Across Australia and other developed nations, morbidity and mortality follows a socioeconomic gradient whereby the lowest socioeconomic groups experience the poorest health. The dietary practices of low socioeconomic groups, which are comparatively less consistent with dietary recommendations, have been thought to contribute to the excess morbidity and mortality observed among low socioeconomic groups, although this phenomenon is not well understood. Using a socioecological framework, this thesis examines whether the local food retail environment and confidence to cook contribute to socioeconomic differences in fruit and vegetable purchasing. To achieve this, four quantitative analyses of data from two main sources were conducted. The food retail environment was examined via secondary analysis of the Brisbane Food Study (BFS) and confidence to cook was examined in a cross-sectional study designed and carried out by the author. The first three manuscripts were based on findings from the BFS. Briefly, the BFS was a multilevel cross-sectional study, designed to examine determinants of inequalities, that was conducted in Brisbane in the year 2000. A stratified random sample was taken of 50 small areas (census collection districts, CCDs) and 1003 residents who usually shopped for their households were interviewed face-to-face using a schedule that included a measure of fruit and vegetable purchasing and three socioeconomic markers: education, occupation and gross household income. The purchasing measure was based on how often (never, rarely, sometimes nearly always or always) participants bought common fruits and vegetables for their households in fresh or frozen form, when in season. Food shops within a 2.5 km radius of the CCDs in which survey respondents lived were identified and audited to determine their location, type, their opening hours, and their price and availability of a list of food items. The first publication demonstrated there was minimal to no difference in the availability of supermarkets, greengrocers and convenience stores between areas that were most and least disadvantaged, in terms of the number of shops, distance to the nearest shop, or opening hours. Similarly, the second publication showed the most disadvantaged and least disadvantaged areas had no large or significant difference in the price and availability of fruits and vegetables within supermarkets, greengrocers and convenience stores, but small differences were consistently apparent, such that on average, low socioeconomic areas had lower prices but also lesser availability than more advantaged areas. The third submitted manuscript presents results of multilevel logistic regression analyses of the BFS data. While there were some associations between environmental characteristics and fruit and vegetable purchasing, environmental characteristics did not mediate socioeconomic differences in purchasing the fruit and vegetable items since there was no substantial socioeconomic patterning of the price or availability of fruits and vegetables. The fourth submitted manuscript was based on the cross-sectional study of cooking skills. A stratified random sample of six CCDs in Brisbane was taken and 990 household members ‘mostly responsible’ for preparing food were invited to participate. A final response rate of 43% was achieved. Data were collected via a self-completed questionnaire, which covered household demographics, vegetable purchasing (using the same measure employed in the BFS for continuity), confidence to prepare these same vegetables, and confidence to cook vegetables using ten cooking techniques. Respondents were asked to indicate how confident they felt (ranging from not at all- to very- confident) to prepare each vegetable, and to use each technique. This fourth study found respondents with low education and low household income had significantly lower confidence to cook than their higher socioeconomic counterparts, and lower confidence to cook was in turn associated with less household vegetable purchasing. Collectively, the four manuscripts comprising this thesis provide an understanding of the contribution of food accessibility, affordability and cooking skills to socioeconomic differences in fruit and vegetable purchasing, within a socioecological framework. The evidence provided by this thesis is consistent with a contributory role of confidence to cook in socioeconomic differences in fruit and vegetable purchasing, but is not definitive. Additional research is necessary before promoting cooking skills to improve population nutrition or reduce nutritional inequalities. An area potentially useful to examine would be how cooking skills integrate with psychosocial correlates of food and nutrition, and socioeconomic position. For example, whether improvement of cooking skills can generate interest and knowledge, and improve dietary behaviours, and whether a lack of interest in food and nutrition contributes to a lack of both fruit and vegetable consumption and cooking skills. This thesis has demonstrated that an inequitably distributed food retail environment probably does not contribute to socioeconomic variation in fruit and vegetable purchasing, at least in contemporary Brisbane, Australia. Findings are unlikely to apply to other time periods, rural and regional settings, and perhaps other Australian cities as residential and retail development, and the supply and pricing of produce vary substantially across these dimensions. Overall, the main implication for public health is that interventions targeting the food supply in terms of ensuring greater provision of shops, or altering the available food and prices in shops may not necessarily carry a great benefit, at least in major cities similar to Brisbane. Future studies of equitable food access may need to look beyond mapping the distribution of shops and prices, perhaps to more personal and subjective facets of accessibility and affordability that incorporate individuals’ perceptions and ability to access and pay for foods.

In the past 20 years, the way in which food is prepared has rapidly changed. Convenience has become a way of life and Americans have replaced meals made from scratch with meals that are quick and easy. During that time, body mass index has risen steadily. The prevalence of overweight and obesity among children has become common in the American population. “Pink Chefs,” a six-week culinary intervention for middle school girls 12 to 14-years-old, was developed and piloted to combat childhood obesity by teaching nutrition through basic cooking skills. The social cognitive theory was used as the theoretical framework. The goals of this program were to increase the subjects’ self-efficacy for cooking; to build knowledge for healthful dietary practices; and to provide a fun and safe environment conducive for interactive learning. This culinary enrichment program was piloted in reduced-income communities in south San Luis Obispo County, California, with 22 self-selected participants. Surveys were used to measure self-efficacy, knowledge, barriers and diet pre- versus post-intervention. Post-intervention measures demonstrated a significant (p = 0.005) intervention effect on self- efficacy for cooking. No significant increases were observed for knowledge, barriers and diet. This research, like that of Larson et al. (2006), illustrated that honing both skills and knowledge learned in a practical setting is one of the first steps for increasing self-efficacy for dietary improvements.

High ultra-processed food (UPF) consumption is associated with weight gain, obesity, metabolic syndrome, cardiovascular disease, all-cause mortality, and type 2 diabetes. "Food agency" refers to an individual's food preparation attitudes and capabilities within a given social and physical food environment. Although there is an association between the ability to prepare certain dishes and higher cooking frequency with lower UPF intake, it is still unclear if cooking and food agency influences UPF consumption due to the lack of research in this area. To date, studies of food agency have not included detailed dietary analyses. This cross-sectional study included 40 adults (73% female, aged 39±15 years, body mass index [BMI] 25.8±4.9 kg/m2) and aimed to determine the relationship between food agency and UPF intake. Food agency scores were calculated using the validated Cooking and Food Provisioning Action Scale (CAFPAS). Cooking behaviors and frequency were also collected. Dietary intake was assessed using three 24-hour dietary recalls with each item categorized by degree of processing using the NOVA classification system. Analyses included one-way ANOVAs between CAFPAS score quartiles [Q] and Pearson correlations between CAFPAS, cooking behaviors, and dietary intake. UPF intake was calculated in percent total calories and percent total grams to account for artificial sweeteners and other low calorie products that may be classified as UPFs. Low food agency was associated with a 14% higher UPF intake (% total calories) compared to high food agency (P=0.03). There were no differences between CAFPAS quartiles and UPF intake in % total grams. When age was divided into three categories, UPF intake was significantly lower in older adults (60+ years) compared to adults aged 19-39 years and 40-59 years by 26.4% and 29.1% respectively (P=0.02). When analyzed using bivariate analysis, lunch (r=-0.482, P=0.002) and dinner (r=-0.385, P=0.014) cooking frequency, frequency of cooking a meal from scratch or fresh ingredients (r=-0.320, P=0.044), and CAFPAS self-efficacy (r= -0.369; P= .019) were negatively correlated with UPF intake (% total kcal). These findings provide support for the possibility of reducing UPF intake through cooking interventions aimed at improving components of food agency such as problem solving, skills to create a meal from what is available, and cooking confidence. Future studies should include a larger, heterogeneous population to provide more insight into dietary differences between levels of food agency and expand the diversity of research in this area. / Master of Science / High ultra-processed food (UPF) consumption is linked to weight gain, obesity, metabolic syndrome, cardiovascular disease, all-cause mortality, and type 2 diabetes. "Food agency" refers to an individual's food preparation attitudes and capabilities within a given social and physical food environment. Although there is a link between the ability to prepare certain dishes and higher cooking frequency with lower UPF intake, it is still unclear if cooking and food agency influences UPF consumption due to the lack of research in this area. To date, studies of food agency have not included detailed dietary analyses. This study aimed to determine the relationship between food agency and UPF intake. Food agency scores were calculated using the validated Cooking and Food Provisioning Action Scale (CAFPAS). Cooking frequency and behaviors were also collected. Dietary intake was assessed using three 24-hour dietary recalls with each item categorized by degree of processing using the NOVA classification system. Participants with low food agency had higher UPF intake in percent total calories compared to those with high food agency. There were no differences between food agency and UPF intake in percent total grams. Adults aged 60 and over consumed less UPF compared to adults below the age of 60. Participants with higher food agency were more likely to make a meal from scratch or fresh ingredients. As frequency of cooking a meal from scratch or fresh ingredients, cooking dinner or lunch increased, and CAFPAS self-efficacy scores increased percent total calories from UPFs decreased. These findings provide support for the possibility of reducing UPF intake through cooking interventions aimed at improving components of food agency such as problem solving, skills to create a meal from what is available, and cooking confidence. Future studies should include a larger, heterogeneous population to provide more insight into dietary differences between levels of food agency and expand the diversity of research in this area.

Cooking skills are important but declining, with significant health, social, cultural, political, economic, and environmental implications. Food and cooking education can begin to address some of the negative effects of the cooking skills decline. This thesis makes the case for cooking classes in the education system, especially in higher education. The paper begins with a history of cooking education and skills, outlines the implications of the decline in skills, and discusses the potential for cooking education in higher education. The second part consists of a course syllabus, designed for Pomona College. The third section includes a discussion of the implementation of this course at Pomona College specifically, including a description of the course creation process, challenges, available resources, and recommendations for future action.

Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the United States. The prevalence of CVD will increase in conjunction with the rise in obesity and type 2 diabetes and decrease in physical activity, due to the adverse effects of adiposity and atherosclerosis associated with these syndromes. Excellent inpatient, outpatient, and community-based program s are available to educate and direct healthy behavioral changes, yet the number of programs available is not sufficient for the volume of patients, nor widely distributed in all areas (particularly rural areas). There is a lack of comprehensive education programs for adults directed toward decreasing CVD with an emphasis on food portioning skills; cooking skills; low-fat cooking techniques; increasing fruits , vegetables, and dairy products in the diet; and increasing exercise. The Cooperative Extension Healthy Beat education program and curriculum was developed and evaluated to improve the cardiovascular health of Utah residents. This curriculum focused on improving nutrition knowledge, food portioning skill, food preparation/cooking skills, regular exercise, lipid panel, anthropometric indices, and blood pressure. The program was distributed in CD format to 59 extension agents; identical CDs were used by instructors of live sessions for 43 participants in Sanpete, Washington, and Beaver counties. The CDs were also used by the instructor of a third group, consisting of 16 nutrition education assistants from the Expanded Food and Nutrition Education Program, who were also taught in a live session setting. The evaluation was done through measurement of nutrition knowledge, cooking skills, lipid panel biochemical indices, weight loss, blood pressure, and waist and hip circumferences. This study demonstrated that on completion of the heart healthy curriculum, those with CVD or those at risk for CVD appropriately altered their risk factors for a myocardial infarction (decrease in one or more of the following: serum total cholesterol, LDL cholesterol, blood pressure, weight, body mass index, and waist and hip circumferences).

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Background Individuals with intellectual disabilities need continued supports in completing daily living tasks to increase the likelihood of achieving independence. Fortunately, research has shown that assistive technology, and particularly video prompting helps support independent living for individuals with intellectual disabilities. Aims This study investigated the efficacy of a highly customizable task analysis smartphone application in assisting three young adults with intellectual disabilities learn how to cook three different multistep recipes. Materials & Methods Three young adults with intellectual disabilities enrolled in a four-year postsecondary education program (PSE) participated in a multiple probe design across participants to examine the effect of a Task Analysis app on the participants' completion of three cooking tasks. Results In this present study, the use of video prompting to teach a daily living skill resulted in large and meaningful effect size gains of 99%–100% for all three participants, as measured by Tau-U. Discussion Video prompting is an effective instructional strategy which allows the user to self-prompt and manage their ability to successfully complete daily living skills. In this current study, video prompting made a substantial difference in the safety of participants. Conclusion The use of video prompting can decrease the reliance on others (e.g., teachers and caregivers), improve self-confidence of the user, and improve the user's level of autonomy.

Objectif. Décrire les attitudes et habitudes de Canadiens relativement à la préparation des aliments à la maison et au repas familial, afin de saisir les motivations à exploiter lors de la promotion de ces habitudes. Méthodes. Un sondage électronique de 39 questions à choix multiples a été placé sur le site des Diététistes du Canada du 16 novembre au 22 décembre 2006. Les énoncés analysés abordent la perception des bénéfices associés à la cuisine maison, à la planification des soupers et au repas familial, les obstacles à cuisiner, le temps de préparation et la planification des soupers, l’apprentissage de la cuisine, les sources d’idées recettes et la consommation des repas familiaux. Résultats. Au total, 4080 individus ont complété le questionnaire. Bien qu’ils croient que la cuisine maison puisse améliorer la qualité de l’alimentation et les comportements alimentaires, les répondants rencontrent plusieurs obstacles à la préparation des aliments au quotidien, parmi lesquels le manque de temps, d’énergie, d’idées et de planification. Bien qu’une majorité de Canadiens soupent en famille, il existe des écarts selon les groupes d’âge et les régions canadiennes. Conclusion. Cette étude souligne la pertinence d’élaborer des stratégies de communication pour informer les consommateurs sur les bénéfices de la cuisine maison et du repas en famille, afin de les aider à surmonter les défis associés à ces habitudes. Si les nutritionnistes sont des intervenants de choix, des collaborations interdisciplinaires sont proposées pour promouvoir une cuisine maison saine, bien planifiée, simplifiée et savourée en famille. / Objective. To describe Canadians' attitudes and habits with regard to home food preparation for family meals in order to seize the motivations to be exploited during the promotion of these habits. Methods. An electronic poll of 39 multiple-choice questions was posted on the Dieticians of Canada's website from November 16th till December 22nd, 2006. The analyzed statements cover the perception of the benefits associated with home cooking, supper planning and family meals, the barriers to cooking, the preparation time and supper planning, the development of cooking skills, sources of recipes ideas and consumption of family meals. Results. A total of 4080 individuals completed the questionnaire. Although they believe that home cooking can improve the food quality and eating habits, the participants meet several barriers to food preparation in everyday life, among which the lack of time, energy, ideas and planning. Although a majority of Canadians have family suppers, there are gaps according to age groups and Canadian regions. Conclusion. This study highlights the relevance of elaborating communications strategies to inform consumers of the benefits of home cooking and family meals in order to help them to deal with the challenges associated with these habits. If nutritionists are the best interveners, interdisciplinary collaborations are proposed to promote a healthy, well planned home cooking enjoyed with the family.

No description available.

Objectif. Décrire les attitudes et habitudes de Canadiens relativement à la préparation des aliments à la maison et au repas familial, afin de saisir les motivations à exploiter lors de la promotion de ces habitudes. Méthodes. Un sondage électronique de 39 questions à choix multiples a été placé sur le site des Diététistes du Canada du 16 novembre au 22 décembre 2006. Les énoncés analysés abordent la perception des bénéfices associés à la cuisine maison, à la planification des soupers et au repas familial, les obstacles à cuisiner, le temps de préparation et la planification des soupers, l’apprentissage de la cuisine, les sources d’idées recettes et la consommation des repas familiaux. Résultats. Au total, 4080 individus ont complété le questionnaire. Bien qu’ils croient que la cuisine maison puisse améliorer la qualité de l’alimentation et les comportements alimentaires, les répondants rencontrent plusieurs obstacles à la préparation des aliments au quotidien, parmi lesquels le manque de temps, d’énergie, d’idées et de planification. Bien qu’une majorité de Canadiens soupent en famille, il existe des écarts selon les groupes d’âge et les régions canadiennes. Conclusion. Cette étude souligne la pertinence d’élaborer des stratégies de communication pour informer les consommateurs sur les bénéfices de la cuisine maison et du repas en famille, afin de les aider à surmonter les défis associés à ces habitudes. Si les nutritionnistes sont des intervenants de choix, des collaborations interdisciplinaires sont proposées pour promouvoir une cuisine maison saine, bien planifiée, simplifiée et savourée en famille. / Objective. To describe Canadians' attitudes and habits with regard to home food preparation for family meals in order to seize the motivations to be exploited during the promotion of these habits. Methods. An electronic poll of 39 multiple-choice questions was posted on the Dieticians of Canada's website from November 16th till December 22nd, 2006. The analyzed statements cover the perception of the benefits associated with home cooking, supper planning and family meals, the barriers to cooking, the preparation time and supper planning, the development of cooking skills, sources of recipes ideas and consumption of family meals. Results. A total of 4080 individuals completed the questionnaire. Although they believe that home cooking can improve the food quality and eating habits, the participants meet several barriers to food preparation in everyday life, among which the lack of time, energy, ideas and planning. Although a majority of Canadians have family suppers, there are gaps according to age groups and Canadian regions. Conclusion. This study highlights the relevance of elaborating communications strategies to inform consumers of the benefits of home cooking and family meals in order to help them to deal with the challenges associated with these habits. If nutritionists are the best interveners, interdisciplinary collaborations are proposed to promote a healthy, well planned home cooking enjoyed with the family.