The Healthy Cooking Index: Nutrition Optimizing Home Food Preparation Practices across Multiple Data Collection Methods

BACKGROUND: 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. OBJECTIVE: 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. DESIGN: 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. PARTICIPANTS/SETTING: 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. MAIN OUTCOME MEASURES: Food preparation data were collected from parents through direct observation during preparation as well as, eButton, and paper questionnaires completed immediately after the event. STATISTICAL ANALYSES PERFORMED: 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 (PCA) were conducted on the observed Healthy Cooking Index items to examine patterns of cooking practices. RESULTS: Two main components of cooking practices emerged from the PCA: 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 < .001), with no significant differences between scores computed from eButton images and observations (p=.187). CONCLUSIONS: 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.