Assessing Acceptability: The Role of Understanding Participant, Neighborhood, and Community Contextual Factors in Designing a Community-Tailored Cooking Intervention

Nicole Farmer; Ralph Tuason; Kimberly R Middleton; Assumpta Ude; Gladys Tataw-Ayuketah; Sharon Flynn; Narjis Kazmi; Alyssa Baginski; Valerie Mitchell; Tiffany M Powell-Wiley; Gwenyth R Wallen

doi:10.3390/nu16030463

Assessing Acceptability: The Role of Understanding Participant, Neighborhood, and Community Contextual Factors in Designing a Community-Tailored Cooking Intervention

Nutrients. 2024 Feb 5;16(3):463. doi: 10.3390/nu16030463.

Affiliations

¹ Translational Biobehavioral and Health Disparities Branch, The National Institutes of Health, Clinical Center, Bethesda, MD 20892, USA.
² Clinical Center Nursing Department, The National Institutes of Health, Bethesda, MD 20892, USA.
³ Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Bethesda, MD 20892, USA.
⁴ Intramural Research Program, National Institute on Minority Health and Health Disparities, Bethesda, MD 20892, USA.

Abstract

Background: Cooking is an identified dietary strategy that is positively associated with optimal diet quality. Prior to initiating cooking interventions, evaluating the prospective acceptability of the intervention among community members living within low food access areas and understanding geospatial food shopping locations may aid in designing community-tailored interventions.

Methods: A sequential mixed methods study was conducted to determine the prospective acceptability of a planned community-located cooking intervention among African American adults living in a low food access area and with at least one cardiovascular disease risk factor. A semi-structured guide was used to conduct five virtual focus groups. Qualitative data were analyzed using thematic analysis and validated through participant check-in interviews. Survey responses were analyzed based on descriptive data. Geospatial analysis of participant locations that were reported for food shopping was conducted to show food environment utilization.

Results: Focus groups with study participants (n = 20, all female, mean age 60.3, SD 9.3, mean cooking frequency per week 4.0, food insecure n = 7) were conducted between March and April, 2021. Thematic analysis of the focus group transcripts identified five main themes as follows: (A) Barriers to Cooking (family and caregiving, transportation, COVID-19 pandemic, time availability, household composition); (B) Motivators for Cooking (family, caregiving, health, enjoyment, COVID-19 pandemic); (C) Strategies (food shopping, social support, social media, meal planning); (D) Neighborhood (gentrification, perceived safety, stigmatization, disparities in grocery stores); (E) and Acceptability of the Intervention (reasons to participate, barriers, recruitment, intervention delivery). Participant validation interviews confirmed the themes and subthemes as well as the illustrative quotes. Geospatial analysis showed a majority of locations were outside of the participants' residential areas.

Conclusions: Prospective acceptability of a community-tailored cooking intervention found that the planned intervention could be modified to address individual level factors, such as caregiving and health, community contextual factors, such as perceived safety, and the general health needs of the community.

Keywords: African American; acceptability; community tailored; cooking intervention; food environment; mixed methods.

MeSH terms

Adult
COVID-19*
Cooking
Diet / methods
Female
Humans
Infant
Pandemics*
Prospective Studies

Grants and funding

The authors are funded through the NIH Intramural Research Program at the NIH Clinical Center and the National Heart, Lung, and Blood Institute. The manuscript and the views expressed in this manuscript are those of the authors and do not necessarily represent the views or work of the National Institutes of Health Clinical Center, the National Heart, Lung, and Blood Institute; the National Institute on Minority Health and Health Disparities; the National Institutes of Health; or the U.S. Department of Health and Human Services.