Barton K.L et al (2015). Trends in socio-economic inequalities in the Scottish diet:2001-2009. Public Health Nutrition, 18(16), pp.2970-2980. d:10.1017/S13689800150000361
2. Hartman C et al (2013). Importance of cooking skills for balanced food choices. Appetite. 65, pp125-131. doi:10.1016/j.appet.2013.01.016
3. Garcia,A.L et al (2020). Community-based cooking programme, ‘Eat Better Feel Better’, can improve child and family eating behaviours in low socioeconomic groups. J Epidemiol Community Health. 74, pp. 190-196. doi.org/10.1136/jech-2018-211773
4. Good Governance (2024). Engaging with the hard-to-reach. Good Governance. Engaging with the hard-to-reach | Good Governance (good-governance.org.uk) date accessed 02/07/2024
5. Community Health Exchange (2024). What is Community Led Health. Community Health Exchange. Community-led health — CHEX date accessed 02/07/2024